Janet Cruz, Medicare Insurance Broker

Answer: It depends Medicare and Life Insurance are two separate entities.

Medicare covers:

Hospital Stays Part A

Medical Services Part B

Prescription Drugs Part D

Some preventive and outpatient care.

It does not provide Life Insurance.

Life Insurance provides a death benefit to your beneficiaries after you die.

Funeral/ Burial Expenses

Debts

Final Medical Bills

Estate Taxes

Bottom Line, Medicare doesn’t replace life insurance. You might want to have a small policy if you don’t want your loved ones burdened with final expenses or if you want to leave something behind.

Answer: Medicare parts A and B is portable in all 50 states which means it doesn’t change.

If you have a Medicare Advantage Plan, a Medicare Supplements or a Part D they are all state specific. You may have to change your plan based on the state you move to if you have any of these.

Otherwise, just update Social Security with your address.

Answer: Many people choose Medicare Advantage (MA) plans based on low or $0 premiums, only to find out later that copays, coinsurance, and out-of-pocket costs can add up, especially if you need frequent care.

Here’s a breakdown of a Medicare Advantage Plan, in my opinion

1. Low premium = higher cost-sharing: Plans with $0 or low monthly premiums often have higher copays for services like specialist visits, hospital stays, or physical therapy.

2.If you’re generally healthy and rarely need care, these plans can save you money. But if your health needs increase, the out-of-pocket costs can spike.

3. Networks can be limited: Some MA plans also have narrow provider networks or require prior authorizations, which can affect access and costs.

Whenever you have a Medicare Advantage plan, pay attention to the maximum out of pocket costs, which is usually $4,000-$9,000 annually depending on the plan.Compare it to what you’re spending and see if it makes sense.

This wasn’t a mistake it was a trade off based on what you knew and expected.

I hope this helps.

Answer: One piece of advice I wish every senior knew before picking a plan is not to choose it based on the monthly premium. Look closely at total annual costs and whether your prescriptions, doctors and hospitals are covered.

Many people look at Medicare Advantage plans with a $0 premium, but in the long run for serious issues they can come with a higher out of pocket costs later. This remains true especially if you need specialists, travel frequently or have chronic conditions.

Always check for maximum out of pocket limits to avoid unexpected expenses and make sure to always check the formulary for medications and network for your preferred providers.

Answer: Marijuana is classified as a schedule 1 controlled substance under federal law indicating it has no currently accepted medical use and a high potential for abuse. So, no, it is not covered by Medicare. Medicare cannot cover substances that are illegal at the federal level even though state laws permit its use.

Answer: Medicare advantage plans cover medically necessary eye surgeries, such as glaucoma or cataracts procedures.

Each Medicare advantage plan has its own cost sharing structure. You’ll need to review your plan’s summary of benefits.

Furthermore you may be responsible for out of pocket costs depending on the plan you have.

Answer: Medicare Parts A and B do not cover dental implants or other routine dental care. Such as:

Cleanings

Tooth extractions

Fillings

Dentures

The only way Medicare would cover dental work, is if it’s medically necessary, for example:

Jaw reconstruction, after an injury or tumor removal.

Infections or complications, where delaying the dental work, would impact another medicare covered treatment, like heart surgery.

Some Medicare Advantage Plans (Part C)

Offer dental implant coverage,coverage, copays and limits may vary by plan. Some may offer $1,000-$2,000, which will leave you paying the rest out of pocket.

Answer: You can use concierge medicine with Medicare but :

Your experience will vary depending on whether your doctors take Medicare or not.

You’ll pay out of pocket for the membership fee.

You’ll still use Medicare for other medical services.

How it works with Medicare:

Your concierge doctor may bill Medicare for office visit or labs or they may opt out of Medicare all together. It all depends.

Answer: Medicare does not cover assisted living—it actually falls short when it comes to help with high costs of assisted living. If assisted living might be needed planning ahead through Medicaid or other insurance is crucial. Medicare it’s primarily designed for medical care, not daily living support, like assisted living.

Answer: A common Medicare myth—even some agents still believe is that Medicare covers long term custodial care. This is not true. Medicare does not cover long term care services. Such long term care services like nursing homes or asisted living care.

The only service that Medicare covers under care, is short term skilled nursing facility care after a qualifying hospital stay and only under specific conditions and up to 100 days. This is considered as helping with daily tasks, such as bathing, dressing, or eating.

Answer: The biggest disadvantage about having an advantage plan is the limited provider networks and higher out of pocket costs when you go out of networks. It’s also a disadvantage if you live in múltiple states. Your limited to care based on your location, sometimes, it doesn’t travel with you.

Answer: The catastrophic coverage phase worked this way, in previous years you would have to pay 5% of the cost of each drug or a small copay whichever is greater. After you reached the catastrophic ( troop). The plan and Medicare pays the rest.

Starting in 2025 once you hit the annual out of pocket max there will be no more catastrophic cost phase sharing.

The maximum (troop) limit for 2025 is $2,000 one you reached the $2,000 limit for out of pocket drugs, you pay nothing for your medications.