Ashley Broussard, Medicare Insurance Broker
Ashley Broussard
Steadfast Insurance Advisors
Medicare Broker Licensed in LA, AR, AZ, MS and TX
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Louisiana
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About Me
Local, licensed insurance broker with an active Medicare AHIP certification in Louisiana, Mississippi, Texas, Arkansas, and Arizona. Offering a wide range of robust Medicare plans including MediGap (Supplement), Medicare Advantage, and Prescription Drug plans - providing personalized service to meet specific healthcare needs. 20 years' experience specializing in Medicare and Medicaid benefits. Medicare can be tricky and at times overwhelming. Knowing all your options is the first step to choosing the most cost-effective plan in confidence. Contact me today for a free Medicare review and honest advice!
You also have the option to explore plans on your own & SELF-ENROLL!
Contact me.
Q&A with Ashley Broussard
If I voluntarily drop Medicare Part B to live abroad or return to creditable employer coverage, will I get a new Medigap Open Enrollment Period? What happens if I reenroll in Part B years later?
Answer: No, not automatically. If you voluntarily drop Medicare Part B and reenroll several years later, you generally do not receive a new six-month Medicare Supplement (Medigap) Open Enrollment Period if you already used or started that enrollment opportunity at age 65 or older.
This is an important distinction because Medicare Part B enrollment rights and Medicare Supplement enrollment rights are two separate things.
How does Medigap Open Enrollment work?
Under federal law, your six-month Medigap Open Enrollment Period begins the first month you are both:
- Age 65 or older.
- Enrolled in Medicare Part B.
During those six months, insurance companies cannot deny you a Medigap policy because of your health or charge you more based on preexisting medical conditions.
Once that six-month period begins, voluntarily dropping Part B does not reset the clock. Reenrolling in Part B years later generally doesn't create another federal Medigap Open Enrollment Period.
Do Medicare Supplement plans have an out-of-pocket maximum like Medicare Advantage plans do?
Answer: Most Medicare Supplement (Medigap) plans do not have an annual out-of-pocket maximum like Medicare Advantage plans do. However, that doesn't necessarily mean you'll pay more out of pocket with a Medicare Supplement.
The two types of coverage work differently.
Medicare Advantage vs. Medicare Supplement
Medicare Advantage (Part C) plans have an annual maximum out-of-pocket (MOOP) limit for covered Medicare Part A and Part B medical services. Once you reach that limit, the plan pays 100% of covered medical costs for the remainder of the calendar year. Monthly premiums, prescription drug costs, and noncovered services generally don't count toward that limit.
Medicare Supplement (Medigap) plans work alongside Original Medicare to help pay expenses such as deductibles, copayments, and coinsurance. Depending on the supplement plan you choose, you may have very little out-of-pocket expense for Medicare-covered services.
Are there any exceptions?
Yes! Medicare Supplement Plans K and L have annual out-of-pocket limits.
Plan K - $8,000
Plan L - $4,000
Plans F, G, N and most others - No formal annual limit
Does Medicare cover osteoporosis treatment like Prolia or Reclast, or just the bone density test?
Answer: Yes! Medicare covers more than just bone density testing. It can also help pay for osteoporosis treatments, including Prolia injections and Reclast infusions, when medically necessary and coverage requirements are met.
Bone density test (DEXA scan) Part B generally covers testing once every 24 months, or more frequently when medically necessary. Eligible patients pay $0 when the provider accepts Medicare assignment.
Prolia (denosumab) Part B may cover injections administered in a doctor's office, typically every six months.
Reclast (zoledronic acid) Part B may cover an IV infusion, typically given once a year for osteoporosis treatment.
Oral osteoporosis medications Part D may cover prescriptions such as Fosamax (alendronate), depending on the plan's formulary.
If I need long-term care in the future, how does Medicare fit into that plan, and what should I be doing now to prepare?
Answer: Planning for long-term care is one of the smartest things you can do as you approach retirement or get older. The most important thing to understand is that Medicare does not cover most long-term care expenses.
Medicare may cover short-term care in a skilled nursing facility, such as rehabilitation following a hospital stay, if you meet certain requirements. Coverage is limited to a maximum of 100 days per benefit period, and you may have out-of-pocket costs.
However, Medicare generally does not pay for ongoing assistance with everyday activities such as bathing, dressing, eating, or using the bathroom. This type of care is called custodial care, and it may be needed at home, in an assisted living facility, or in a nursing home. Medicare Supplement plans also do not cover these long-term custodial care expenses.
How do you educate clients who are completely new to Medicare?
Answer: Medicare can seem complicated, but it's actually easier if we break it into steps. First, we'll make sure you understand how Medicare works. Then we'll discuss your doctors, prescriptions, and budget. After that, we'll compare the plans available to you and find the option that fits your needs. My goal today isn't to sell you anything—it's to make sure you understand your choices.
I've heard Medicare covers home health care, but what exactly does that include?
Answer: Medicare covers limited, temporary, part-time home health services if you are deemed homebound, need skilled nursing or therapy, and have a doctor's plan of care. Covered services include intermittent skilled nursing, physical therapy, and home health aides for medical needs, typically with $0 copay. It does not cover 24-hour care, meal delivery, or long-term custodial care.
Does Medicare pay for pulmonary rehab sessions?
Answer: Yes. Original Medicare under Part B covers up to 36 sessions, with the option for 36 more if medically necessary. Pulmonary rehab includes supervised exercise, breathing techniques, and emotional support designed to improve daily functioning and reduce hospitalizations.