Angel Feliciano, Medicare Insurance Broker

Answer: Navigating the complexities of Medicare can indeed feel overwhelming, but there are several resources and professionals who can help you make sense of it all:

1. **Medicare Advisors and Brokers**: Licensed insurance agents who specialize in Medicare can provide personalized guidance based on your specific needs. They can help you compare plans, understand costs, and choose the best options for your situation.

2. **State Health Insurance Assistance Programs (SHIP)**: SHIP offers free, unbiased counseling and assistance to Medicare beneficiaries and their families. They can help you understand your options and answer any questions about coverage, costs, and enrollment.

3. **Medicare.gov**: The official Medicare website is a valuable resource. It provides comprehensive information about Medicare plans, coverage options, enrollment periods, and more. You can also use their plan finder tool to compare different Medicare plans based on your needs.

4. **Local Community Organizations**: Many local organizations and non-profits offer educational seminars and workshops on Medicare. These can be great opportunities to learn more and ask questions in a supportive environment.

5. **Feliciano Fiduciary Services**: At Feliciano Fiduciary Services, we specialize in Medicare and can assist you in navigating the various options available. We can help clarify the "maze and alphabet soup" of Medicare, ensuring you have a clear understanding of your choices.

Don’t hesitate to reach out to professionals or organizations that can provide the support you need. Taking the time to get informed will help you make the best decisions regarding your Medicare coverage!

Answer: The new Medicare drug payment plan changes set to take effect in 2025 could potentially benefit many beneficiaries, including you, especially if you have expensive medications. Here are some key aspects of the plan that may help:

1. **Out-of-Pocket Maximum**: Starting in 2025, Medicare Part D will have a cap on out-of-pocket spending for prescription drugs. The maximum out-of-pocket limit is set at $2,000 per year. This means once you reach that threshold, your costs for covered medications will significantly decrease, as you will enter the catastrophic coverage phase.

2. **Lower Costs for Medications**: The plan includes provisions to reduce costs for certain high-priced medications. This may include negotiated prices for specific drugs, which could lower your overall expenses.

3. **Monthly Premiums and Cost Sharing**: The changes aim to make monthly premiums more predictable and affordable. While specific details may vary by plan, the goal is to provide better cost-sharing options for beneficiaries.

4. **Expanded Access to Insulin**: In 2025, seniors will see a cap on insulin costs at $35 per month for covered insulin products, which can provide significant savings for those who rely on insulin for diabetes management.

5. **Broader Coverage**: The new plan may expand the list of covered drugs, which could mean more options for those with specific medication needs.

To determine how these changes will specifically impact you, consider evaluating your current medication needs and costs. If you take expensive medications, the out-of-pocket maximum and lower costs could provide significant relief.

For more personalized assistance in understanding how these changes will affect your situation, feel free to reach out to us at Feliciano Fiduciary Services. We're here to help you navigate your Medicare options!

Answer: Once you reach the out-of-pocket maximum in the Medicare Part D prescription drug plan, you enter the "catastrophic coverage" phase. Here’s how it works:

1. **Out-of-Pocket Costs**: To reach the catastrophic coverage phase, you must have incurred a certain amount in out-of-pocket costs for covered prescription drugs. This includes your deductible, copayments, and coinsurance. The specific threshold can change annually, so checking the current limit for the year is important.

2. **Catastrophic Coverage**: After you reach the out-of-pocket maximum, your coverage shifts to catastrophic coverage. This means that your costs for covered medications will significantly reduce.

3. **Cost Sharing in Catastrophic Phase**:

- During the catastrophic coverage phase, you will generally pay a small copayment or coinsurance for each prescription. As of 2025, most beneficiaries will pay either $4.15 for generic drugs or $10.35 for brand-name drugs, or 5% of the drug cost, whichever is higher.

- The exact amount you pay can vary based on the specific Part D plan you are enrolled in.

4. **Coverage Continuity**: Catastrophic coverage continues for the remainder of the calendar year, where you will only pay the reduced coinsurance or copayment for your medications.

