Janis Lakkees Medicare Agent

Janis Lakkees Medicare Agent I will help you with Medicare. I work with integrity and intention and always do whats best for you. I work with my clients every step of the way.

My name is Janis Lakkees and I am an Independent Medicare Agent with Bridgelink Insurance Solutions. I truly love what I do - which working with seniors and helping them understand Medicare and their choices. I have an office in Upland, Ca and also will come to you so you don't have to travel. I have 4 children ages 10, 10, 12, and 23. My son is Special Needs and keeps me focused and clear on my mission which is to always have integrity in my life.

Medicare does not pay for assisted living facilities or custodial long-term care. However, Medicare may cover short-term...
03/06/2026

Medicare does not pay for assisted living facilities or custodial long-term care. However, Medicare may cover short-term stays at skilled nursing facilities under specific circumstances.

Original Medicare covers up to 100 days per benefit period at a Medicare-certified skilled nursing facility when a doctor determines you need specialized medical services following a qualifying hospital stay. To qualify, you must be formally admitted to a hospital for three consecutive days. Observation time and outpatient visits do not count toward this requirement.

The skilled nursing facility must be Medicare-certified and provide skilled medical care, not just custodial assistance. Assisted living facilities do not qualify as skilled nursing facilities since they do not provide intensive medical care.

Medicare covers the full cost for days 1 through 20 of your skilled nursing facility stay. For days 21 through 100, you pay a daily copayment of $217.00 in 2026 while Medicare covers the remaining costs. After 100 days, you are responsible for all costs unless you have supplemental insurance coverage.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

Medicare only covers medically necessary surgical procedures. Medicare defines medically necessary services as “health c...
03/04/2026

Medicare only covers medically necessary surgical procedures. Medicare defines medically necessary services as “health care services or supplies that are needed to diagnose or treat an illness, injury, condition, disease, or its symptoms – and that meet accepted standards of medicine.” Medicare further defines medically necessary services as ones that:

- Are proper and needed for the diagnosis or treatment of your medical condition.
- Are provided for the diagnosis, direct care, and treatment of your medical condition.
- Meet the standards of good medical practice in the local area and are not mainly for your or your doctor’s convenience.

To see a list of covered services, including surgeries, you can search the Medicare website at Medicare.gov.

Even if a surgery is covered, you may still have out-of-pocket costs in the form of deductibles, coinsurance, or copays that you are required to pay.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

The Medicare SNF Three-Day Rule requires you to have at least three consecutive days as an admitted inpatient in a hospi...
03/03/2026

The Medicare SNF Three-Day Rule requires you to have at least three consecutive days as an admitted inpatient in a hospital before Medicare will cover skilled nursing facility care. This rule is crucial because it determines whether your SNF stay will be covered by Medicare Part A.

The key distinction is between inpatient admission and observation status. When you're under observation, you're technically an outpatient, and this time does not count toward the required three-day inpatient stay. Hospitals are required to inform you of your status, but it's important to ask directly whether you're admitted as an inpatient or under observation.

Here are two examples to illustrate the rule. If you were formally admitted to the hospital as an inpatient for three days and discharged on the fourth day, you would meet the three-day requirement for covered SNF care. However, if you spent one day in the emergency room under observation services and then were admitted as an inpatient for only two more days, your SNF stay would not be covered because the observation day doesn't count toward the three-day requirement, leaving you with only two qualifying inpatient days.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and discover the right plan for you today!

Whether or not to admit you as an inpatient to a hospital is a decision made by your doctor after reviewing your medical...
02/27/2026

Whether or not to admit you as an inpatient to a hospital is a decision made by your doctor after reviewing your medical situation, and they decide whether it is necessary to admit you to the hospital. According to Medicare, an inpatient admission is generally appropriate when you're expected to need 2 or more midnights of medically necessary hospital care. Your doctor must order the hospital admission, and the hospital must formally admit you to be considered an inpatient.

Whether you are classified as an inpatient or an outpatient impacts the out-of-pocket costs (deductibles, copays, and coinsurance), you have to pay for hospital services (X-rays, drugs, and lab tests). Your hospital status (inpatient vs. outpatient) may also affect if Medicare will cover care in a skilled nursing facility (SNF) after your hospital stay.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

There are two parts to how Medicare Advantage plans get paid.The first is the premium members pay; how the premium depen...
02/25/2026

There are two parts to how Medicare Advantage plans get paid.

The first is the premium members pay; how the premium depends on the benefits of the plan you purchase. It can be as low as $0, or it can be higher in other cases.

Secondly, since Medicare Advantage Plans completely replace Original Medicare, Medicare pays the Medicare Advantage insurance company an amount per member based on location, health, and many other factors. The Medicare Advantage insurance company's responsibility is to pay for all the health care needed by that Medicare Advantage member. The payment from Medicare makes up the majority of the money the insurance company gets for each member. They then manage their members' healthcare which allows them to provide additional benefits and lower the premiums they can charge, even to the point of having $0 premium plans.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

In 2026, Medicare Part D continues its significant modifications aimed at enhancing affordability and accessibility for ...
02/25/2026

In 2026, Medicare Part D continues its significant modifications aimed at enhancing affordability and accessibility for beneficiaries. The cornerstone remains the $2,000 yearly limit on out-of-pocket expenses for prescription drugs, which was implemented in 2025. This cap still offers significant financial relief to those who faced higher costs.

The elimination of the 5% coinsurance requirement during the catastrophic coverage phase also remains in effect. This means that once beneficiaries reach this stage, they continue to have no out-of-pocket expenses for their medications.

A notable new feature for 2026 is the Medicare Prescription Payment Plan, which allows beneficiaries to spread their out-of-pocket prescription costs into manageable monthly payments throughout the year, rather than paying the full amount at the pharmacy counter.

