Deborah Webster, Medicare Insurance Broker

Answer: I enjoy helping seniors navigate the Medicare space. I offer after-sales customer service to assist them as they use their Medicare plans and also offer ancillary products to improve their coverage.

Answer: They are not "free" plans, these plans are a pay-as-you-go plan. They do offer benefits that original Medicare does not offer, such as coverage for Dental, Vision, and hearing.

Answer: Medicare coverage is set up by CMS (center for Medicare and Medicaid services) If regulations are changed in the future, that we cannot predict but an illness such as heat stroke are covered by Medicare.

Answer: Contact an Elderly Care Attorney to help with full Power of Attorney. They assist with setting up a Medical or full power of attorney status. This way, you can have full control of what is happening with your loved one. Typically, not a very expensive investment to have the authority to make decisions on behalf of a family member who can no longer make those decisions on their own.

Answer: Medicare Advantage and Medicare Supplements are the only two options available to lower the gap left with traditional Medicare. We are currently seeing a strong trend toward Medicare Advantage plans with our seniors. Neither option is wrong, it's about making sure that the coverage you choose fits your situation. The system is designed the way it is; we can only maneuver within what systems we have to work with.

Answer: Traditional Medicare does not cover eyewear. I cannot really answer this question in detail because I do not have enough information about what plan she was enrolled in. I would need more details about the circumstances in this situation.

Answer: Most of the Medicare Advantage plans will cover diabetic counseling. This counseling is covered at no cost to the member. Diabetic testing supplies are also covered on these plans at no cost to the member.

Answer: this is concerning that you don't have your preferred hospital in the network. Are you on a Medicare Advantage PPO plan? This would still allow you to go to that hospital (although you may pay a higher co pay), If it is an emergency situation, your plan would still cover an out-of-network hospital.

Answer: Either way insulin are now capped at 35 per month you do need to make sure the insulin you are taking is on the formulary of the plan. That is where an agent like myself can help guide you through the plans.

Answer: Original Medicare is the same regardless of what state you reside in. Your supplemental plans will have to change to what is offered in the state you reside in. You will want to contact your agent or your plan to find out what is provided in the state you are relocating to.

Answer: Your plan may offer smoking cessation coverage. Typically, the Medicare Advantage or Part C plans offer smoking cessation. You can look it up in the insurance company's evidence of coverage or call customer service, or your agent if you are unable to find the information in the evidence of coverage.

Answer: Drug plans do cover many weight loss drugs such as Ozempic. Be sure to look at your drug formulary to determine which medications they cover as well as any deductibles or co-pays that may apply to this medication, to determine what your out-of-pocket costs may be.

Answer: We would need to look at what plan your on and compare. I am independent and work with lots of carriers and plan options

Answer: You can call your drug carrier and have them apply for a payment plan to spread the cost of your medications over the whole year.

Answer: Medicare seminars are designed to educate people turning 65 about how Medicare works. Compliance does not allow agents to talk about any specific carriers or any benefits at those seminars. So no these are not " sales pitches".

Answer: PPO's allow you to go to out-of-network doctors. (at a higher cost sharing) PPO's however, can still require a referral to see a specialist. To find out whether your company requires this, you should check this information in your evidence of coverage document.

Answer: You may be eligible for a federal retirement group retiree plan. This will not affect your Medicare eligibility but may offer you better plan options than someone who is only eligible for individual Medicare plans.

Answer: You are eligible for A& B when you turn 65. You can call Social Security about any of your benefits questions. You may also access everything online through the social security website ssa.gov

Answer: Most generally, there are already apps in place with Medicare Advantage plans. If you did not receive the information on how to sign up by mail or email, you can call the customer service number on your Advantage plan card.

Answer: Medicare does not cover any of the above. Whether or not they should is irrelevant because it's not covered. Sending feedback to your congressmen or to Medicare would be a way to let them know what the public wants or needs. Medical costs are increasing, so the expense to consumers will continue to rise regardless of whether they cover any extras.

Answer: Contact the carrier you have for your Medical coverage, or refer to your evidence of coverage on your policy. If all you have is original Medicare, you may call 1-800-Medicare for more information.

