Diana Salisbury, Medicare Insurance Broker

Answer: What should I do if I miss the Medicare Open Enrollment period and I want to change my plan?

Contact me as soon as possible to see if you might qualify for a special enrollment period.

Answer: How does losing a spouse impact my Medicare plan if I was on their employer plan Most importantly, you will have to check with the employer to see if insurance is still being offered to you. If not, there are a number of options to explore. Give me a call and we will review all options keeping you insured.

Answer: You must check if your doctor accepts either a PPO or HMO with a specific plan. All plans do not have to accept all doctors.

Answer: You can not assume that will happen. An agent or broker will help compare plans to see what type of plan will work best for you.

Answer: You had medical appointments or services performed. This summary indicates what Medicare paid, if you have a secondary insurance plan (such as a Medigap plan), and if you have met your current year deductible.

Answer: Yes, you can check to see if you qualify for Extra Help through Social Security, or apply for pharmaceutical assistance through the manufacture of the prescription.

Answer: You might want to apply for Medicaid. If you qualify, your state will pay for your Medicare premium.

Answer: If you have an advantage plan, a number of carriers offer assistance with the cost of hearing aids if you use and go to their hearing vendor. Original Medicare does not cover the cost of hearing aids.

Answer: You should work with an agent or broker to go over what changes might impact you. This is a good every year practice to get starting doing.

Answer: Medicare always pays 80% first. You must always ask the provider if they accept Medicare and if so you will pay for the remaining 20%.

Answer: Medicare is a little higher due in part to many COVID claims. Will it be unsustainable - that is something the Government has to work through.

Answer: If you have a supplement, such as a plan G, you must meet your 2025 deductible first - which is $257 this year. If you have original Medicare you will pay the 20% that Medicare didn't cover.

Answer: Yes....Medicare Part B typically covers bone density tests also known as bone mass measurement\s for individuals who meet certain criteria. These tests are covered once every 24 months, or more frequently if medically necessary.

Answer: Work with an insurance agent or broker to help you understand what type of plan your Dad has. The medications should fall under Part D of Medicare, prescription coverage in either an advantage plan or a stand alone-prescription plan. Maybe the prescriptions aren't covered and you could ask his doctor if there is a generic version of an expensive prescription.

Answer: You need to work with an insurance agent or broker to help navigate you to understand your insurance plan. Or check into the 2025 plan guide your Medicare plan you have.

Answer: Go to www.Medicare.gov and type in what prescription your taking. Then if not covered by one of the plans, your doctor might have to write an exception for your plan to help cover you.

Answer: Yes - your doctor needs to write an order for this and/or any durable medical equipment that would help you at home. If you don't get one from the doctor you can figure on paying for most of the cost out of pocket.

Answer: There is no medical copay for anything with plan F. This includes, doctor's visits, hospital stays, emergency room visits, etc. It is a fabulous plan!

Answer: That is a question for Medicare to answer. The government will have to determine how they want Medicare to proceed with new technology.

Answer: Yes if you are out of your initial enrollment period with Medicare,

Or If you have been on an advantage plan and now want to try out a Medicare supplement, you will be asked medical questions on an application and could be denied coverage due to some specific health issues.

Answer: No, not all types of blood tests are covered by Medicare. What is covered is medically necessary diagnostic blood tests which are ordered by a physician, but it may not cover routine or preventative blood work that is not medically justified.

Answer: Not meeting with an insurance agent or broker. Getting your options prior to enrollment is critical to not making future mistakes.

Answer: You can. But if you have a personal relationship with your insurance agent or broker, you shouldn't have to call an insurance carrier direct for 98% of most questions. And you don't have to be on hold for lots of wait time.

Answer: That Medicare isn't free. It costs a premium each month and that there are government rules each person turning 65 needs to know to avoid penalties.

Answer: I have a sit down meeting with them and go over their options. Then I leave behind information for their files should questions arise after we sign them up for their plan.

Answer: One mistake might be that they think that all copays are the same. Most plans require that a deductible be reached on Tier 3 and higher tiers before the cost of their expensive prescription is reduced.

Answer: Not paying attention when they turned 65 and should have signed up for prescription coverage. This would be in a stand along prescription Part D or embedded in an advantage plan.

Answer: Educating them about their options. Pieces of information that they need to know to have the best medical care at their fingertips.

Answer: Check with your tax accountant. Do not assume what others are telling you. Go to the professionals for help with financial matters.

Answer: Take generic rather than brand name prescriptions if you are able. Request three months at a time rather than a 30-day supply.

Answer: If you can't answer this on your own, you should schedule a meeting with an insurance broker or agent.

Both have pros and cons - and it is a good idea to see which will work best for you.

Answer: Number 1 - eye-exams (for eyeglasses)

Number 2 - Long-term care

Number 3 - cosmetic surgery

Number 4 - massage therapy

Number 5 - routine physical exams

Number 6 - hearing aids and exams for fitting them

Answer: Medicare will pay for 80% of medically-needed services. You will be personally responsible for the remaining 20%.

Answer: Do research on your own. Or take time to meet with an insurance professional to learn what your options might be.