Derek Warren, Medicare Insurance Broker

Answer: Part A is for inpatient hospitalization. However you could see an increase in out of pocket expense based upon medicares negotiated rate for hospitalization. If you’re turning 65 then you could face a penalty on part b and d for not taking the necessary steps during your initial enrollment period. These penalties would be an additional monthly expense for the rest of your life. Please reach out if this doesn’t completely answer your question. I would be happy to assist.

Answer: The only way you pay zero for your Medicare is if you have low income subsidy or Medicaid. Most people have to pay $206.50 for their Medicare part b while they have worked 40 qtrs so part A is no cost. Hope this helps..

Answer: I like the hospital indemnity plans. Most have guarenteed issue periods as well. If your using the advantage plans a lot it might be a good option for you.

Answer: Yes it helps all of the seniors on any named brand medications. The donut hole aka coverage gap was removed. It was replaced by a Medicare prescription payment plan. This will put a cap on the medications at 2100. The intent of this is to allow our seniors to spread the cost out over 12 months if the individual is paying more for than 2100 on their prescriptions.

Answer: It should be considered Durable Medical Equipment. The cost is usually 20% coninsurance. I would notify your doctor who most likely will coordinate benefits with your plan. In addition you could also contact your plan to see where your best cost sharing would be. I hope this helps.

Answer: The Maximum Out Of Pocket is what protects your 20%. With original Medicare there break down is 80/20. It’s the most you’ll ever pay in a calendar year.

Answer: If you are collecting ssdi you will automatically be enrolled in Medicare parts an and b. At the time it will open a special enrollment period which will give you a 63 day period to enroll in a Medicare advantage plan to help protect your 20%. Med Supps are available upon turning 65 years old.

Answer: Yes all Medicare plans cover emergency care inside and outside of the US. Some advantage plans have national travel benefits built into them as well. I hope this answers the question.

Answer: Several times people get caught up with call centers through a virtual phone call. In Northwest Ohio we have to be careful as to what plans we select due to the Promedica network. If people on a Medigap policy then the individual is essentially paying it forward due to having a premium affiliated on top of your Part B cost.

Answer: Most of the Medicare Advantage plans will cover In Home Healthcare. The most important part is to check the network and medications to make sure that the certain advantage plan would be the right fit.

Answer: Hospitals are taking advantage plans. They take both HMO and PPO. Network restrictions may apply but that’s part of a brokers responsibility to ensure that the specific advantage plan chosen would work for the doctors, specialist, hospital, etc. that an individual is using to know what plans would work for that individual. In addition to that would go off the cost of the medications to ensure that you will have both the network and the meds will be covered at the lowest out of pocket cost for the individual.

Answer: Education with newer clients is more thorough. The objective is to educate these clients more so they understand the ins and outs. For people that are new it’s more about understanding their concerns and questions with their current plan. Once you identify these you’re able to show them what’s available in their service area.

Answer: Yes unless you have creditable coverage from an employer with over 20 employees. If that’s the case you could defer the start date of part b which would give a Special Enrollment period lasting up to 63 days.

Answer: The 11% increase on the part b when the Cola adjustment only went up 2.7% which ultimately means the seniors are losing 8% on average.