Barbara Hawes, Medicare Insurance Broker

Answer: If you have a Medicare Supplement, Plan G, you already have some limited coverage. With the current climate around the world, much depends on where you are going and the risks involved as to whether you may want additional coverage. Travel insurance can be a great help and plans differ according to your priorities.

Do you want to be able to go to a doctor in case you get sick, or just want emergency treatment?

Do you want protection in case your plans get canceled, you lose your luggage or your wallet stolen?

Are you going to a place where there is civil unrest or risk of natural disasters, and want to make sure that you can have an unscheduled exit from the country?

There are many types of plans with some combination of these elements and more. Whether you are an annual traveler, or a frequent flyer, there's a plan that can help you feel more confident when you travel. Your travel agent may have a plan or you can shop through us or other sources. Safe travels wherever you go!

Answer: Great question! Many people get used to being on company plans which offer few options at different levels, and their brokers attempt to keep benefits basically the same from year to year. It's comfortable and feels safe.

But when you are buying a house or a car, do you just take the first option that presents itself? Those are more complex items.. .you check the details, what you are getting for what price compared to others, the size, the color... all the details that go into that price. Health insurance contains many "parts" and choices to review. Worse yet, plans can change from year to year!

So maybe the correct term is "review" rather than update each year. Every year, there are changes:

1. Medicare changes its premium and Part B deductible.

2. Medicare Advantage plans change their benefits and copays... and sometimes network of doctors.

3. Prescription plans change their premiums, their formularies (list of covered medications), copays and sometimes preferred pharmacies.

First, it's important to not toss those letters from your insurance company. While you may get offers for other plans with the company, they will also send you updated information about your Medicare Advantage or prescription plan for the following year.

Second, it's one thing to compare what you have vs what they will do next year to see if you want to keep it. But as of Oct 1st you should also start reviewing what other plans could offer by comparison. Maybe there's a better option which covers your medications, accepts your doctors and offers lower copays or premium.

I know it feels like a necessary hassle, but would you rather feel comfortable knowing what you have and how to use your plans for the next year, or the following year after the enrollment is over, go through the year feeling "stuck" with a plan that you were comfortable with last year, but the changes that started are much higher than you expected?

Talk to your agent and be prepared!

Answer: With the changes in Medicare, finding ways to save on your medications may or may not work in your favor. Last year's modification where no senior should pay more than $2000 for their medication works well for some if their medication is especially expensive. Otherwise:

1. The new Prescription Payment Plan will lower the monthly cost, especially if your medication is affected by the deductible in the beginning of the year.

2. Every year, you should watch your current prescription plan changes. This year, the premiums have jumped a bit-- is the increased cost worth keeping the plan or should you move to a different one?

3. Is your medication available in generic form? Moving to generic is the easiest way to save on medication.

4. For those on Medicare, finding other sources to save on medication is limited but can take many forms. Check with your agent or contact us for more information.

Answer: Depends on what kind of plan you have. Original Medicare will cover the opthalmologist visit, as with any specialist, but you will pay out of pocket for glasses and lenses. Some people don't mind paying for their glasses, or going to a box store such as Costco, they get their glassses for a good price. Most Medicare Supplement plans would do the same, but you may find an option with some companies to choose a plan which will add discount dental, vision and hearing plans.

Medicare Advantage plans on the other hand, offer not only opthalmologist visits via the specialist benefit, but also optometrist visits and frequently have coverage for eye glasses and contacts.

If you have original Medicare or a Medicare Supplement plan, you can of course buy a separate vision plan. For a single person, it may be less than $20 per month and offer a higher allowance for the frames and better copays for additional features such as tinting or scratch resistant lenses.

Answer: Great question and an important one especially if you have a Medicare Advantage plan.

