Becki Jennings, Medicare Insurance Agent

Answer: Sometimes when people say concierge medicine, they actually mean direct primary care. Direct primary care is usually a clinic offering memberships. Typically they do not bill insurance. If you're referring to concierge medicine, this typically means the provider will bill insurance, but they limit the number of patients that they take. In this case, you would have to confirm that the provider accepts medicare or your advantage plan.

Answer: Maximum Out of Pocket (MOOP) limits cannot exceed $9,350 in 2025. However, many plans have a considerably lower MOOP. When you pay copayments or coinsurance for Medical expenses, those payments typically go toward the MOOP. Things like prescription costs, copayments for dental coverage, or prescription eyewear do not count toward the Maximum Out of Pocket. However, hospital stay copays, emergency room copays, as well as lab and xray costs do count toward MOOP.

Answer: Star ratings are a tool Medicare utilizes to "score" Medicare Health Plans and Prescription plans. Center for Medicare and Medicaid Services (CMS) uses the star ratings to measure key performances by the plan; such as beneficiary satisfaction, complaints, resolutions, screenings, as well as dozens of other indicators to determine ratings.

Answer: That depends. If you have original Medicare with a supplement and are traveling outside the country, your coverage is very limited. Most likely, you will not be covered. Many Medicare Advantage Plans will pay. However, you may have to settle the bill with the provider, then submit to the insurance company for reimbursement. I always suggest the purchase a medical travel plan beyond your trip protection plan.

Answer: If you haven't paid your Part B annual deductible, you will be billed that amount. This year it is $257. If you HAVE paid your Part B deductible, you will likely not receive a bill. The provider will bill Medicare and your Plan G. There should not be any additional charges for that procedure.

Answer: For folks on Medicare who travel outside the country, a travel plan specific to international travel is definitely recommended. These plans cover only outside the US. Benefits and premiums can vary. The coverage cost can also be affected by length of time outside the US, age of client, etc. A travel medical plan is not the same as travel insurance to cover your trip in case of a cancelation.

Answer: If you are on Original Medicare, you can go to any provider that accepts Medicare. However, there are significant restrictions when traveling outside of the country. If you have a Medicare Advantage Plan, you have emergency coverage outside of your network. Consider a health plan specific to international travel outside of your Medicare coverage.

Answer: Yes you could, unless you have creditable coverage—typically through an employer with 20 or more employees.

Answer: Medicare does not generally cover hearing aids. However, some Medicare Advantage Plans do have a hearing or hearing aid benefit.

Answer: Yes. That is really happening. However, there are a few things to consider. For example, the cap only applies to prescriptions covered under your drug plan.

Answer: Medicare Supplement Plans are currently experiencing a shift. When looking at plans, it is a good idea to consider past rate increases, length of time in the market, and other market data.

Answer: If getting married increases your household income to a specific threshold, you may be liable for IRMAA- Income Related Monthly Adjustment Amount.

Answer: Medicare has a Skilled Nursing Facility benefit up to 100 days per benefit period. Once the Skilled Nursing Benefit has been exhausted, the patient will need to arrange payment outside of Medicare coverage. This may mean Medicaid, Long-Term Care Coverage, or Private Pay.

Answer: When someone has Medicare Advantage, the provider will only need to see your Medicare Advantage ID card.

Answer: The ability for a client to come into the office to get help understanding benefits, claims, and other questions, can be extremely helpful. Typically, a client would not experience a "hold" time and continued in-person follow up may make the process easier for many people. Being able to continuously communicate with the same person throughout the process is reassuring.

Answer: Sometimes. Medicare Advantage Plans have copays and a maximum out of pocket. For people who have high utilization of their health insurance, Medicare Advantage may be cost prohibitive. But for people who have less utilization, Medicare Advantage could be a great way to save money.

Answer: Choosing your health plan is a personal decision. Cost, prescriptions, doctors and budget are different for everyone.

Answer: I love providing peace of mind by offering solutions for those who are concerned about healthcare costs & retirement.