Heidi Wotton, Medicare Insurance Agent

Answer: Medicare is definitely under pressure as more baby boomers age into the system, but it’s not on the verge of collapse. While the Part A trust fund may face funding challenges in the future, that doesn’t mean benefits will disappear—it just means adjustments will likely be needed. Parts B and D are funded differently and will continue as long as the government supports them. The more realistic outcome is gradual change, like higher premiums or shifts in coverage, rather than a sudden crisis.

Answer: Yes. Medicare covers hip, knee, and shoulder replacement surgery when it is medically necessary.

Part A helps cover the hospital stay, and Part B helps cover the surgeon, outpatient services, and follow-up care. Your out-of-pocket costs will depend on whether you have Original Medicare only, a Medicare Supplement, or a Medicare Advantage plan.

Answer: HMOs can save money, but they’re best for people who are comfortable staying in one network and getting referrals. If flexibility and provider choice matter more, another plan type may be a better fit.

Answer: The right plan depends on your parent’s specific medications and pharmacy. What works for one person can be very expensive for another.

Answer: Yes. Losing employer coverage usually qualifies you for a Special Enrollment Period, allowing you to enroll in Medicare without penalties.

Answer: Yes. You can meet with multiple Medicare agents to compare options before deciding who to work with.

Answer: If covered under your spouse’s active employer plan, you can delay Medicare Part A without a penalty. When that coverage ends, you have a special enrollment window to sign up.

Answer: Once you hit the max out-of-pocket on a Medicare Advantage plan, you shouldn’t have any more copays for covered medical services for the rest of that plan year. That’s the point of the limit. Just make sure the services are in-network and medically covered by the plan.

Answer: If you have Medigap Plan C, your bloodwork should be covered as long as it’s ordered by your doctor and Medicare approves it. Plan C helps pay the Part B coinsurance, so you usually won’t have extra costs for standard lab work.

Answer: A Medicare agent can help you with Medicare plans, but they might only work with one company. A broker works with multiple companies, so you get to compare options in one place. I work as a broker, which means I shop around to find what actually fits you.

Answer: Medicare usually doesn’t cover things like stairlifts, but some Medicare Advantage plans may offer limited home safety benefits. I can check what’s available for your situation.

Answer: If you miss Open Enrollment, don’t panic. There are certain Special Enrollment Periods that may still let you change your plan — like moving, losing other coverage, or certain health or income changes. Just reach out and I’ll help see if you qualify for one of those windows.

Answer: Original Medicare is pretty limited with holistic care and mostly sticks to medically-necessary treatment. Medicare Advantage plans can sometimes include extra wellness benefits, like acupuncture, chiropractic, fitness programs, or over-the-counter allowances. It depends on the plan, so it’s something we compare to see what fits your needs.

Answer: You can call the insurance company, but they’ll only tell you about their plans. When you work with me, I compare multiple companies side-by-side and help you figure out what actually fits your doctors, medications, and budget. It saves time, stress, and guesswork.

Answer: Medicare Part A does cover hospital stays, but it’s usually not enough on its own. There are deductibles and costs you may still be responsible for, so most people add Part B and sometimes a supplement or Advantage plan to help with those gaps.

Answer: A lot of people don’t realize their plan may include things like over-the-counter allowances, gym or fitness programs, transportation to medical appointments, meal delivery after a hospital stay, or hearing and dental discounts. It really depends on the plan, so it’s always worth reviewing to make sure you’re getting everything you’re entitled to.

Answer: No, Medicare doesn’t usually cover supplements, herbs, or homeopathic treatments. Most natural or alternative therapies are paid out-of-pocket, with a small exception for acupuncture in certain cases.

Answer: Yes — but it’s limited. Medicare can cover Medical Nutrition Therapy if someone has diabetes or kidney disease, or has had a kidney transplant in the last 36 months. Therapeutic supplements are usually not covered unless they are part of a feeding tube or medically necessary nutrition ordered by a doctor.

Answer: Yes. Medicare does cover mental health therapy by telehealth. You can talk with a licensed therapist or mental health professional by phone or video, as long as they accept Medicare or are in-network with your plan.

Answer: Because Medicare can feel overwhelming — there are a lot of plans, fine print, and changes every year. A good agent listens to your needs, helps you compare your options, checks your doctors and medications, and makes sure you’re in a plan that fits you — not just what’s advertised. There’s no cost to use an agent, and you have someone you can call anytime if questions or issues come up later.