5. **Annual Reset**: At the beginning of the next calendar year, your out-of-pocket costs reset, and you will need to go through the phases of the Part D coverage again.

Understanding how catastrophic coverage works can help you plan for your medication expenses, especially if you have high prescription drug costs. If you have any further questions or need assistance with your Medicare options, feel free to reach out to us at Feliciano Fiduciary Services!

Answer: Under Original Medicare, mental health services, including therapy, are covered, but there are specific details to be aware of:

1. **Coverage for Outpatient Mental Health Services**: Original Medicare (Part A and Part B) covers outpatient mental health services, which include individual and group therapy sessions provided by a licensed psychologist or psychiatrist.

2. **Cost-Sharing**:

- You typically pay 20% of the Medicare-approved amount for outpatient mental health services after you have met your Part B deductible.

- The deductible for Part B must be met before Medicare starts to pay its share.

3. **Inpatient Mental Health Services**: If you require hospitalization for mental health reasons, Medicare Part A will cover the costs of inpatient care after you meet the deductible. However, there are limits on the number of days covered in a psychiatric hospital (generally up to 190 days in your lifetime).

4. **Preventive Services**: Medicare also covers an annual depression screening as part of its preventive services, which may be beneficial for seniors.

5. **Limitations**: It's important to note that while many mental health services are covered, not all types of therapy or providers may be included. Always check if the provider accepts Medicare and if the services you need are covered.

In summary, while therapy and mental health services are covered under Original Medicare, there are costs involved, and it’s essential to understand your financial responsibilities. If you have any further questions or need assistance navigating your Medicare options, feel free to reach out to us at Feliciano Fiduciary Services!

Answer: Under Original Medicare, mental health services, including therapy, are covered, but there are specific details to be aware of:

1. **Coverage for Outpatient Mental Health Services**: Original Medicare (Part A and Part B) covers outpatient mental health services, which include individual and group therapy sessions provided by a licensed psychologist or psychiatrist.

2. **Cost-Sharing**:

- You typically pay 20% of the Medicare-approved amount for outpatient mental health services after you have met your Part B deductible.

- The deductible for Part B must be met before Medicare starts to pay its share.

3. **Inpatient Mental Health Services**: If you require hospitalization for mental health reasons, Medicare Part A will cover the costs of inpatient care after you meet the deductible. However, there are limits on the number of days covered in a psychiatric hospital (generally up to 190 days in your lifetime).

4. **Preventive Services**: Medicare also covers an annual depression screening as part of its preventive services, which may be beneficial for seniors.

5. **Limitations**: It's important to note that while many mental health services are covered, not all types of therapy or providers may be included. Always check if the provider accepts Medicare and if the services you need are covered.

In summary, while therapy and mental health services are covered under Original Medicare, there are costs involved, and it’s essential to understand your financial responsibilities. If you have any further questions or need assistance navigating your Medicare options, feel free to reach out to us at Feliciano Fiduciary Services!

Answer: One crucial piece of advice for seniors selecting a Medicare plan is to **thoroughly understand your healthcare needs and preferences before making a decision**. This involves:

1. **Assessing Current and Future Healthcare Needs**: Consider your medical history, any chronic conditions, and the likelihood of needing specialized care in the future.

2. **Evaluating Coverage Options**: Compare the benefits offered by different plans, including Medicare Advantage and Original Medicare. Look for coverage for services you regularly use, such as prescription drugs, specialists, and preventive services.

3. **Understanding Costs**: Beyond premiums, examine deductibles, copayments, and out-of-pocket maximums. Make sure you know how these costs will impact your budget.

4. **Checking Provider Networks**: If you have preferred doctors or specialists, ensure they are included in the plan’s network, especially for Medicare Advantage plans, which often have more restricted networks.

5. **Reviewing Plan Flexibility**: Consider how much flexibility you want regarding provider choice. Original Medicare offers more options, while Medicare Advantage may have limitations.

