Jake Purvis - CMIP, Medicare Insurance Broker

Answer: Yes, Medicare covers MRI scans when they are considered medically necessary and ordered by a doctor. Medicare Part B usually covers outpatient MRIs, but your out-of-pocket costs will depend on the type of Medicare coverage you have and where the MRI is performed. Some Medicare plans may also require prior authorization before the scan is approved.

Answer: Some Medicare Advantage plans may automatically assign you a primary care doctor if you do not choose one when you enroll. In many cases, you can change that doctor later if you prefer someone else. Original Medicare does not require you to select a primary care doctor. It is always a good idea to review the doctors available in a plan’s network before enrolling.

Answer: If you qualify for Medicare because of a disability, enrollment happens automatically after you have received Social Security Disability benefits for 24 months. Your Medicare card is usually mailed to you before your coverage begins. If you are unsure about your eligibility or timing, contacting Social Security or speaking with a Medicare agent can help make sure everything is on track.

Answer: Yes, Medicare covers medically necessary shoulder replacement surgery. Medicare Part A helps cover the hospital portion, while Part B helps cover doctor visits, outpatient care, and follow up treatment. Your actual out of pocket costs will depend on the type of Medicare coverage you have.

Answer: The simple answer is you really can’t. Medicare Advantage plans change every year, sometimes for the better and sometimes not. Premiums, copays, prescription coverage, and extra benefits can all change annually, and sometimes plans stop offering coverage altogether. The good news is that Medicare gives you the Annual Enrollment Period each year to review your coverage and decide if a different plan makes more sense for the following year. Also, if your plan ever leaves the market, you may qualify for guaranteed issue rights to enroll in other Medicare coverage without health questions.

Answer: Yes, Medicare does offer some coverage for chiropractic care, but it is limited. In most cases, Medicare Part B will cover medically necessary spinal adjustments. Things like massage therapy, routine maintenance visits, or other services at the chiropractor’s office are usually not covered. Depending on the Medicare plan you have, your costs and coverage can vary.

Answer: Most people can enroll in Medicare during their Initial Enrollment Period, which starts three months before the month they turn 65, includes their birthday month, and lasts three months after. This is usually the best time to enroll because you can avoid late penalties and gaps in coverage. Enrolling early also gives you time to review your options and choose coverage that fits your healthcare needs.

Answer: If you have TRICARE or VA benefits, Medicare still plays an important role when you turn 65. With TRICARE, you generally need to enroll in Medicare Part A and Part B to keep your TRICARE coverage. With VA benefits, you can use VA healthcare facilities, but Medicare is still important for care outside the VA system. Having both helps ensure you are covered in more situations and avoid unexpected costs.

Answer: Most people simply are not told about it.

When you first enroll in Medicare Part B, you get a one time Medigap open enrollment period where you can buy a Supplement plan with no health questions. After that window closes, insurance companies can ask health questions and can decline you.

This rule is buried in Medicare materials and rarely explained clearly, so many people assume they can sign up anytime.

This is one of the biggest reasons working with a Medicare agent matters. An agent makes sure you understand these deadlines before they pass so you do not lose guaranteed options.

Answer: If your preferred hospital is not in network, it is important not to ignore it. Using an out of network hospital can lead to much higher costs or limited coverage except in emergencies. You may be able to switch to a different plan that includes your hospital during an enrollment period, or consider other coverage options that give you more flexibility. A Medicare agent can help review your situation and determine the best path forward based on your needs.

Answer: Original Medicare does not include routine dental and vision care, so most people add coverage separately. This can be done either through certain Medicare Advantage plans that include additional benefits or by purchasing standalone dental and vision insurance plans. The best choice depends on your healthcare needs and budget, and an agent can help compare options to find what fits you best.

Answer: The best protection is to STOP ANSWERING CALLS from unknown numbers and never share your Medicare number or personal information with someone who contacts you unexpectedly. Medicare will never call you! Be cautious of offers that sound urgent or too good to be true, and when in doubt, check with a trusted Medicare agent before making any changes.

