Glenn Quinn, Medicare Insurance Broker

Answer: Yes, Medicare will cover nutrition counseling. Both original Medicare and Medicare Advantage plans will cover nutrition. That is considered preventive services.

Answer:

If you are paying ERISA and your income drops to the Norma range due to retirement, you can appeal to Social Security and as for a review.

If you are low income as a result of lost incomyou can apply for Low Income Subsidy.

Answer: Are you on Original Medicare or an Advantage plan.

Original Medicare only pays 80% of provider services. Most Advantage plans have copays.

Answer: Generally, Medicare does not cover preventive genetic testing or testing to detect undiagnosed diseases or predispositions. However, Medicare Part B may cover genetic testing for certain conditions, like diagnosing inherited disorders or guiding medical treatment decisions, if ordered by a physician and deemed medically necessary. For example, genetic testing for specific cancer risks or to determine how a person may respond to specific medications might be covered.

Answer: A Medicare Summary Notice (MSN) is a quarterly statement sent to individuals with Original Medicare (Parts A and B) that summarizes their claims for services and supplies billed to Medicare during that period. It details what Medicare paid, what you owe, and if the service was approved. MSNs are not bills; they are a record of claims and payments. There is nothing you need to do with the statement.

Answer: While Medicare generally doesn't allow for backdating of enrollment, there might be exceptions if you missed your Initial Enrollment Period due to a medical emergency. You may qualify for a Special Enrollment Period (SEP) due to unforeseen circumstances like hospitalization or temporary cognitive disability, which could allow you to enroll without incurring penalties. The best thing to do is to contact Medicare.

Answer: Medicare provides a range of preventive services to help you stay healthy, detect health problems early, and prevent certain diseases. These services are covered by Medicare Part B (Medical Insurance).

Key Preventive Services Covered by Medicare:**

Wellness Visits: Including a one-time "Welcome to Medicare" visit and annual "Wellness" visits to review health history and create prevention plans. Note that these are not full physical exams.

Screenings: Medicare covers various screenings for conditions such as cancer (colorectal, breast, cervical, vaginal, prostate, lung), cardiovascular disease, diabetes, depression, glaucoma, abdominal aortic aneurysm, hepatitis B and C, HIV, and sexually transmitted infections (STIs).

Vaccinations: Covered vaccinations include flu shots, COVID-19 vaccines, pneumococcal shots, and Hepatitis B shots. Shingles and Tdap shots are covered under Medicare Part D.

Counseling and Therapies: Services include counseling for tobacco use, alcohol misuse, medical nutrition therapy for certain conditions, and behavioral therapy for obesity and cardiovascular disease.

Other Services: Bone mass measurements for those at high risk for osteoporosis and the Medicare Diabetes Prevention Program for individuals at high risk for diabetes are also covered.

Important Notes:

You generally pay nothing for most preventive services if the provider accepts Medicare assignment.

Medicare Advantage plans (Part C) must offer at least the same benefits as Original Medicare, but may have different rules and network restrictions.

Consult your doctor to determine which preventive services are appropriate for you.

Utilizing these covered services can help you proactively manage your health and potentially detect health issues early.

Answer: Working with Medicare clients is rewarding because it allows one to build lasting relationships and make a meaningful difference in their lives by helping them navigate the complexities of healthcare options. Agents find satisfaction in educating clients and empowering them to make informed decisions about their coverage, which can lead to peace of mind and confidence in their healthcare choices.

Answer: The biggest mistake seniors make when enrolling in Medicare is not understanding the differences between Medicare Advantage (Part C) and Original Medicare (Parts A & B), and the implications of each, especially during the initial and annual enrollment periods. This can lead to choosing the wrong plan, missing out on important benefits, or incurring unnecessary costs.

Answer: One of the most rewarding aspects of being a Medicare agent is the opportunity to help people navigate the complexities of Medicare and find coverage that meets their individual needs. Agents can make a tangible difference in people's lives by providing clarity and reassurance, especially during stressful times when they are making important healthcare decisions.

Answer: Yes, it's common for Medicare Advantage plans to offer limited dental coverage, even if they advertise it. While many plans include dental benefits, they often come with restrictions like low annual maximums, high coinsurance, or limited coverage for specific procedures. This can leave beneficiaries with significant out-of-pocket costs for more extensive dental work.

Answer: PPO health insurance plans, while offering flexibility in choosing providers, have several disadvantages. These include higher monthly premiums, potential for higher out-of-pocket costs, and the possibility of increased paperwork. Additionally, PPOs may lead to fragmented care due to the lack of strong coordination between providers.