Answer: You may purchase stand-alone plans available in your state. Medicare Advantage plans often have some Dental and Vision coverage as well.

Answer: No, you should be able to access the dentist who are participating by calling member services or go on your member website to look up the dentist who are participating with your Medicare advantage carrier.

Answer: Medigap plans are a supplement to Medicare A and B ( Original Medicare). Medical plans do have health underwriting. The only time you do not have to pass underwriting is when you are first eligible for B outside of that you must be able to pass underwriting. Medigap companies do not all have the same health questions. It's important to work with an agent who has multiple options to look at underwriting and find a carrier who may take your current pre-existing conditions.

Answer: You can contact your insurance agent to help you file an appeal if you like. If you don't have an agent, you can contact customer service on your health plan and they can help you with the appeal process.

Answer: I personally think they are trying to give seniors access to choices.

As an agent, I think they are more hindering than helpful.

Medicare.gov shows seniors all choices online, and they offer a ship office

for those who don't have access to the internet.

Medicare also welcomes feedback from seniors on Medicare.

Answer: Yes, you can pay part A& B, and D premiums are eligible. Medicare Advantage premiums would

also qualify. Medicare supplement or Medigap policy premiums do not qualify for pretax HSA.

Note: Contribution to your HSA account must cease at this time.

Answer: Specified disease plans such as heart attack, Cancer and Stroke are additional policies one can buy that will give extra help to pay for costs for treatment; additionally can be set up to cover travel expenses as well.

Answer: People may leave a Medicare Advantage plan to go to another one during open enrollment.

Some people may try a Medicare Advantage plan and then decide to go back to a Medicare Supplement plan. As far as how many are on Medicare Advantage vs supplement, there are now more Medicare beneficiaries on Medicare Advantage than supplement plans across the US.

Answer: Medicare is a straight 80/20 plan with deductibles on A & B. Medigap plans lower that potential out-of-pocket and eliminate the A deductible. If you're eligible for a plan F medigap, you also eliminate the part B deductible.

Answer: Yes, the max in 2025 is 2,000 while the max in 2024 was 8,000. There may be deductibles on your plan if you are on brand-name medications. Work with your agent to determine whether the deductible will apply on your medications.

Answer: This information is in your evidence of coverage. If you worked with a broker to sign up for your part D plan, the agent should have covered that when you signed up. This information is also available on Medicare.gov

Answer: If your income is over a certain threshold you may pay more for part B. IRRMA is figured on single or joint household income. For IRRMA thresholds visit ssa.gov. social security site.

Answer: Answering phone calls from telemarketers who call constantly can be a little scary.

It is recommended that if you didn't ask for the call or didn't give permission to call, it is best to disconnect.

Medicare will not call you; instead, they will mail any correspondence relevant to your account.

Do not give out your Medicare number over the phone unless you are sure about the company or agent that you are speaking with.

Answer: SOA is a scope of appointment. It defines what products your agent is going to discuss in relation to Medicare coverage. It is required for all agents, including telemarketers. The rule in 2025 requires all agents to have this signed by the medicare beneficiary 48 hours prior to a Medicare meeting. There are a few exceptions to this rule. It is Medicare's requirement, and all agents licensed to sell Medicare must comply.

Answer: There are often local educational events that will help you understand the Medicare process.

These are registered with Medicare, you can contact 1800Medicare to inquire about dates and times for your area.

There is always the ship office that will schedule a time to visit with you about Medicare.

Contact a local agent to set up an individual appointment to review how Medicare parts work.

Answer: I believe you are referring to a rule with Medicare Advantage plans that requires a 3-day stay in the hospital before the plan will pay for skilled nursing care. This is the 3 midnight or after stay.

You can refer to your plan's evidence of coverage to see if this rule applies to your plan.

Answer: Yes, you are eligible for guaranteed issue when you are first eligible to take your Part B or when leaving creditable group health care coverage after your initial enrollment period.

Answer: Unfortunately, Medicare is not free. When you worked, the Medicare you paid for out of your paychecks is going toward your Part A. This covers inpatient stays like a hospital or skilled nursing facility. Part B premiums start when you turn 65 or take your Part B. This section covers doctors and outpatient services. This is still, however, never fully paid for; there is still an out-of-pocket expense you will incur when you use your Part B.