Answer: Yes, Medicare costs can be different for each person. What you pay depends on things like your income, the plan you choose, the medications you take, and how often you use healthcare services. Premiums, copays, and prescription costs can all vary, which is why it is important to look at Medicare options based on your personal situation rather than assuming everyone pays the same.

Answer: It depends on the type of coverage you want and your overall healthcare needs. Medicare Part D is prescription drug coverage that you add to Original Medicare, while Medicare Advantage combines medical coverage and usually includes prescription drugs along with extra benefits. In many cases, prescription coverage is stronger and more affordable within Medicare Advantage plans, but some people still prefer Original Medicare with Part D for greater freedom to choose doctors. The best option depends on your medications, health needs, and budget.

Answer: One of the biggest hidden costs is prescription drugs. Many people focus on doctor and hospital coverage but do not look closely at how their medications are covered. Copays, drug tiers, and plan changes can cause costs to add up quickly, which is why reviewing drug coverage every year is so important.

Answer: If you travel often within the U.S., it is important to choose a plan that allows you to see doctors nationwide, not just in a local network. Original Medicare with a Medicare Supplement plan usually offers the most flexibility. Medicare Advantage plans may use networks but often cover emergencies when you are away from home. For international travel, Medicare usually does not cover care outside the U.S., though some Medicare Supplement and Medicare Advantage plans offer limited emergency coverage.

Answer: The Medicare Advantage 5 Star Special Enrollment Period lets you switch into a top rated Medicare Advantage plan one time during the year if one is available where you live. This is different from AEP, which runs from October 15 to December 7 and is when most people review and change plans for the next year, and OEP, which runs from January 1 to March 31 and only allows changes for people already on Medicare Advantage. The 5 Star period gives you an extra opportunity outside of those normal enrollment times.

Answer: What are the benefits of Medicare Advantage compared to Medicare?

Medicare Advantage plans often include extra benefits like prescription drugs, dental, vision, and hearing. They also have a yearly limit on how much you can spend out of pocket.

Is Medicare Advantage better if I have several health issues?

It can be for some people because of the out of pocket limit.

But you should always check doctor networks and copays to make sure it fits how often you use care.

Do more doctors accept Medicare Advantage?

Most doctors accept Original Medicare.

Medicare Advantage plans usually use networks, so not every doctor may be covered.

Do you pay more out of pocket with Medicare Advantage?

Many plans have low monthly premiums, but you usually pay copays when you get care.

Some people save money. Others who use a lot of services may pay more during the year.

Should I talk with an insurance agent?

Yes. An agent can compare plans, check doctors and medications, and help you choose the right coverage. There is no extra cost to use an agent.

Answer: Yes, in most cases losing employer health coverage gives you a Special Enrollment Period. This allows you to enroll in Medicare or change your coverage outside of normal enrollment times. It is important to act quickly so you do not have gaps in coverage or late penalties, and a Medicare agent can help make sure everything is done correctly.

Answer: Medicare is made up of different parts, and each one covers something different.

Part A covers hospital care

Part B covers doctor visits and outpatient services

Part D covers prescription drugs

Part C is Medicare Advantage; these plans combine coverage and often include extra benefits.

Medicare does not cover everything, which is why many people add additional coverage to help with out-of-pocket costs.

Answer: Yes, in most cases you can use money from your Health Savings Account to pay certain Medicare premiums, including Part B, Part D, and many Medicare Advantage plans. You cannot use HSA funds to pay for Medicare Supplement premiums. Once you enroll in Medicare you can no longer add money to your HSA, but you can still use the funds you already saved.

Answer: Medicare can be confusing, and plans change every year. A Medicare agent helps explain your options in plain language, compares plans from multiple companies, and makes sure your doctors and medications are covered. There is no extra cost to work with an agent, and you have someone you can call anytime questions come up. Most importantly, an agent helps you avoid costly mistakes and missed deadlines.