Bonnie Beliveau, Medicare Insurance Broker

Answer: You can change your Medicare Advantage Plan during AEP (Annual Election Period) which runs from October 15 - December 7 each year for a January 1 effective date. There is also OE (Open Enrollment) that runs from January 1 - March 31 each year that allows for a one time change to your Medicare Advantage plan with some special considerations.

In addition, there are several qualifying events that give you the opportunity to change your Medicare Advantage plan at other times of year. Here is a list of some options:

1. You move your primary residence to another county and or state - you have 60 days to change your plan

2. You move into or out of skilled nursing facility - again 60 days to change your plan

3. Your carrier terminates your specific plan

4. You want to enroll in a 5 star plan - you can do this one time at anytime during the year

5. You have Diabetes or certain cardiac issues and are interested in a C-SNP (Chronic Special Needs Plan) - you can do this one time anytime during the year as long as you are not already enrolled in a C-SNP

There are a couple of other scenarios - best to speak with an Independent Health Insurance Broker who specializes in Medicare to review all of the options.

Answer: Original Medicare does not cover preventative and comprehensive dental care, routine vision care - routine annual exam (unless you are Diabetic) and glasses/contacts, hearing aids, long term care and care outside of the US. Medicare Advantage plans typically will include coverage for Dental/Vision/Hearing within the plan. There are ancillary plans that offer dental, vision, hearing, long-term care and coverage outside of the US. Another reason to utilize an Independent Health Insurance Broker.

Answer: Any time you move to a new county, you should review your Medicare plan as Medicare plans, especially Medicare Advantage, can be different, not only by state, but by county. Your current plan may not be available in your new county and/or there may be a richer plan available. It is a great opportunity to check in with your trusted broker, who will ensure you are always on the best plan for your specific needs.

Answer: The best way to stay up to date with changes is to have a trusted Independent Health Insurance Broker who reaches out to you each fall during AEP. AEP is when we review your current plan and needs and compare it to the next year's plans and determine which plan is the best fit for your specific needs.

Answer: This depends on the type of therapy and the Medicare plan you are enrolled in. If you are asking about Behavioral Health Therapy then no referral required. If you are asking about any other therapy (physical, speech, etc), then if you have a Medigap plan then no, you do not need a referral. If you have Medicare Advantage, you will need to review your summary of benefits for your specific plan to get this answer. Some carriers require a referral (i.e. United Healthcare) and some don't.

Answer: Medicare Advantage plans typically have $0 premium but to say they are really "free" is a bit misleading. There are pros and cons to having a Medicare Advantage plan vs a Medigap plan and it's best to speak with a qualified Independent Health Insurance Broker to get the proper education so you can understand the good, the bad, and the ugly of both options.

Answer: You can potentially avoid IRMAA surcharges by submitting form SS-44 with documentation to your local Social Security office. You should submit the form as soon as possible after receiving notice of an IRMAA surcharge.

Answer: To protect yourself from scams related to Medicare, do not answer your phone if you don't know the phone #. Let it go to voicemail and only call back if it is someone you know and trust. Do not respond to texts either if you don't know the individual. Guard your MBI as you would your SSN - only give it out to individuals you know and trust. Do not click on ads on the Internet - you will be bombarded with calls, texts and emails, many of which are scams. Do not use the word "yes" on a phone call with an individual you do not know - they take that "yes" and move it in the recording and the next thing you know your plan has been switched to a plan that doesn't have your providers in network and doesn't cover all your medications.

Answer: The new $2,000 out of pocket maximum for drug costs is important because it puts a cap on how much you have to pay for your prescription medications. While generic medications are typically free or low cost, those brand name medications (and generics that are new) can get cost prohibitive and the goal of the Inflation Reduction Act was to reduce the cost of Rx to seniors.

Answer: One of the most common misconceptions people have about Medicare is that it covers all of your medical and Rx costs. It only covers what Medicare deems medically necessary and since 2006, you must also have a Part D plan. Note that dental, vision and hearing are not covered by Medicare unless medically necessary such as Cataracts or Glaucoma.

Answer: No, Original Medicare does not require referrals before visits to specialists. You have the freedom to see any provider who accepts Medicare.

Answer: Medicare is confusing and working with a Medicare Agent gives you a NO cost resource to educate you on how and when to enroll in Medicare, what paths you can take to mitigate the unlimited 20% that Original Medical doesn't cover and then assist you with finding the best plan available at the lowest possible cost to meet your individual needs. In addition, you can reach out at any time with questions about your benefits, help with claims, additional coverage where you feel you may have a gap. I income qualify every person high (and help with IRMAA questions and appeals) and low (and help with LIS and Medicaid applications). I also review your plan with you every AEP to ensure that you are still on the best plan for you.