Andrew Zurbuch, MBA, Medicare Insurance Broker

Answer: Does this new coverage with Original Med cover me outside of the United States.

Answer: No, Original Medicare Part A & Part B does not cover Medicare Beneficiaries outside of the United States. Except for limited coverage near the U.S. border.

Answer: For both Original Medicare Part A & Part B for eligibility it doesn't. It does not change your eligibility status. If your entitled to Original Medicare, like working 40 quarters in the U.S., then you are entitled to it. It starts the Month of your 65th birth Month or the month after receiving 24 Months of Disability payments. This is just 2 of the ways to be eligible.

As for coverage if your already on Medicare Part A & Part B at the time of your diagnosis then dialysis does not affect your status on Original Medicare.

Claims regarding dialysis are a different question or questions & therefore not addressed herein. Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Answer: It depends where it is dispensed. If you get it at a local Pharmcy or mail order Pharmacy, then please contact your Insurance Company on the Part D Policy & ask the representative of the Insurance Company for a Tier Exception. They have so many specific hours to respond to you.

If it is administered by your Doctor's Office, then it falls under Medicare Part B. Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Answer: Medicare Advantage covers many preventative care measures. Please check your Evidence Of Coverage document of your Policy or call your Medicare Advantage Insurance Company & request a copy be mailed to you. Further please go to

www.locatemedicareinsurance.com

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Answer: Yes, it is inplace now under Medicare Part D & Medicare Advantage. Brought on by the Inflation Reduction Act.

Please call your Insurance Company to discuss your Policy. Further please go to

www.locatemedicareinsurance.com

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Please contact 1800MEDICARE & speak with a representative about it. Discuss with them if it would be under Medicare Part A or Part B or is it being reviewed.

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: No. Medicare doesn't cover outside the U.S. except for limited coverage near the U.S. border.

Please see www.locatemedicareinsurance.com for other information.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: You don't understand private Medicare Insurance Plans unfortunately. There's Medigap Insurance plans & Medicare Advantage plans. Please see www.locatemedicareinsurance.com

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Yes, Original Medicare does cover home health care. Please contact 1800MEDICARE & speak to a representative. If your on a Medicare Advantage Policy contact your Broker. Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Medicare Part D covers most vaccines at no cost for Medicare Beneficiaries. Medicare Part D covers all adult vaccines recommended by the Centers Disease Control's Advisory Committee on Immunization Practices. Please contact your Part D Policy or Medicare Advantage Policy. For Medicare Beneficiaries covers vaccines that prevent shingles, whooping cough, tetanus, respiratory syncytial virus, COVID-19 vaccine and more.

Source: www.medicare.gov.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: The difference between the Welcome to Medicare visit and the Annual Wellness visit described. While both visits are important and serve a similar purpose, it is important to remember the differences between the Welcome to Medicare visit and the Annual Wellness visit.

What is the Welcome to Medicare visit?

The Welcome to Medicare visit is a one-time preventive visit that occurs within the first 12 months of the Insured’s first enrollment in Medicare Part B. This is considered a once per lifetime benefit, meaning a member is only eligible when they sign up for Medicare for the first time. This visit is covered by Original Medicare as well as possibly a Medicare Advantage plan, the Insured would need to check with their Insurance Company to see if it is covered, when performed by the Insured’s primary care provider. This visit typically consists of a review of the patient’s medical and social history, an examination of the body like height, weight, BMI, blood pressure and other routine measurements, education and counseling about preventive services and more.

What is the Annual Wellness visit?

The Annual Wellness visit is a yearly preventive visit which is covered once per calendar year. The Annual Wellness visit is covered by Original Medicare as well as possibly some Medicare Advantage plans when performed by the Insured’s primary care provider. This visit allows the physician and patient to develop or update a personalized prevention plan. The Insured would need to check with their Insurance Company to see if covered.

This typically consists of a review of the patient’s Health Risk Assessment, an update of the patient’s medical and family history, and more. If the Insured has had Medicare Part B for at least 12 months, they do not need to have their Welcome to Medicare visit before getting the Annual Wellness Visit.

