Amber Sigg, Medicare Insurance Broker

Answer: Yes, Medicare does cover IV chemo.

Which part of Medicare covers the IV chemo depends on where the treatment happens. What I mean by that is if your treatment is given in a doctors office, outpatient clinic or an infusion center, typically your Part B will cover that treatment. What this means is that Medicare will pay for a very large portion of the cost and your portion of the cost would fall under your Part B coinsurance, (this would only change if you have a supplement or Advantage plan that reduces or eliminates that)

If the chemo treatment is given while you are admitted as a inpatient to the hospital then your Part A would cover the treatment instead.

Answer: For the quick overview Medicare will conduct free cancer screening under your Part B if the provider you are using accepts Medicare:

Breast cancer: basic mammogram once every 12 months.

Cervical/vaginal cancer: Pap test & pelvic exam every 24 months (they will do an exam every 12 months if you are high-risk).

Colorectal cancer: Colonoscopy, stool tests (FIT/FOBT), and Cologuard on Medicare’s schedule.

Prostate cancer: Annual PSA blood test.

Lung cancer: Annual low-dose CT scan (if you meet smoking-history criteria).

Note: If a screening becomes diagnostic (example: removing a polyp during colonoscopy), your plan's cost-sharing may apply.

This is a typical schedule, make sure to reference your plan to double check your screening allowance and timelines.

Answer: The simple answer is that an agent typically represents one insurance company while a broker is independent and can offer plans from multiple insurance companies. Both the agent and broker are licensed and certified, but brokers generally have a wider range of options to compare to which allows the client to find the plan that best fits their individual needs.

Answer: Under Part B, when assessments are considered medically necessary and ordered by your doctor to check for issues like Dementia or Alzheimers they would be covered. Also Neurologist visits are covered under Part B as long as the provider you are seeing accepts Medicare. Note that if you are under a Medicare Advantage plan, your visits are still covered, but your copays and network requirements may vary so check with your plan.

Answer: The simple answer is yes. Heart medications are usually covered by your Part D drug coverage. Pacemakers or other implantable cardiac devices are typically covered under Part A if they are put in during a hospital stay, for the procedure and follow-up that would fall under your Part B. So overall cardiac treatments are covered in most cases, it would just simply depend on necessity.

Answer: Don't just look at what is right in front of you. Try to look at what may be coming up for you in the next year or two, especially if you are trying to stay on the same plan. I know that no one can predict the future, but if you are truly trying to plan and stick with something, try and look at the big picture as best you can and look at all of your options so you can make the best decision for you and your needs.

Answer: With the changes this year, don't assume either way. Look at your current plan, costs, coverage etc, and compare your upcoming needs with what you currently have. If what you have fits your needs stay put, if it isn't going to work for the upcoming year, look at possibly making a change and explore other options.

Answer: A good time to start preparing for (AEP) or Annual Enrollment Period is late August/September. This allows you to review your current coverage what you currently like and dislike about it. You can also look for any upcoming changes from your current plan, compare new options, and gather medications or provider lists, this helps with not having to rush through the process of renewal after the October 15th start date.

Answer: People under 65 qualify for Medicare if they are receiving Social Security Disability Insurance or SSDI for at least 24 months; have End-Stage Renal Disease (ESRD) that requires dialysis or a transplant or have (ALS) Amyotrophic Lateral Sclerosis (in this case Medicare would begin the same month disability benefits begin. Currently these are the cases where Medicare would kick in before 65.

Answer: It’s helpful to follow up with your parents after discussing Medicare as the information can feel overwhelming, they may have new questions after thinking things over. Following up ensures they understand their options, haven’t missed important deadlines, and feel supported in making the decisions that are best for their health and budget. It also helps catch any details or documents they may still need to complete their coverage correctly. Lastly, it's good to follow up to make sure they felt comfortable with the process as whole, including the agent or broker they met with.

Answer: If your Medicare Advantage plan denied coverage for a specialist, you can file an appeal with your plan and provide medical documentation showing why the visit is necessary. Your PCP (primary care physician) can also request a peer-to-peer review with the plan to overturn the denial. Sometimes the issue is network-related meaning that the specialist you are looking to see is not covered by your network; so you can look for in-network specialists or request an exception if none meet your needs. If problems continue, you MAY have options to change plans during certain enrollment periods, but there are no guarantees for that option.

Answer: You will have to reach out and request a new one. The fastest way is to log in to your Medicare.gov account, go to "My Medicare," and select "Replacement Documents," then "Get Replacement Medicare Card." A new card will be mailed to the address on file.

You can also call Social Security, and you can request a new card be sent to you over the phone.

You can also visit your local Social Security office. Make sure to bring your ID to request a card.

It usually takes about 30 days. If you have access to your online account, you can print off a temporary card from your Medicare.gov account this works as valid proof for coverage.

Answer: Really there are many reasons, but three of the big ones are you end up with one point of contact that has the knowledge and expertise to assist you, in addition you have year-round support when you need it and you don't need to navigate the system alone; as well you are working with independent agents who offer unbiased support by showing you multiple carriers helping you find what best fits your needs all at no extra cost to you.