Constance Phillips, Medicare Insurance Agent

Answer: You need to weigh your options between a supplement and an advantage plan by going over all the benefits and costs with each plan to make sure the plan you decide on will serve your needs. While Advantage plans and Supplemental plans are both suitable plans, seniors are drawn to an Advantage plan because there is 0 premium for many plans but there are other costs involved. Both Advantage and Supplement plans are approved by CMS before they can offer their plans to seniors.

Answer: Yes. Medicare Part B covers both, psychiatrist and therapist, but the providers must accept Medicare. You must meet your yearly deductible for Part B and then you are responsible for a 20% coinsurance with original Medicare.

Answer: You can keep original Medicare, which is considered Part A and Part B, but you will also need a prescription plan, which is Part D. If you do not have that prescription plan, you will be penalized for the rest of your life. That penalty is decided upon by a formula that the Centers for Medicare and Medicaid Services has established.

But just remember, with only A and B, you will be responsible for 20% of all your medical expenses. So if you don't have a supplement, which is a Medigap plan, or a Medicare Advantage plan, which is Part C, you will incur a lot of medical debt that you alone will be responsible for.

So that's a big decision. But just keep in mind that would be a lot of money that you would be responsible for. For example, if you get a test, say an MRI or a CT scan, Medicare will pay 80% of that. And those tests can be very expensive, so you would be responsible for that 20%.

Answer: Yes. You can change plans during AEP (October 15-December 7) and if you have a Medicare Advantage Plan you can also switch to another plan during OEP (January 1-March 31).

There are other circumstances that allow you to switch: You can have a special enrolment period if you move out of the plan's service area. If you are dual eligible (have both Medicare and Medicaid) you can change your plan once per quarter (Jan-March, April-June, Jul-Sep). There are many other circumstances in which you can change plans and to be sure contact your agent or Medicare (CMS).

Answer: Medigap Plan K has lower premiums than Plan G. Plan K is a good plan for healthy individuals who do not forsee any major health issues. You can be responsible for 50% of most services until the out-of-pocket maximum is met with Plan K whereas with Plan G has comprehensive coverage.

Answer: It depends on what plan you are enrolled in. For example, some surgeries such as cataract surgery, are required to pay at least what Original Medicare would pay. Each insurance company can set their own rates for copays. The cost will also vary since the plan may require you to schedule with in-network providers. You also will need authorization from your plan to have the surgery.

You should check with your plan to make sure your provider is in network. Also check what co-pays or deductibles you will be responsible for.

Answer: Part A hospital coverage

Part B Medical Insurers

Parts A and Bl are Original medicare

Part C Medicare Advantage plans

Part D Prescription Coverage

Medigap plans which supplement original medicare

Medigap plans are differentiated by letters: A,B,C*,D,F*,G,K,L,M,N

Plans C and F are not available if you were new to Medicare on her after January 1, 2020

Answer: First of all, you should not answer calls from an unknown number. Remember, Medicare will not call you. Never give out your Medicare number and or any personal information.

I have received numerous calls from callers that claim they work with Medicare and they recite some of my diagnoses. The callers use a number that has my area code.

If you get a fraudulent call, you can report it to the Medicare Fraud Hotline: 1 (800)-HHS-TIPS or you can file a complaint with the Department of Justice to name a few ways to report fraud.

Answer: Yes, Medicare Part B will cover certain durable medical equipment including wheelchairs after you meet your part B deductible. For 2025, the deductible is $233.50. If approved, you will be responsible for 20% of the cost of the wheelchair. If you have a Medicare Advantage plan, they are required to cover everything that Original Medicare offers. If you have an Advantage plan, you should contact the insurance company since the plans pricing may be different than Original Medicare.

If you have a Medicare Supplement plan, the plan will pay the remaining 20% and Medicare Part B will pay 80%. You will also need a prescription from your doctor.

Answer: There are many but one that comes to mind is that some Medicare Advantage plans impose prior authorization requirements for services which Medicare does not require. Prior Authorization many times may interfere with timely care.

Answer: The most important tip would be to go over and compare the plans with someone who is knowledgeable about Medicare plans if you need assistance. By comparing benefits offered, your preferred doctors, medications covered and whatever else that is important to you, perhaps as location of pharmacies for example, will lead you to your most appropriate plan. You need to be aware of everything the plan offers.