One of the biggest differentiators between the two visits is their timing.

Source: United Healthcare.

Answer: For just Original Medicare coverage overall. Listed as an approved covered expense at a Medicare Qualified Hospital setting. Or Ordered by your medical Doctor & medically necessary.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: That is a great question. From my understanding the Insurance Companies for 2024 Part D coverage didn't have to cover all Rx insulins. A Medicare Beneficiary whom is concerned about their Rx costs for the next year should meet with a Broker during the Open Enrollment.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Depends on what type of Medicare Insurance you have. Original Medicare with a Medigap Insurance Policy, a Medicare Advantage Policy, Group Health Insurance coverage, VA Benefits, or FEHBA coverage. Yes, some Medicare Advantage claims require Prior Authorization. Call 1800MEDICARE for Original Medicare or contact your Broker for assistance. Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Low Income Subsidy program, also referred to as Extra Help, through Social Security.www.ssa.gov is 1 way to get there. You can call them at 18007721213.

State Pharmaceutical programs.

Your State's Medicaid you could contact.

Contact your Broker to assist you in when you can go to another Medicare Advantage Policy with Part D included or another Part D Policy. For information please go to

www.locatemedicareinsurance.com Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answer: Yes, Original Medicare covers various kinds of screenings. Please see https://www.medicare.gov/coverage/preventive-screening-services#:~:text=Preventive%20services%20include%20exams%2C%20shots%2C%20lab%20tests%2C%20and,secure%20Medicare%20account%20to%20check%20your%20preventive%20services

Thank you.

Answer: Guarantee Issue for Medicare Supplement Insurance plans, also called Medigap Insurance, is when an Insurance Company cannot underwrite the proposed insured, the applicant. The proposed insured does not need to provide evidence of insurability to the Insurance Company and cannot be denied as long as they are eligible for the Policy & pay the initial premium.

It applies at certain times. Six months before & six months after the 65th birth month of the applicant. Thank you.

Answer: Original Medicare Part B, Medical Insurance,

covers a baseline mammogram once in your lifetime. A woman between ages 35-39.

Screening mammograms once every 12 months if a woman ages 40 or older).

Diagnostic mammograms more frequently, if deemed high risk, than once a year, if medically necessary.

Source: www.medicare.gov

Thank you.

Answer: You can inquire on a reduction to your Medicare Part B premium by calling Medicare at 1800MEDICARE. When you call Medicare please note the date of the call & the Medicare representative's name. If you call Medicare back, you will most likely not get the same representative on that call.

You can also apply for Medicaid in your State of residence. Please call your State's Medicaid Office. Thank you.

Answer: That is a good question. There will be less funding for Original Medicare unless Congress acts in the upcoming years. Less scientific research possibly for it. They, Congress, need to fix & remove the extreme waste in the Government & Medicare. Furthermore, Americans are living longer & less of the population is paying into Medicare than 50 years ago most likely.

Answer: When a American Citizen whom comes off of C.O.B.R.A. there is no guarantee issue right into a Medigap Insurance plan. C.O.B.R.A. can last 18 months or 36 months. Medigap Insurance means the same as Medicare Supplement Insurance. Therefore, their application for Medigap Insurance may be denied.

Answer: Yes, Original Medicare covers weight-loss counseling and specific surgeries for people who have a body mass index of 30 and above and meet other criteria.

Furthermore, Medicare covers some types of bariatric and metabolic surgery for people who meet certain conditions associated with morbid obesity, a body mass index of 35 or above, and other conditions.

Source: www.aarp.org.

Answer: Yes, you can do that for Medicare Supplement Insurance. However, that is an Internal Agent whom only represents 1 Insurance Company. Called a Captive Agent. That is not the way to go though. Use an Independent Broker. A Broker represents many Insurance Companies, & will give you more choice & can give a Medicare Beneficiary unbiased advice. This could give you lower premiums. Thank you.