6. **Staying Informed**: Medicare plans can change annually, so it’s important to review your coverage during the Open Enrollment Period each year to ensure it still meets your needs.

By taking the time to evaluate your specific healthcare needs and understanding the details of different plans, you can make a more informed choice that aligns with your health and financial situation. At Feliciano Fiduciary Services, we're here to guide you through this process and help you find the best Medicare plan for your needs!

Answer: Medicare Advantage plans, also known as Medicare Part C, are an alternative to Original Medicare (Part A and Part B). Here’s a breakdown to help you understand the key differences and benefits:

1. **Coverage**:

- **Original Medicare**: Provides hospital insurance (Part A) and medical insurance (Part B). It covers a wide range of services but does not include many additional benefits.

- **Medicare Advantage**: These plans include all the benefits of Original Medicare and often offer additional coverage, such as dental, vision, hearing, and wellness programs. Some plans may also include prescription drug coverage (Part D).

2. **Provider Networks**:

- **Original Medicare**: Allows you to see any doctor or specialist who accepts Medicare, giving you more flexibility.

- **Medicare Advantage**: Typically has a network of providers. If you choose a plan with a Health Maintenance Organization (HMO) structure, you may need to use doctors within that network, and referrals may be required to see specialists.

3. **Costs**:

- **Original Medicare**: You pay premiums for Part B, and there are deductibles and coinsurance for services. There’s no cap on out-of-pocket costs.

- **Medicare Advantage**: Usually has lower monthly premiums, but you might have copayments for specific services. Many plans have a maximum out-of-pocket limit, which provides financial protection.

4. **Enrollment**:

- **Original Medicare**: Enrollment is typically automatic if you are collecting Social Security benefits when you turn 65.

- **Medicare Advantage**: You need to enroll in a specific plan during the Open Enrollment Period (October 15 to December 7) or during Special Enrollment Periods if you qualify.

5. **Flexibility**:

- **Original Medicare**: Offers the flexibility to see any provider who accepts Medicare.

- **Medicare Advantage**: While it offers additional benefits, you may have less flexibility due to provider networks.

6. **Prescription Drug Coverage**:

Answer: At Feliciano Fiduciary Services, we specialize in Medicare and understand the complexities surrounding it. Here's a clear answer to your question about taxes related to Medicare:

1. **Medicare Premiums**: Generally, you do not pay taxes on the Medicare premiums you pay for your coverage. These premiums are considered personal expenses.

2. **Medicare Benefits**: The benefits you receive from Medicare are also not taxable. This means that the funds used for your medical expenses covered by Medicare do not count as taxable income.

3. **Income Taxes on Premiums**: However, if you are enrolled in a Medicare Advantage plan or Medicare Part D, and you pay premiums for those plans, those premiums may be deducted from your taxable income if you itemize deductions. This is applicable if your total medical expenses exceed a certain percentage of your adjusted gross income.

4. **Reporting Requirements**: While Medicare itself does not impose taxes, it's important to report any income accurately on your tax returns, as your income may affect your premiums for Medicare Part B and Part D.

If you have any further questions or need personalized guidance, feel free to reach out to our team at Feliciano Fiduciary Services. We're here to help you navigate your Medicare options and ensure your financial well-being.

Answer: When considering long-term care and how Medicare fits into that plan, it's important to understand the following key points:

1. **Medicare Coverage Limitations**: Medicare generally does not cover long-term care services. It primarily covers short-term rehabilitation and skilled nursing care after a hospitalization, but only under specific conditions. For example, Medicare will cover up to 100 days in a skilled nursing facility following a hospital stay of at least three days, but it does not cover custodial care in a nursing home.

2. **Types of Long-Term Care**: Long-term care includes services like assistance with daily activities (bathing, dressing, eating) and may take place in various settings, including nursing homes, assisted living facilities, or at home. Since Medicare does not cover most of these services, individuals often need additional coverage options.