Answer: It is not a requirement for taking part B when you are covered under a group health plan with your employer. Most people will delay B while still working if they are allowed to stay on employer coverage (check with your HR on policy rules). They will take B at a later date when they fully retire and quit working. Ship offices will help with information about this, as well as local agents you may work with to help explain your options for Medicare.

Answer: No, original Medicare does not cover groceries. There are plans (Medicare Advantage) that do give a grocery allowance. These are private insurance companies contracted with Medicare that manage your Parts A and B and can give you additional coverage above and beyond what original Medicare offers. Contact a local insurance agent or talk to a local ship office about what options may be available to you.

Answer: Original Medicare does have gaps; this is why it is important to purchase supplemental plans that can help fill those gaps. You can contact a ship office or a local agent to discuss what those plans consist of and what they cost. Whether it was designed well or not, it is the healthcare option that seniors must work with as of now.

Answer: you will automatically get your A and B (original Medicare) without having to sign up. Your effective date will be the 1st of the month that you are born in unless your birthday is on the 1st of the month: in that case your effective date will be the 1st of the month before the month you were born.

Answer: I have not heard of any Medicare Advantage giving gift cards to enroll. This practice would not be permissible by Medicare. They have Advantage plans available that may give you a card to purchase over-the-counter medications after enrollment, or gift card rewards you may earn for doing healthy activities during the year. This is not the same as an incentive to buy.

Answer: I sit down with each prospect and give them a Medicare 101 that includes many different things. Discussion on the parts of Medicare and how they function: Discussion of Medications, doctors, and overall areas of concern for each individual. Expected costs and plans that can help cover gaps in Medicare coverage. I also do group settings in a public location that is free to the public to listen and learn all the aspects of Medicare.

Answer: Prescription savings are available both through the state and Federal Programs.

You can apply on the DHS website for the state pharmaceutical program. The Federal program is called LIS (low income subsidy) and this is available to apply online or contact your social security office for a paper version or sign up over the phone.

Answer: Yes, this is the current maximum out-of-pocket for all Medicare beneficiaries. If your plan has a deductible, this also counts towards your maximum out-of-pocket.

Answer: My favorite is getting to know my clients on a personal level and helping them navigate Medicare in this special time of retirement.

Answer: Yes, there are special enrollment periods created for someone who may have continued working past age 65 and is now losing their employer-sponsored benefits.

Answer: Yes, open enrollment is the time to review changes with your current plan and allows you to look at other options. If you work with an agent, they should be reviewing your doctors, preferred facilities, and prescriptions to ensure that you have proper coverage within your plan.

Answer: What you choose to do for your plan should be 100% your choice. No agents should be steering a beneficiary one way or the other. Insurance is supposed to make you sleep at night. If, for any reason, you don't feel comfortable with Medicare Advantage, then it isn't for you.

Answer: Medicare can be primary or secondary insurance depending on your situation. You can work with an agent to determine how this would work. The ship office is another place you can schedule an appointment to speak with a licensed agent.

Answer: Your medication costs go to 0 regardless of the tier of medication you are taking.

Once you cross the 2,000 max out-of-pocket thresholds, you incur no more cost for the rest of the year.

Answer: Star ratings determine how Medicare (CMS) ranks Medicare plans. Low star ratings can be a warning sign that beneficiaries have been unsatisfied with a plan. Medicare may not allow the plan to continue offering benefits if star ratings stay below a certain score. Work with an independent agent who can offer multiple carriers and plans to help you choose a plan that is going to work for your particular concerns.

Answer: The best way to determine if your insurance covers your medication is to look on the drug formulary. This is sent to you when you join a plan. You may also call the customer service number on your card to have them assist you in looking into the formulary to determine that your medication is covered and at what cost to you.

Answer: Coverage on Medigap plans is the same from one carrier to the other. In other words, a G plan is the same medical coverage regardless of the carrier you choose. There are some carriers that offer some extra benefits, such as a gym membership that may give you a little perk; however, the medical coverage is identical. The cost will vary from one carrier to another, as well as the increases they take annually.