Dana Dane, Medicare Insurance Agent

Answer: What is the difference between Medicare Supplements and Medicare Advantage Plans? Which plan is right for me?

Answer: Some Medicare Advantage plans have a $0 monthly premium. Medicare Advantage plans are subsidized by the government. Legitimate advertising must be approved by Medicare.

Answer: To specifically answer this question and maintain compliance with Medicare guidelines, comparing plans should be discussed with a licensed agent with Medicare approved outlines and sales materials. Most people are enrolled in a Plan G or Plan N. Plan K is not offered by some companies. Plans with less market share tend to be higher in premium in comparison to the benefits.

Answer: Benefits vary from plan to plan. Often times you may have a $0 copay with an in-network primary care physician, for example. There is usually cost sharing for out-patient surgeries, hospitalization, major diagnostic tests as well as other services. Cost sharing can be a set dollar amount or a percentage of the cost.

Answer: This is a complex question that is not specific enough. Did you delay or forget to enroll in Medicare Part B and missed your initial enrollment period? Did you not choose a Medicare Supplement or Medicare Advantage plan during your initial enrollment period?

Answer: Maybe you mean, why is a Medicare Supplement better than a Medicare Advantage plan? There are pros and cons depending on your needs. I would recommend you speak with your local licensed agent to find out what your needs are and to give you a thorough overview of the differences.

Answer: In general, most people on Medicare who receive employer health insurance will delay Medicare Part B enrollment. In this case Medicare Part A (in-patient services) is billed first. I would contact your employer health insurance plan to find out what your cost sharing would be for specific services.

Answer: In general, other than emergencies, you must see in-network providers if you are enrolled in Medicare Advantage HMO plan. Please call your agent or your insurance company to fully answer your question.

Answer: Some Medicare Supplement companies offer discounts on hearing aids at no extra cost. Some Medicare Advantage plans have hearing aid benefits up to a certain dollar amount. Please contact your local insurance agent to find out what is available in your area.

Answer: Yes, Puerto Rico is a U.S. territory. I would recommend travel/trip insurance, especially outside of the continental U.S. Get the best plan available which would include medical services as well as emergency air travel for you and your traveling partner to bring you back home. The cost is relatively inexpensive as it covers you for the duration of your trip only.

Answer: It's easy to get caught in the weeds! Please work with a local agent who has access to a variety of companies. They can work with you to explain the options in your area and find a plan that fits your needs. There is never a fee to work with an agent.

Answer: Medicare Advantage plans and Medicare Supplements must cover everything that Medicare covers. Medicare covers home health visits. How it's covered depends upon your plan but many plans will cover home health at a $0 copay but visits are limited. To receive the benefit you must qualify. Please contact your local agent to find out how home health is covered under your plan. There is never a fee to work with an agent.

Answer: Sometimes there are billing errors. In my experience, the number one error is coding something as routine when it should be coded as medically necessary. A call to your provider is usually enough to fix the problem. They simply add the correct code and rebill. If you are being charged for services not rendered or items not received, for example, I would first contact your agent. In this case, you may also contact the provider. The next step would be to report it to CMS which is Medicare.

Answer: First, your doctor needs to prescribe this. Next, please call your agent who can contact your insurance company to see if you qualify for a replacement.

Answer: Your agent should have shown you the details of your prescription coverage at the time of enrollment, including but not limited to prior authorization, quantity limits and step therapy. Contact your doctor about prior authorization for those particular medications and they will send prior authorization to your prescription company. Please contact your agent for more information.

Answer: Medicare Supplements and Medicare Advantage plans cover mental health visits and hospitalization due to mental health. Part D prescription drug plans cover medications. Please contact your agent to see if your medications are covered. If you do not have Medicare yet, please contact a local agent to help you.

Answer: I just searched online and the second article listed was written in 2008 and stated that Medicare Part A will have insufficient funds by 2019. Be careful of the information you read online. It's good to be informed but don't get caught in the weeds or buy into fear-based articles. If you called Medicare I would guess they would not be able to answer that question, other than Part A funds must be increased every year.

Answer: A few Medicare Supplements and some Medicare Advantage plans have a benefit for gym memberships. Some Medicare Advantage plans will pay you a specific dollar amount for preventative visits. I would not choose a plan based on these benefits. Focus on the quality of the medical coverage. Please contact your local agent for more information about the plans in your area.

Answer: Some preventative screening are covered under Medicare. Please contact your agent or if you don't have one, call your insurance company.

Answer: I am assuming you have a Medicare Advantage plan. I have not see a Medicare Advantage plan that offers a $0 copay for ambulance service. Please call your agent to review your plan benefits again. If you do not have an agent, please review your summary of benefits and/or call your insurance company. If you are educated about your benefits there will be no surprises.

Answer: I would call an agent and meet face to face if you can. They can educate you on the plans available in your area and find out what type of plan would be best for you.

Answer: Enrollment in Medicare Part A is automatic and there is usually no cost to you. Maybe your are thinking about Medicare Part B. As long as your spouse is actively working you could stay on that plan and DELAY MEDICARE PART B enrollment. Please speak to a licensed insurance agent to compare cost and benefits vs. Medicare enrollment with a Medicare Supplement or Medicare Advantage plans. Face to face meetings are best.

