Donnie Vermillion, Medicare Insurance Broker

Answer: Yes, it is considered a preventive service.

Medicare Part B (Medical Insurance) covers this test once every 24 months (or more often if medically necessary) if you meet one or more of these conditions:

You’re a woman whose doctor determines you’re estrogen-deficient and at risk for osteoporosis, based on your medical history and other findings.

Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.

You’re taking prednisone or steroid-type drugs or are planning to begin this treatment.

You’ve been diagnosed with primary hyperparathyroidism.

You’re being monitored to see if your osteoporosis drug therapy is working.

You pay nothing for this test if the doctor or other health care provider accepts assignment.

Answer: Medicare does not cover around the clock supervision or personal care. Long Term Care insurance helps with ADL's "activities of daily living" and dementia specific needs. Depending on the policy it may help cover personal home care.

Answer: I would advise seniors that are feeling overwhelmed by all of their medicare options, to number one talk to a trusted independent insurance broker / agent.

Independent brokers are not beholden to any specific insurance provider and can help you find the right plan to meet your needs and budget.

When shopping for a health plan remember that its exactly that a health plan. The goal should be at the very least to have comparable coverage to what you had during your working years.

If there are extra perks with the plan like gym memberships or groceries thats great but the focus should be on selecting the right health coverage for you.

An independent agent can review the summary of benefits, deductibles, copayments, coinsurance and verify that your doctors and prescriptions are covered by plan you select.

Answer: Talk with your doctor about alternate dosages or generic drug options.

Talk with your pharmacy about discount programs.

You may qualify for "extra help " if your income is below a certain level.

You can also request a tier exception on your medications, this requires doctor support.

Answer: If you have what medicare considers to be "credible coverage" from your employers group health plan or your spouses group health plan , it may make sense to delay enrollment in Part B to save on the monthly premium. You must maintain credible coverage from an employer with at least 20 employees.

Setting up your my social security account is the first step.

Answer: Review your summary of benefits for your HMO plan. Out of network usually requires a referral from your primary care physician to see a specialist. Out of network will usually require greater out of pocket expense.

Answer: A medicare supplement plan can help cover many of the expenses original medicare does not cover. Just going with original medicare can leave you exposed to a high deductible $1676 for 2025 and 20% coinsurance.

An advantage plan offers services not covered by original medicare such as dental, vision, hearing and part D prescription drug coverage.

Answer: You will pay 20% of the "medicare approved amount" - the amount that original medicare sets for a service or item. When your provider accepts assignment medicare pays their share and you pay your share.

Answer: If you are collecting Social Security when you turn 65 you will automatically be enrolled in Part A (Hospital Care) and Part B (Medical Care) You do not need to do anything to enroll in Medicare and the part B premium of $185 will automatically be deducted from your social security check.

$185 for 2025

Answer: I explain that it's a good idea to go ahead and set up your my social security account online. Even if you are not ready to receive benefits you can set it up now so that when you turn 65 you will be automatically enrolled in medicare.

Part A = Hospital Stay - Part A is free for most

Part B = Medical - Part B everyone pays a premium - for most $185 - but based off income, your

tax return from 2 years back

Part C - Combines Part A/B with coverage from private insurance companies, could include

prescription drug coverage.

Part D - Prescription Drug Coverage

Answer: Yes, attending a free educational medicare 101 seminar is a great way to learn the basics of medicare. If it is titled an educational event it should not be plan specific. You will learn how to enroll in medicare. You will learn about the basics of Part A and B , what they cover.

You can get your medicare coverage in different ways. Whether that be just using Original Medicare A/B, a Medicare Supplement / Medigap plan or a Medicare advantage plan.

Answer: If you have had Part B for at least a year, Medicare will cover an annual wellness visit. The purpose of this visit to to create a personalized plan for to prevent disease or disability based on your current health and risk factors.

Answer: Expanding Medicare benefits to cover dental, vision, and hearing would more than likely increase the cost of Medicare.

Answer: Set up your my social security account online. You do not have to collect benefits yet but it will ensure you are enrolled in Medicare on time. It may make sense to delay Part B enrollment if you are still working and have "credible coverage". You want to avoid signing up late for Part B, there are lifetime penalties if you do not enroll in time.

Credible coverage is coverage that is at least as good as what Original Medicare offers, discuss this with your Human Resources department, and contact an Independent Insurance broker.

Medicare.gov and the medicare and you handbook are also good resources.

Answer: Yes, to avoid a lapse in coverage and possible penalties, you must still pay your Medicare Part B premium if you live abroad for part of the year.

Answer: If you are close to turning 65 and not receiving Social Security benefits you will need to sign up for Medicare at SSA.GOV/MEDICARE

You can also contact social security 3 months before you turn 65.

Answer: This depends on your financial situation. Medicare may cover some of the treatments for critical illness. But it will not cover the cost of travel, lodging, food or your caregiver or spouse missing work.

Answer: Ask them if they have thought about the future and how they will get their healthcare after they retire. An independent broker can help them with their options and get them coverage thats at least as good as what they had while working.

Answer: If you continue to work and are covered by a group health plan by your employer then no you just need to maintain credible coverage, your HR department can verify that for you.

If you miss your initial enrollment period when you turn 65 you could face late enrollment penalties if you are not working / maintaining credible coverage through your employer.