Cindy Dedini, Medicare Insurance Broker

Answer: As long as the surgery is medically necessary and covered by Medicare, your out-of-pocket cost should generally not exceed the annual Part B deductible of $283 with a standard Medigap Plan G, or $2,950 if you have a high-deductible Plan G, assuming all providers accept Medicare assignment. If post-surgical rehabilitation in a Skilled Nursing Facility is medically necessary, Medicare typically requires a minimum 3-day inpatient hospital stay for that rehab stay to be covered. Once qualified, Medicare covers days 1–20 in full, and Plan G generally covers the remaining coinsurance for days 21–100.

Answer: The simple answer is no. Your part D prescription drug plan is a one year contract from January to December. During annual open enrollment, I would suggest reviewing all the other prescription drug plans available for the next year to verify coverage and pricing.

Answer: The simple answer is yes. You can use Medicare anywhere in the nation so long as they accept the Medicare assignment. Your supplement will be accepted as well.

Answer: Most procedures require prior authorization for Medicare. Once Medicare approves the procedure, then your supplement will pick up their portion.

Answer: An agent can assist you with changing your Medicare plan during open enrollment or you can go to www.medicare.gov and change your plan yourself online.

Answer: Agents can sell Part D plans when a Medicare beneficiary is first eligible for Medicare, loses prescription drug plan such as from an employer group plan or during annual enrollment period from 10/15 - 12/7. There are other Special Enrollment Periods that occur less frequently, but you can get more information for an agent or www.medicare.gov.

Answer: The simple answer is No.

Medicare does cover medical services such as doctor visits and short-term rehab, but when it comes to room and board, assistance with daily living, and n0n-medical services, Medicare does not pay for those services.

Answer: Most Medigap plans cover up to $50,000 lifetime travel where the beneficiary pays a $250 copay and 20% and amounts over $50,000. Medicare does not cover foreign travel.

Answer: In 2025 the MOOP (Maximum Out Of Pocket) was $2000 for covered prescriptions.

In 2026 the MOOP (Maximum Out Of Pocket) is $2100 for covered prescriptions.

Answer: Most Part D plans have the IRA in place. Talk with a licensed agent that can evaluation your your list of meds or go to medicare.gov to see the list of insulin costs.

Answer: Listen to a license agent. The agent can evaluation your budget and medical needs to advise you on a plan that fits you specifically.

Answer: Talk with a Medicare agent to find out what your enrollment eligibilty is to Medicare Parts A and B. If you are still working and have group medical benefits, you may want to hold off on enrolling to Part B and Part D. If you are already receiving social security, you will be automatically enrolled to Medicare. You typically have 3 months prior to your 65th birth month, the month of your birthday and 3 months after, but there are circumstances to may vary. Always talk with a licensed agent to understand your specific situation.

Answer: Yes. Medicare Supplements are based on zip codes whereas MAPD's are based on counties. Check with your local agent for advise or go on Medicare.gov to see what plans are available in your City (zip code or county)

Answer: Seniors should have a trusted agent to walk them through the process of choosing a Medicare plan. DO NOT listen to neighbors, friends and associates because they are not licensed and are not the experts.

Answer: Administrative staff can assist with the SOA process, but it is the agent's responsibility to assure correctiveness and timeliness in following the 48-hour rule, with some exceptions such as walk-ins or the day before the deadline.

Answer: Wearable devices can offer real-time information to help beneficiaries receive quick response to medical situations. For example, most smart watches detect if you have fallen or if your heart rate decreases/increases to an unsafe level. There are smart devices that detech blood sugar levels in real time, which can potentially save a person's life. This is proactive care vs reactive care.

Answer: For beneficiaires that turned 65 before 01/01/2020, Plan F offers the best value due to having no deductible and no copays. For those who turned 65 after 01/01/2020, Plan G offers the best value for most seniors and has no Part A deductible and a small Part B deductible, Out of pocket costs are predictable.

Answer: Some MAPD's require a 3-consecutive night stay at a hospital to qualify for admittance to a Skilled Nursing Facility (SNF). Other MAPD's do not require the 3 midnight rule.

Answer: Generally, Medicare does not cover nutritional counseling for high cholesterol. Medicare covers care for other ailments listed at medicare.gov. Some MAPD's offer nutritional counseling for certain medical conditions and some offer meals to maintain certain medical conditions.

Answer: Some of the rural areas do not offer MAPD's, although the beneficiary may live within the County limits, it is often difficult to find local medical providers. You may have to travel in town to receive medical care.

Answer: The main reason why people are unhappy with MAPD's is because of the limited amount of doctors that accept the plans. The other reason why people are unhappy with HMO MAPD's is because of the long wait times for referral approvals. Some people also compain that the MAPD's do not travel well do to the doctor limitations, but these people ARE covered in an emergency situtation.

Answer: Yes, Medicare Advantage (MAPD) plans are will be rapidly increasing, and will further expanding, their offering of digital health tools. There will apps and monitoring devices—by 2030. CMS will continue to create new initiatives and the competition will continue to rise.

Answer: A licensed Medicare agent is certified, knowledgable and can customize a plan based on the beneficiary's needs. The agent can evaluate the benficiary's budget and medical needs with a professional needs analysis platform that most people do not have access to. The other reason to work with a Medicare agent is to establish a relationship based on trust and honesty. The beneficiary will always have a live person to contact by phone, text or email and get the same person versus a robot or AI attendant.

Working with a Medicare agent provides personalized, expert guidance to navigate complex enrollment, compare multiple carrier plans, and find the best coverage for your budget and doctors at no cost to you. These licensed professionals offer annual plan reviews, help minimize out-of-pocket costs, and serve as ongoing advocates for claims or benefit issues.