Answer: I have found calling early in the morning on Wednesdays and Thursdays have shorter hold times. Please call your insurance agent to see if they can offer assistance.

Answer: Please contact your insurance agent who can explain how all the Medicare benefits work, how they coordinate with Medicare Part B, a Medicare Supplement, a Medicare Advantage plan or an employer health plan.

Answer: Please contact Medicaid as soon as possible and make an appointment to see if you qualify. There may be an office in your area. Some hospitals offer financial assistance if you are low income but do not qualify for Medicaid.

Answer: Ask them if they can seek treatment (other than an emergency) with any doctor/hospital/facility nationwide that accepts Medicare. Ask them what their annual maximum out-of-pocket is in-network and out-of-network? Ask them if their plan changes from year to year.

Answer: Medicare does not cover acupuncture however, some Medicare Advantage plans offer some coverage. Please contact your insurance agent for more information about plans in your area.

Answer: Please contact your insurance agent for assistance. If you don't have an agent, please contact your prescription insurance company.

Answer: Instead of looking for red flags (If one is a hammer one tends to look for nails.), instead I would focus on important attributes. Are they an EXPERIENCED agent - how many years have they been in business? Does the agent have access to MULITPLE COMPANIES and access to multiple plan types? Is the agent LISTENING to your concerns? Ask yourself, would you invite them to your home or would you hire them if you were an employer?

Answer: Without knowing what your plan is, that question should be answered by your agent. If you do not have an agent, please call your insurance company for that information. You could also request that you have a local agent assigned to you which costs you nothing.

Answer: I would call your local ambulance company and ask what their charges are. Often, they will have a base fee and add mileage. You might want to contact a licensed agent to talk about how much you would also pay for hospitalization, major diagnostic tests, etc. Please consider getting a Medicare Supplement or Medicare Advantage plan as soon as possible or maybe Medicaid is an option for you.

Answer: Please visit the Medicare link listed below for all the details including forms. I would call your agent for assistance. if you don't have an agent, you could call Medicare.

https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals

Answer: Contact your agent. Otherwise, I would get the best travel insurance you can find. Get the highest coverage available which includes medical benefits as well as emergency transportation back home to the US and other benefits. You can find this coverage online. Look at online reviews.

Answer: Please contact your Medicare Advantage plan agent. If you do not have one, please contact your insurance company.

Answer: Please go to the Medicare link below for complete information. You could also contact your agent or your insurance company.

https://www.medicare.gov/coverage/preventive-screening-services

Answer: Quite a few preventative benefits are covered by Medicare. See the Medicare link below.

https://www.medicare.gov/coverage/preventive-screening-services

Medicare Supplement and Medicare Advantage plans are offered by private insurers. When Medicare mandates a benefit, the Medicare Supplement and Medicare Advantage plans must cover the benefit.

Answer: An agency out of state sent a Medicare Advantage plan ad/mailer to my husband. The plan they were advertising was a plan not in our zip code or county. I called the agency and it took a bit of time for him to tell me that United HealthCare plan is not available where we live. I contacted United HealthCare about this ad. Hopefully they contacted the agency. When shopping around for a Medicare plan, please contact a local agent who will care if you happy with your plan and will try to keep you happy to keep your business.

Answer: Yes, some Medicare Advantage plans cover acupuncture and naturopaths. Please call your local agent who has access to all the plans available in your area.

Answer: I would like to see an open enrollment period for Medicare Supplements in all states. I would prohibit Medicare Advantage plans from using PROPRIETARY prior authorization. They use this in addition to Medicare's prior authorization guidelines. Why? I would prohibit the use of AI in the prior authorization process that some Medicare Advantage plans use. I would like to see some coverage for custodial long-term care.

Answer: That depends upon what plan you have at the time of claim. Medicare Advantage plans can change from year to year. There are several Medicare Supplements to choose from. Please call your agent.

Answer: We are insurance agents. We cannot and should not predict the future of Medicare's benefits. Some Medicare Advantage plans cover personal emergency response devices and may include a wristwatch that also monitors heart rate. Please contact your agent to see what is available in your area.

Answer: Medicare covers chiropractic services. Some Medicare Advantage plans cover other alternative services. Please call your agent to see what plans are available in your area.

Answer: Stairlifts, wheelchair ramps and other home modifications are not covered by Medicare. Please contact your agent for assistance.

Answer: We are insurance agents and cannot answer questions or give opinions about the economics of expanding Medicare. This is way beyond our scope of appointment.

Answer: We are insurance agents. Our scope of appointment is to tend to business regarding insurance policies. We cannot offer our opinion or predict the future.

Answer: Please go to the link provided below that will take you to Medicare's website explaining your question.

https://www.medicare.gov/coverage/inpatient-hospital-care

Answer: If you work with an agent they can look up your health care providers to check in-network providers. If you are taking medications, please check to make sure they are covered and how much they would cost you.