Chuck Winslow, Medicare Insurance Agent

Answer: I love being a Medicare agent because I get to make a real difference in people's lives by helping them find the coverage they truly need. There's nothing more rewarding than seeing someone feel confident and relieved after we walk through their options together.

Answer: A Medicare Advantage PPO generally offers more flexibility because you can see out-of-network doctors, often at a higher cost, while an HMO usually requires you to stay within the plan’s network and get referrals for specialists. The trade-off is that PPOs give you more freedom, but HMOs often have lower out-of-pocket costs if you’re comfortable staying in-network.

Answer: The Medicare Advantage 5-Star Special Enrollment Period allows you to switch to a 5-Star rated Medicare Advantage plan once per year outside of the usual enrollment windows. It's different from the OEP (Open Enrollment Period) and AEP (Annual Enrollment Period) because it’s specifically tied to the quality rating of the plan, not the time of year.

Answer: The Medigap "birthday rule" allows people in certain states to change their Medigap plan around their birthday each year without medical underwriting. States like California, Oregon, Idaho, Illinois, and Nevada have versions of this rule, making it easier for Medicare beneficiaries to switch to a plan with equal or lesser benefits.

Answer: Medicare Advantage star ratings measure a plan’s quality based on things like member satisfaction, customer service, and healthcare outcomes. Generally, higher-rated plans (4 or 5 stars) are a good sign that you can expect better customer service, more reliable access to care, and higher overall satisfaction compared to lower-rated plans.

Answer: As of January 2025, Medicare has begun covering certain digital therapeutics (DTx) specifically for mental health conditions, such as depression, insomnia, and substance use disorders. These are FDA-cleared, prescription-based software tools designed to deliver clinical interventions, and they are now reimbursable under the Medicare Physician Fee Schedule. ​

However, for chronic physical conditions like diabetes or kidney disease, Medicare's coverage of digital health tools remains limited. While Medicare does provide reimbursement for remote patient monitoring (RPM) services—such as tracking blood glucose or blood pressure—this coverage is typically indirect, billed through your healthcare provider as part of their care management services. ​

It's important to note that Medicare Advantage plans may offer additional digital health benefits, including wellness apps or chronic care management tools, but these offerings vary by plan. If you rely on specific digital therapeutics for managing your chronic conditions, it's advisable to consult with your healthcare provider or Medicare plan administrator to determine if these tools are covered under your current plan.

Answer: Yes, Medicare has begun covering certain AI-powered diagnostic tools, particularly those that have received FDA clearance and demonstrate significant clinical benefits. For instance, AI-enabled coronary plaque analysis tools, such as those using CT-based quantitative coronary topography (AI-QCT), are covered when deemed medically necessary for diagnosing conditions like coronary artery disease. Additionally, AI algorithms for diabetic retinopathy screening have seen increasing Medicare claims, indicating growing adoption in clinical settings.​

However, coverage is not universal for all AI diagnostic tools. Medicare Advantage plans may also utilize AI technologies, but they must adhere to regulations ensuring that coverage decisions are based on individual patient circumstances and medical necessity, not solely on algorithmic recommendations.​

It's important to note that while Medicare is expanding its coverage of AI diagnostics, the inclusion of specific tools depends on factors like FDA approval, demonstrated clinical efficacy, and adherence to Medicare's coverage criteria.​

If you're considering an AI-powered diagnostic tool, it's advisable to consult with your healthcare provider and Medicare plan administrator to determine if the specific technology is covered under your plan.

Answer: Great question — here's how it works with Medigap Plan G:

Medigap Plan G covers everything that Original Medicare covers except the Part B annual deductible (which is $240 in 2025). So for your knee replacement:

1. Medicare Part A will cover your hospital stay and related inpatient costs.

2. Medicare Part B will cover the doctor fees, outpatient surgery costs, and physical therapy.

Once you've paid your $240 Part B deductible, Plan G pays 100% of the remaining Medicare-approved charges, including:

Hospital costs

Surgeon's fees

Anesthesia

Outpatient rehab

Durable medical equipment like a walker

So yes — after your deductible is met, your Plan G will cover the rest of the knee replacement surgery as long as it's Medicare-approved.

Answer: Medicare Part B helps cover your outpatient care. That includes doctor visits, lab work, durable medical equipment (like walkers or oxygen), preventive screenings (like mammograms or colonoscopies), mental health services, and even some home health care.

But is it enough? For many, not quite. Part B doesn’t cover prescriptions, dental, vision, hearing aids, or long-term care. Plus, you still pay a monthly premium, an annual deductible, and usually 20% of the cost of services.

That’s why many people add a Medicare Supplement (Medigap) or switch to a Medicare Advantage plan to fill in those gaps.

Answer: Covered Preventive Services with Medicare Part B:

1. "Welcome to Medicare" Visit (First 12 Months)

One-time check-up to review your health, risk factors, and future screenings.

2. Annual Wellness Visit (Yearly)

A personalized prevention plan to update screenings and manage health goals.