3. **Medicaid as an Alternative**: For long-term care, many individuals rely on Medicaid, which can help pay for services that Medicare does not cover. However, Medicaid eligibility requirements can be strict, often requiring individuals to meet certain income and asset thresholds.

4. **Long-Term Care Insurance**: This is another option to consider. Long-term care insurance can help cover costs associated with long-term care services. It's advisable to look into this type of insurance while you are younger and healthier, as premiums can be lower and eligibility easier.

5. **Planning Ahead**: Preparing for potential long-term care needs involves several steps:

- **Assess Your Needs**: Evaluate your health, family history, and the likelihood of needing long-term care.

- **Explore Insurance Options**: Research and consider long-term care insurance policies to see if they fit into your financial plan.

- **Financial Planning**: Consult with a financial advisor to understand how your assets and savings can be managed to prepare for potential long-term care costs.

- **Legal Planning**: Consid

Answer: Seniors may be losing Medicare Advantage plans for several reasons:

1. **Plan Changes**: Insurance companies may change their offerings, leading to discontinuation of certain plans in specific areas. This can force seniors to find new coverage.

2. **Network Changes**: Some Medicare Advantage plans may alter their provider networks, which can result in seniors losing access to their preferred doctors or hospitals.

3. **Cost Increases**: Premiums, deductibles, or out-of-pocket costs may rise, making the plans less affordable for some seniors, prompting them to switch to other options.

4. **Health Needs**: As health conditions change, seniors may find that their current Medicare Advantage plan no longer meets their needs, leading them to seek different coverage.

5. **Enrollment Limitations**: Seniors may miss enrollment periods or be unaware of their options, resulting in a loss of coverage when their current plan is no longer available.

6. **Regulatory Changes**: Changes in Medicare regulations or policies can also impact the availability or structure of Advantage plans, affecting seniors' access to these options.

Ultimately, it’s important for seniors to stay informed about their Medicare options and any changes to their plans to ensure they maintain appropriate healthcare coverage.

Answer: Medicare Advantage plans are often marketed as "free," but this can be misleading. Here's a breakdown to clarify:

1. **Monthly Premiums**: While some Medicare Advantage plans have low or even $0 monthly premiums, you may still be responsible for other costs, such as copayments, deductibles, and coinsurance.

2. **Medicare Part B Premium**: Even if the Advantage plan itself is free, you still need to pay your Medicare Part B premium, which is typically deducted from your Social Security benefits.

3. **Out-of-Pocket Costs**: Many plans have out-of-pocket expenses that can add up, especially if you require frequent medical care or services.

4. **Network Restrictions**: Many Advantage plans have specific networks of providers, and going out of network can result in higher costs or no coverage at all.

5. **Limitations on Coverage**: While these plans often include additional benefits (like dental or vision), they may not cover everything that traditional Medicare does, which can lead to unexpected costs.

So, while some aspects of Medicare Advantage plans can appear "free," it's essential to carefully review the details and understand all potential costs involved before enrolling. It’s always a good idea to compare plans and consider your healthcare needs.

Answer: Working with a Medicare agent can be beneficial for several reasons:

1. Expert Knowledge: Medicare can be complex, with various plans and options. An agent has the expertise to help you navigate these choices.

2. Personalized Guidance: They can assess your specific health needs and financial situation to recommend the best plan for you.

3. Time-Saving: Researching plans and understanding the details can be time-consuming. An agent can streamline this process and save you effort.

4. Access to Various Plans: Agents often have access to multiple carriers and plans, allowing you to compare options side-by-side.

5. Claims Support: If you encounter issues with claims or billing, an agent can assist you in resolving those problems.

6. Ongoing Suppor: Many agents provide continued support even after you enroll, helping you with any questions or changes that may arise.

7. No Cost to You:Typically, Medicare agents are compensated by insurance companies, so their services are often free for you.

Overall, working with a Medicare agent can simplify the process and ensure that you make informed decisions about your healthcare coverage.