Jerry Cohen, Medicare Insurance Broker

Answer: I think the most important question a person should be asking about Medicare is how will MediCare cover things if I develop a serious medical problem. Which plan will be easier for me to get the care that I need if I develop a serious medical problem a Medicare supplement or a Medicare advantage plan?

Answer: I like using materials that are published by the Federal government as a big part of my introductory meeting with a client. The government publishes a tremendous amount of useful and informative materials on just about evry Medicare topic. I have also taken the time to put together questionaires that I complete with new clients to find out what medications they are using and whether they have any doctors that are important to them. If a specialist or two are mentioned this gives me a track to question so far as the extent of the medical item the person might be experiencing.

Answer: A person would need to have a crystal ball to predict the future in terms of treatments and costs that may surface over the next 10 years. Given the current fnancial issues at medicare it may be good to asume that coverage reductions will occur or higher cost sharing will be expected from covered participants so the answer is liquid cash; easily accessed if needed for medical costs is the smartest strategy.

Answer: While Medicare does encourage maintenance of good health by covering an annual physical each year the real support comes from Medicare Supplement or Medicare Advantage plans that cover gym memberships and healthy living options such as dieting and smoking cessation.

Answer: For people who want a Medicare Supplement plan who currently are in good health High Deductible plans offer a low monthly premium even though they require satisfaction of a high dedutible before they cover medical costs. If a person is in good health they also may be willing to consider a Plan N over a Plan G wit the only difference in the two plans being a $ 20 Co Pay on Plan N when and if a person needs medical services.

Answer: There is a lot of confusion about what Medicare will and will not cover under the " free " status so far as it pertains to an annual physical.

What Medicare will pay for isa a visit that only addresses health maintenance and preventive care. Included in the Medicare annual wellness visit there is no requirement for an actual hands-on physical exam such as listening to your heart and lungs.

It is really just to check on stuff that is not actively going on that you might not have symptoms of—and that’s what makes it different from other types of visits where you usually go in because either you’re sick, you’re not feeling well, there’s something wrong or you already have a disease that you’re managing and want to make sure that it hasn’t gotten worse or ... what to do next for it. Medicare calls the visit to the doctor an Annual Wellness visit. There is also a one time Welcome to Medicare visit which is covered by Medicare at 100% but it is not the same as a comprehensive Physical Exam.

Answer: My first question is did you check to make certain that the providers you value are in the network of the plan you purchased. Second did you clearly understand the plan deductibles for in and out of network care. Were you clear on plan Co Pays in and out of network? Are you receiving services that are covered by Medicare?

Answer: Generally Medicare will cover hospice care 100 per cent. In order for expenses to be covered you need to use a facility that participates with Medicare.

Answer: The main benefit of Medicare part D is that the cost of prescription medications are covered in part or totally by having this coverage. If you are covered by a Medicare part D plan the most you could be expected to pay for prescription medications is capped at $2000 for the year.

Answer: If we are talking about Original Medicare Parts A and B the answer is No. Original Medicare never included coverage for dental expenses. Covered isureds have the option of purchasing individual dental insurance which may or may not cover dental implants. Depending on circumstances, Original Medicare may cover some of the medical costs of implant insertion like prescription medication.

Answer: Eklimination of the donut whole means that a big portion of patient cost sharing on prescription medication expenses has been eliminated. In 2025 maximum out of pockets expense for a covered person becomes $ 2,000.

Answer: Nothing was missed in signing up for Medicare Parts A and B. Medicare Part A has no premium because it was paid for from income earned during the workin g life of the insured. In the case of Medicare Part B, no seperate premium was paid for during a person's working life which means that in retirement there is a payment to be made.

Answer: The Medicare Savings Program is a Medicaid-administered program that can assist people with limited income in paying for their Medicare premiums. Depending on income, the MSP may also pay for other cost-sharing expenses. When you enroll in an MSP, you will also automatically get Extra Help, the federal program that helps pay most your Medicare prescription drug (Part D) plan costs. There is no resource test for the MSP programs. This means many Medicare beneficiaries who may not qualify for Medicaid because of excess resources can qualify for an MSP.

Answer: There realy is no " best " insurance company so far as Medicare Supplements since all supplemental plans are standarized by the Federal government with a letter of the alphabet depending on the benfits offered by a specific plan. The only criteria that really differentiates Medicare Supplement plans is the monthly premium for a given letter of the alphabet and whether ( in states that permit it ) whether a person qualifies based on underwriting.

Answer: Medicare offers at least two ways to reduce costs for benificiaries. The Kow Income Su

bsidy reduces costs on prescription medications and the costs of drug plan premium.A second form of assistance comes in a program called a Medicare Savings Plan which lowers deductibles, co pays, and premiums for beneficiaries.

