Heidi Delaney, Medicare Insurance Broker

Answer: LIS is the Low Income Subsidy program provided through Social Security. Even people that do not qualify for Medicaid can qualify for LIS; you can apply by calling SSA or use this link to apply online https://www.ssa.gov/medicare/part-d-extra-help .

Answer: 1. Find a good independent agent that works with all of the insurance carriers in their area.

2. Help them gather their medications, including dosage and frequency of refills & the pharmacy they prefer to use.

3. Help them gather their list of providers, primary care, cardiology, dermatologist, dental, eye doctor... and any hospitals or facilities they prefer to use.

4. Join their meetings with the agent. Any agent that has a problem with you being involved is not working for your parents.

Answer: It depends on the data you choose to believe. Personally and professionally, I believe it would broaden the pool and improve the program.

Answer: It truly depends on the type of medication. Insulin is $35 for a month supply but the specific insulin you use must be on the plan formulary. Plans under specific circumstances can cover the GLP-1's. Having a good independent agent check your medications against all the plan formularies in your area is the best place to start. For now, you can ask your doctor to request it be added to the plan formulary.

Answer: Dental is not perfect, it's great when it works but crummy when it doesn't. Dentists have a habit of jumping in and out of network all year long, leaving you hanging. Depending on the plan you may still be able to use the dental benefit. Your agent or the customer service phone number on the back of your card can help you.

Answer: Every plan has slightly different benefits, some things people dont know about or forget about are:

1. Meals delivered to your home following an admission to the hospital or Skilled Nursing Facility.

2. Wigs for cancer patients.

3. Shoes for diabetic patients.

4. Rewards by way of giftcards for doing preventive care like flu shots, annual physical...

Answer: Yes. Generally the deadline is 30 days although some carriers may allow 60. The person will have a Special Enrollment Period for any other Medicare Advantage plan.

Answer: Yes. OT is a benefit under Medicare Advantage plans. You will have a copay and you need a Doctor to place the order.

Answer: The short answer is no, you can do it on your own. Navigating Medicare—between Parts A, B, C, D, and supplemental options—can feel like a maze. Many people unknowingly overpay, duplicate coverage, or miss key deadlines, leading to avoidable expenses. Uninformed choices can be costly—especially when every dollar matters.

Working with a good independent agent does not cost you anything, provides you with comparisons and assurance that you are aware of all the deadlines and have an advocate who is working for you.

Answer: It's important to know that Ling Term Care also known as custodial care is never covered. The VA and Medicaid and Long Term Care plans are the only ones that cover those services. Short term admissions at Skilled Nursing Favilities are covered by Medicare.

At this time, it is too soon to know what impact the audits will have on any of this.

Answer: Who is my reliable resource, and will they be there to help me when I have a question? It is important to work with someone who is knowledgeable, who can help you with any Medicare plan type and will go to bat for you against the carriers if a problem arises. The individuals at the insurance company and the phone numbers you see on TV are less likely to have the same contact for you and be less willing to help you later.

Answer: Enrolling in one plan and staying with it year after year. It is important to review your plan changes, compare your plan with other plans and make a good choice for you. Your insurance carrier is not loyal to you; why should you stay with something that doesn't give you the best benefits at the lowest cost?

Answer: Once you hit the catastrophic phase, the medications that are on the plan formulary, including any your physician got added for you will cost you $0.

Answer: Home health is a covered benefit on Medicare Advantage plans; it must be ordered by your physician/provider, and it must be supported by medical necessity.

Answer: Check every doctor you see or want to see, check every medication you are on, and take the time to understand your benefits, including the ones you do not think you will use.

Answer: Medicare Advantage plans may have a $0 premium, but this does not mean that you will not pay anything for services. In place of an additional premium, you will have copays and coinsurance for the services you use.

Some individuals with Medicaid may not have copays and coinsurance due to the state Medicaid program picking up the cost-share amounts for them.

Answer: The best place to start is the provider's Compliance Department, or your Medicare Advantage or Supplement carrier. If you do not get a satisfactory response within a reasonable time, you can report directly to Medicare, to your State Department of Insurance, or to the Office of Inspector General.

Answer: Medicare covers the surgery, pre- and post-operation, a standard lens, and one pair of glasses after each eye is done. A standard lens is a single distance. If you select an advanced lens, for multiple distances, or astigmatism, then you can expect to pay for that lens yourself.

Answer: Annual Enrollment is October 15 through December 7th each year; any change you make during this time will go into effect January 1. You may also qualify for a Special Enrollment based on a number of factors. It is best to contact an independent licensed agent to see if you have an enrollment period. Medicare Supplements can be changed at any time, but will require answering health questions unless you have a specific circumstance that qualifies you for Guaranteed Issue.

Answer: As long as your employer group plan is creditable under Medicare, you do not need to apply for Medicare. Employers are required to provide this information in September/October each year. That said, you may be surprised to find that Medicare is more cost-effective for you. It's good to compare costs and options side by side each year.

If, however, your employer group plan is not creditable, you will need to enroll in Medicare Parts A, B, and D to avoid late enrollment penalties.

Answer: I love helping people with something that can be confusing and frustrating for so many. I enjoy being a resource in my community.