The standard benefit parameters for 2026 include an annual deductible of $590 and an initial coverage limit of $5,340, reflecting modest increases from 2025 levels.

Looking beyond these specific changes, Medicare Part D plans continue to evolve. The focus remains on refining coverage options to better suit individual needs and makes the program more manageable overall. Beneficiaries can also anticipate ongoing efforts to increase transparency and strengthen protection against excessive increases in drug prices.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

If you have original Medicare, Part B will cover telehealth services, and you will have to pay a 20% coinsurance of the ...
02/21/2026

If you have original Medicare, Part B will cover telehealth services, and you will have to pay a 20% coinsurance of the Medicare-approved amount for your doctor or other health care provider's services after you pay the Part B deductible. You will have to pay the same amount for most telehealth services as if you received the service in person.

Due to the Coronavirus (COVID-19) pandemic, Medicare has allowed doctors and other health care providers to use telehealth services to treat COVID-19 (and for other medically reasonable purposes) from offices, hospitals, and places of residence (like homes, nursing homes, and assisted living facilities). Medicare coinsurance and deductibles still apply; however, healthcare providers are reducing or waiving those amounts in some cases.

If you are enrolled in a Medicare Advantage plan, they must, at a minimum, provide the same benefits provided under Medicare Part A and Part B, so the same telehealth services are available. Depending on the Medicare Advantage plan you are enrolled in, additional telehealth services may be available, and the out-of-pocket costs may be lower.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and discover the right plan for you today!

Each Medicare Part D plan has a list of covered drugs that are called a formulary. Within every formulary, there are a ...
02/18/2026

Each Medicare Part D plan has a list of covered drugs that are called a formulary. Within every formulary, there are a set of rules applied to the prescription drugs covered by the plan. One of those rules is called step-therapy. If you get a prescription for a medication that has step-therapy rules, there is a process you will have to go through depending on the kind of drug you were prescribed (generic, preferred generic, brand name, etc.). There can be several drugs that are therapeutically equivalent, which means they essentially do the same thing but may have slightly different ingredients. Think of buying a generic brand of ibuprofen vs. buying Motrin ibuprofen over the counter at a drug store. There are the same variations for prescription drugs as well. Step Therapy is a process that requires members to start with the most cost-effective drug (the first step) and only move on to other, more expensive, or risky medications (additional steps) if necessary. The exact number of steps and requirements can vary depending on the drug.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

Starting in 2025, the structure of Medicare Part D changed significantly, and in 2026, catastrophic coverage continues t...
02/17/2026

Starting in 2025, the structure of Medicare Part D changed significantly, and in 2026, catastrophic coverage continues to begin once your out-of-pocket spending on covered prescription drugs reaches $2,000 for the year. This includes what you pay directly and certain payments made on your behalf, such as through the Extra Help program.

Once you reach the $2,000 out-of-pocket cap, you will not pay anything more for your covered Part D prescriptions for the rest of the calendar year. New for 2026, you can also choose to spread your out-of-pocket costs evenly throughout the year through the Medicare Prescription Payment Plan, making medication expenses even more manageable.

This protection replaces the old catastrophic phase and eliminates the donut hole coverage gap entirely. These changes make drug costs more predictable and affordable, especially for those who take high-cost medications. It's a significant improvement for Medicare beneficiaries and helps reduce financial strain caused by rising prescription drug prices. Always review your plan during open enrollment to make sure your medications are covered.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

In 2026, Medicare Part D continues to offer simplified prescription drug coverage. The coverage gap, commonly known as t...
02/14/2026

In 2026, Medicare Part D continues to offer simplified prescription drug coverage. The coverage gap, commonly known as the "donut hole," remains eliminated.

Now, after meeting your plan's deductible (which can be up to $605 in 2026), you enter the initial coverage phase, where you pay a portion of your prescription costs.

Once your out-of-pocket expenses reach $2,000, you've hit the annual maximum, and your plan covers 100% of your covered prescription drug costs for the rest of the year.

This means that your deductible still plays a role in your initial out-of-pocket spending, but the previous "donut hole" no longer exists.

These updates aim to make your prescription drug costs more predictable and manageable throughout the year.

Navigate Medicare with confidence — connect with Janis Lakkees at Medicare Made Easy in Upland, CA and get the personalized guidance you deserve!

The donut hole no longer exists in Medicare Part D as of 2025. Previously, beneficiaries would enter a coverage gap afte...
02/12/2026

The donut hole no longer exists in Medicare Part D as of 2025. Previously, beneficiaries would enter a coverage gap after reaching a certain spending limit on prescriptions. In that phase, they paid a larger share of drug costs until reaching catastrophic coverage.

Starting in 2025, a new out-of-pocket cap replaced the old donut hole structure. For 2026, once your spending on covered Part D drugs hits $2,050, you will no longer pay anything for the rest of the year. This change makes drug costs more predictable and removes the financial burden many faced during the coverage gap.

There's no longer a separate phase where your cost-sharing increases mid-year. The new structure ensures that once you hit the cap, you're protected from further costs on covered drugs.

This is a major improvement for Medicare beneficiaries and means better access to medications without the worry of hitting a high-cost gap in the middle of the year. Always review your plan to ensure your prescriptions are covered and your pharmacy is in-network.

Need expert Medicare guidance? Connect with Janis Lakkees, your trusted Medicare Agent in Upland, CA today!

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876 N Mountain Avenue Suite 200A
Upland, CA
91786

Opening Hours

Monday 9am - 6pm
Tuesday 9am - 6pm
Wednesday 9am - 6pm
Thursday 9am - 6pm
Friday 9am - 6pm

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