3. Screenings (Usually Once a Year or as Recommended):

Mammogram (Breast cancer)

Colorectal cancer screening (includes colonoscopy and stool tests)

Lung cancer screening (for high-risk individuals)

Prostate cancer screening

Cardiovascular disease screening

Diabetes screening

Depression screening

Bone density test (osteoporosis)

4. Vaccinations:

Flu shot (yearly)

Pneumonia shot

Hepatitis B (for those at higher risk)

COVID-19 vaccines and boosters (as recommended)

5. Additional Services:

Smoking cessation counseling

Obesity counseling

Nutrition therapy (for diabetes or kidney disease)

Glaucoma tests (for high-risk individuals)

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Most of these are free if your provider accepts Medicare. Staying up to date on these can make a big difference in staying independent and active.

Answer: Not all blood tests are covered by Medicare — but many essential ones are, especially if they're considered medically necessary.

Covered by Medicare Part B (if medically necessary):

Complete Blood Count (CBC)

Lipid Panel (cholesterol and triglycerides)

A1C Test (for diabetes)

Blood glucose tests

Thyroid function tests

Prostate-Specific Antigen (PSA) (for prostate cancer screening)

Liver and kidney function tests

Hepatitis screenings

HIV and STD screenings (in certain cases)

Not typically covered:

Tests for employment, life insurance, or general curiosity

Experimental or non-FDA-approved blood tests

Some vitamin or hormone level tests (unless deemed medically necessary)

To be covered, the test must be ordered by your doctor and used to diagnose, monitor, or treat a medical condition. Preventive screenings like cholesterol or diabetes tests are often covered 100% under Medicare if you qualify.

Answer: As more people retire and enroll in Medicare, especially with the large Baby Boomer generation aging, there’s more strain on Medicare Part A, which covers hospital care. Since it's mainly funded by payroll taxes, fewer workers supporting more retirees means the fund is expected to run short—possibly by the early 2030s if nothing changes.

Answer: One rule I think is pretty outdated—and honestly not fair to seniors—is the 3-day hospital stay requirement for Medicare to cover rehab or skilled nursing care. A lot of folks don’t realize that if you’re in the hospital under “observation” instead of being officially admitted for three full days, Medicare won’t help with the nursing home costs after. Even if you’re lying in a hospital bed for days, it might not count. It’s confusing, and it ends up costing seniors way more than it should.

Answer: Yeah, it’s crazy—last year we spent around $4.9 trillion on healthcare in the U.S. That’s about $14,570 for every person. And even with all that money being thrown around, folks are still having a hard time getting the care they need. Just doesn’t add up, does it?

Answer: To be honest nothing will happen. However, you have nothing to loose by taken part A now! Happy to help

Answer: Step 1. Learn about who the person is and what your personal health goals are.

Step 2. Explain in depth the differences between a Medicare Supplement and a Medicare Advantage plan along with all the different types if coverages available to them.

Step 3. Help you look over plans that are built to your personal health goals.

Step 4. Making sure after you choose a plan that fits you, that you understand what you do and do not get with the coverage.

Step 5. Give you all the information to make an informative decision.

That is the only way!

Answer: You need to connect with you agent and if you do not have one, you can call me and I will help you with the paperwork.

463-204-8050

Answer: Medicare Savings Programs (MSPs) are special programs that help people with limited income and resources pay for some or all of their Medicare costs. These programs can help cover:

Medicare Part B premiums (which most people pay monthly)

Deductibles

Coinsurance

Copayments

There are four types of Medicare Savings Programs, and eligibility is based on income and assets. If someone qualifies, it could save them hundreds—or even thousands—of dollars each year.

Also, qualifying for an MSP automatically enrolls you in Extra Help, which helps cover prescription drug costs.

Answer: In my professional opinion the best thing is to sit with an agent who offers 4 + companies for you yo look at and compare.

Medicare is an amazing tool for seniors if they have the right person helping them use it.

There is a website that you can compare each plan side by side showing you each thing you get.

Hope this helps and I'm always happy yo assist.

Answer: Medicare provides some help with long-term care, but it’s important to know its limits so you can plan ahead:

How Medicare fits in:

Medicare covers short-term skilled care (like rehab after a hospital stay), usually up to 100 days in a skilled nursing facility if certain conditions are met.

It does not cover long-term custodial care, like help with bathing, dressing, or eating if that's all you need.

Medicare Advantage Plans may offer limited extra benefits, but they still do not cover full-time long-term care.

What you should be doing now:

1. Explore long-term care insurance or hybrid life/long-term care policies—these can help pay for care in the future.

2. Consider short-term care plans that fill gaps in Medicare coverage.

3. Create a financial plan for care needs—including home modifications, in-home support, or assisted living.

4. Talk with a specialist about Medicaid planning if you think you may eventually need state assistance.

5. Document your wishes with a healthcare directive and involve family in your planning.

Preparing now gives you more options, better care, and less stress for your loved ones later. If you want help reviewing your coverage and planning ahead, I’m happy to walk through it with you.

Answer: Great question and it all depends on who you have your Medicare with and the type of plan you're on.

I just helped a gentleman yesterday and now he has hearing, vision and dental.

How can I help you?