Medicare coverage does not change when you enter a facility is the bottom line. As such however, having a Medicare Supplement which has no network will allow you to use doctors in house or in the community. Some facilities offer transportation to community doctors within a certain radius. However, if you have a Medicare Advantage plan, you will want to check in with the admissions department at the facility to see if their in house doctor(s) are in network, in order to give you the best copay for your visit. In some areas an Institutional Special Needs Plan may exist, which provide similar benefits as a Medicare Advantage Plan, at little or no cost to you per month. These plans are generally offered directly to new residents if the facility is in network, and they are not able to be offered by most agents. So it's worth looking into if you already have an Advantage plan, but compare the network and benefits carefully between your current plan and the one they have available, especially if you want to continue seeing a doctor in the community.

Answer: Good question!

Your Summary of Benefits for your particular plan should outline for you what the process should be. Do you require referrals? How much is covered? what is the deductible?

Your plan will also tell you where you can go for help if you need to find a doctor who specializes in that particular condition. Some, like Medicare Supplements will allow you to go anywhere in the country as long as the doctor accepts Medicare. Medicare Advantage plans have networks which may or may not allow you to go outside the network. Also, look up the condition online to see if there's any financial assistance or organizations who can help you negotiate these new medical waters.

Answer: Medicare plan formularies have to offer at least 2 medications in each category, of which Ozempic and other GLP-1 medications may be included. However, weight loss is not an approved classifications. If you are taking it only for weight loss, I'm afraid you will be unable to have your Medicare plan cover it. Ozempic was originally designed for diabetic management, therefore your prescription benefit will cover it to the extent that the policy allows only if there is an appropriate diagnosis in the medical record.

Answer: In certain Medicare Advantage plans, there are extra benefits, among which are over the counter (OTC) and healthy groceries. OTC gives you access to medical-type supplies from aspirin to canes and vitamins. You usually can either order them online through their catalogue or go to a major pharmacy chain such as CVS and buy off the shelf.

Healthy groceries will give you access to specific categories of foods: dairy, meat, fresh veggies, etc. up to a limit. Most times you will find this benefit for lower income Medicare recipients but occasionally they will be found among the general Medicare Advantage plans.

Here are a few hints to look for in these benefits:

1. How often does the card replenish-- monthly? quarterly?

2. If you don't use the entire amount by the end of the benefit period (monthly or quarterly), will the remaining amount roll over to the new cycle?

3. Is there a way to ADD to the benefit amount? Some companies will give specific amounts more to that credit if you do certain tasks, such as get your wellness exam, fill out a survey, watch a wellness video.

4. Buying the items especially the OTC items in person is convenient for some, but you have to watch the brand and size specifically. If it's not on the approved list, you will be charged for that item when you get to the cash register.

In this economy, I can understand the importance of the question. Other avenues to consider would be to see where else you can save money so you can buy more groceries. Prescription assistance programs, Medicare financial assistance and other resources are available if you are eligible. Call us or your local Department of Aging for more information.

Answer: It seems that you already are aware that HMOs require that you stay in network. The only exceptions to this are for urgent care, emergencies, or in certain cases where your insurance company has pre-authorized the out of network provider. Even so, out of network providers can balance bill, so you may still end up paying a substantial part of the cost. For more freedom to choose that cardiologist, change to a PPO at the next open enrollment unless you have a qualifying event that opens you to a special enrollment.

Answer: Im so sorry you had that experience! Its always important to review not only the brochure carefully, but if working with an agent, have a list of things you are specifically looking for in your plan to ask the agent. You can't plan for everything so do the best you can. And do you know that from Jan 1 to March 31, you can change to another medicare advantage plan ? So use those 3 months to " test drive" a plan.. see your dr, scout out dental and other providers ... if you have problems you can't resolve, then find another plan. You can change it once during that time.

You can add a separate dental plan at any time.

Answer: Really good question!

A responsible agent in my opinion will educate first and then let you decide what's best for you. They need to learn about you a bit first as to what's important to you in a plan, what you expect, and then present the advantages and disadvantages of each type of plan. Once you decide whether medicare advantage or medicare supplement, then the selections can whittle down to something more manageable. You should never be pushed; if you don't understand something then you need to get answers until you feel comfortable. And after you enroll, that agent needs to be your right hand person to help answer questions, provide suggestions, or help mediate a solution if needed.