Answer: Insurance companies that offer 0 premium can offer this because they are paid a set amount of money from Medicare for providing coverage. Also, many insurance companies contract with a doctor's networks and with hospitals to save money and thereby offer savings to members.

Keep in mind that just because there is a 0 premium, does not mean that the plan is necessarily free.

Answer: You will have the benefit of having an agent who is local that you can call with questions and you will be talking to your agent. If you decide and enroll in a plan through an insurance company, or Medicare, you will receive the same service an agent can offer. The main difference is that you usually will not be able to talk to the same agent who enrolled you. Therefore, the process is not as personal. This does not only apply to my referral phone number. It applies to any agent. Just keep in mind, agents need to help you decide what plan best serves your needs even if it means that you would keep your current plan. Agents are available to serve YOUR best interests.

Answer: No, Original Medicare does not cover medical alert systems because it is not considered to be a medically needed product. Some Advantage plans offer the medical alert system. Your insurance agent is able to tell you which plans would offer this system. If you don't have an agent, you may also call Medicare directly for help with plans.

Answer: I would suggest getting in touch with an Insurance Agent. Agents are obligated to ensure what plans your doctors accept by using computer software that is updated with this information. I don't suggest calling the doctor's practice for confirmation of acceptance in a plan as many times, this information may not be correctly updated. You can also call Medicare directly if you decide not to consult with an agent.

Answer: Medicare Part B will help pay for in-home healthcare which includes caregivers. Medicare Part B does not cover meal delivery services, 24- hour care or any personal care services if that is all that is needed. Some Medicare Advantage Plans can help with the out-of-pocket costs.

Answer: Th e coverage gap was discontinued in 2025 which was replaced by an out-of-pocket maximum amount which is $2100 for 2026. When you reach your out-of-pocket maximum, you enter the Catastrophic Coverage Phase, and you won't pay anything for your covered medications for the remainder of the year.

Answer: if you work in the U.S., you pay Medicare taxes according to your income but you do not pay taxes on benefits you receive from Medicare.

Answer: You incur Late Enrollment Penalty that is added to your Part D premium. This penalty is permanent, and it is 1% of the national base premium. The penalty is calculated for each month that you did not carry credible insurance coverage.

Answer: Yes you can change your plan any time during the year. You may Be subject to underwriting if you are not within your guaranteed issue period. It may be possible to avoid underwriting with certain regulations under the federal and state specific pathways. You should consult with an agent, or you doctor before changing plans

Answer: yes unfortunately it can be common to not be able to find a dentist under a particular plan. Many Medicare Advantage plans have a limited provider network which makes it difficult to access dental care. Therefore, it is essential that beneficiaries verify the plan with an agent or by directly calling the plan.

I don't suggest calling the dental office because many times when you are signing up especially during the annual enrollment period which would take effect the following year. The dental practice may not have been notified yet if their plan accepts a certain insurance company.

Answer: I love meeting and helping people which was instilled in me while working many years as a Registered Nurse. Also, mainly through my career as a nurse, I have seen firsthand how many of our elderly population are taken advantage of financially. I enjoy listening to client's stories and wisdom gained throughout their lives. As I get older and am also on Medicare, helping seniors and or individuals with chronic illnesses is near and dear to my heart.

Answer: Either way, working with a Medicare agent near you or with one who is remote or virtual are both good options. With that being said, it's really a personal preference. I Ancient I'll meet you some f you have an agent who's in your area that agent could meet you somewhere, Relationship come to your home or you could go to that agent's office which can be beneficial if you prefer to meet that person and develop a professional relationship with him or her. With remote or virtual,you would still have the opportunity to meet with a knowledgeable agent. The only difference is it is not as personal as in home but then again it is a personal preference.

Answer: While some Medicare Supplement (Medicap plans) cover medical care overseas and some Medicare Advantage plans may cover 80% of medically necessary care, it is advised to obtain travel insurance particularly if you have a chronic illness or need prescriptions filled.

Answer: Each year during theannual enrollment period or no earlier than October 1st your plan should be reviewed with an agent. Plans may change every year Many times new plans have different rules for medications that are not the same as your previous plan.