Answer: It depends. The questions does not state the destination of the travel , whether it is in the U.S. or outside the boundaries of the U.S. Medicare supplement plans C, D, E, F, G, H, I, J, M, and N pay up to $ 50,000 for costs involved in medical care abroad for an emergency. Within the United States a Medicare supplement provides coverage throughout the country as long as a provider accepts Medicare. Many Medicare Advantage plan networks also provide national coverage and many plans also have out of network coverage and generally speaking Medicare Advanatge plans are less costly than Medicare Supplements even though they have greater restrictions.

Answer: Medicare does not actually provide prescription coverage the specific plan you are enrolled in has what is known as a formulary. You cneither look at the formulary and see if your medication is covered or you can call customer service at the company you are covered by. If you have not obtained coverage yet you can go to the Medicare.gov website and look at the all the presciption plans for the area you live in. You can input the name and dosage of the medication you are covered by and see if it comes up with any of the plans available.

Answer: Medicare Parts A and B do not cover any of he cost associated with buying hearing aids or the testing for them. Some Medicare Advantage plans will cover some or all of the cost for hearing aids so long as a network participating provider is used.

Answer: Theoretically Medicare will look up your adjusted gross income as reported to the IRS and reduce or eliminate the IRMAA charge without the beneficiary doing anything. As we are delaing with a government agency I see no reason why a phone call to Medicare at the time of the Adjusted Income figure could not hurt the beneficiary just to make sure they pay the amount they should be paying.

Answer: This question omits information like whether the surgery is being performed by an in network or out of network physician but in either case, there will be an out of pocket amount to the patient in the form of deductibles; co insurance; and Co Pays.

Answer: Medicare covers insulin pumps under Medicare Part B as Durable Medical equipment. There is a 20 percent copay charged to the patient.

Answer: yWhen you have Medicare based on a disability and turn 65, you'll have continuous coverage with no interruption. At 65, the reason for Medicare entitlement changes from disability to age, and you get another IEP. This 7-month IEP starts 3 months before the month you turn 65 and ends 3 months after you turn 65.

Answer: All Medicare supplements have been standardized by the Federal government meaning that for a given letter of the alphabet all insuers must provide exactly the same benefits. For most people the choice is pretty simple...if they want the benefits given in a specific letter of the alphabet it probably makes the most sense to select the plan with the lowest cost.

Answer: The best way to verify the benfits of a given plan are to either look at the outline of coverage provided on the edicare.gov website for that specific plan. The insurance company offering he plan also prints a booklet called the Evidence of Coverage that in great detail spells out all the benfits of a given Medicare Advantage plan.

Answer: Situations difer depending on the type of provider being searched. The best thing to do is call the Customer Service area at the company you are covered by and explain that you cannot find a dentist anywhere near your home and let them look into the situation. Often times the company has names of providers that for whatever reason are not listed on the web portal covered people have access to.

Answer: The first and most important step is to make certain that Medicare will be activating your Part B coverage as of your birfthdate assuming you will no t have access to an employer or individual plan once you turn 65. If you have a definite answer to the Part B question the next item is deciding what form of supplemental coverage you would like to have an Advantage plan or a Supplement plan.

Answer: Under most circumstances ( residence for one ) you cannot go from a Medicare Advantage plan tto Supplement plan without answering medical questions. Some states only allow you to buy certain supplement plans with guaranteed-issue rights outside your Initial Enrollment Period if you want to make this switch. Medigap carriers do not have to accept your application unless you have a qualifying election period or live in a state with additional Medigap guaranteed issue (GI) periods. This means there’s no guarantee you’ll be able to switch.

Answer: There are at least two things a Medicare Advantage covered person can do to avoid surprise bills for lab tests 1. make certain that thelab in questions is a participant in the network of the plan you are covered by. 2. Consult with the company or the Evidence of Coverage to make certain that the specific test being requested is a covered test under your plan and what the terms of coverage are.

Answer: The answer to this question is .... it depends. There are qualifications to receive approval on this type of device. 1. The person must be utilizing insulin to control their condition. 2. The doctor must prescribe the use of the device 3. The doctor has to be reasonably sure that you or your caretaker have the knowledge and skill to utilize this device.

Answer: MOOP refers to the highest amount a person can be asked to pay for covered expenses on a Medicare Advantage plan. The Federal government estableshes the MOOP each year but insurance companies are permitted to use a lower figure if they wish. The MOOP includes network expenses for deductibles; CoPays; and hospital related expenses.

Answer: This is an individual choice based on the fact that Medicare Part B leaves the patient with an unlimited 20% cost sharing on covered medical expenses. Some people are willing to self insure and do other thimgs with their money as opposed to obtaining supplemental coverage.

Answer: The answer is...it depends on your state of residence. Most states do not provide guaranteed issue rights so a person switching from one plan to another will need to answer medical profile questions. If the insurance company does not like the answers provided by the applicant you can be rejected. The only states offering guranteed issue Medicare supplement coverage are: Connecticut, Massachusetts, Maine, and New York.