John Ward, Medicare Insurance Broker

Answer: There are several regulations that may be considered outdated or unfair to seniors, but that really depends on your perspective. I'll mention one here: No Annual Out-of-Pocket Limit for Original Medicare for Parts A and B. This can present a problem for individuals who don't purchase a Medigap plan.

Answer: Yes. Whether you can be denied depends largely on when you apply and where you live.

A Medicare Supplement Insurance (Medigap) insurer can deny your application in many situations, but there are important exceptions.

You generally cannot be denied during your Medigap Open Enrollment Period. This is a six-month period that begins when you're both age 65 or older and enrolled in Medicare Part B. During this time, insurers generally must sell you any Medigap policy they offer, cannot charge you more because of your health, and cannot impose waiting periods for pre-existing conditions in most circumstances.

You may be denied if you apply after your open enrollment period and you don't have a guaranteed-issue right. In most states, insurers can use medical underwriting, meaning they may review your health history and decline your application or charge more based on certain medical conditions.

You cannot be denied in certain situations where you have guaranteed-issue rights, such as if you lose certain types of health coverage through no fault of your own or in other circumstances defined by federal or state law.

Answer: Medicare is a US health insurance program, and in almost all cases, it does notcover you if you live outside of the US. Certain Medigap plans cover emergency foreign travel but typically with monetary financial limits. If your an expat you should purchase international or local health insurance in your country of residence.

Answer: If you have fewer than 30 quarters you may enroll at a cost of $505 permonth for Part A as for Part B you may enroll at the standard premium amount of $185 for year 2025. Part D will be available if your elligible for Part A or enrolled in Part B.

Answer: Medicare covers many screenings, vacinations, and wellness visits at no cost to you which promotes healthly living. An annual free wellness vist is available to all Medicare beneficiaries. Extra perks can include gym memberships, nutrition classes, e=weight-loss programs or wellness coaching. Some plans give gift cards or discounts if you complete preventative screenings, vacinations or wellness checkups.

Answer: Premium are membership fees, thatt is what you pay every month just to have Medicare coverage, many plans do not have a premium. Deductibles is the cost that must be paid prior to Medicare starts paying for most covered services. Co-pays are basically a fixed payment for a covered service.

Answer: Yes in most cases you can continue using your current doctors. You must stay within the network and if your doctor is in the network you can see him, if not it will cost you more.

Answer: Physical Therapy generally has a co-pay that your responsible for, amount depends on your plan. Your physician must order the therapy and number of visits allowed. If in doubt check your plan summary or call your insurance company in advance. Always be a self-advocate.

Answer: Medicare Part A covers hospice care under specific conditions. A doctor must certify that the patient has an illness with a life expectancy of six months or less, and the patient must elect hospice care instead of curative treatments for that illness. Medicare covers four levels of hospice care: routine home care, continuous home care, general inpatient care, and respite care.

Answer: Yes guaranteed issue rights are available after Open Enrollment, but are limited to specific circumstances. Guaranteed issue means 1) no denial based on health status, 2) no medical underwriting, 3) no rate increase. Please discuss your circumstances with a licensed agent.

Answer: Agents offer personalized advice, access to multiple plans, and can simplify the Medicare enrollment process. Agents can also help you understand your coverage options, potentially saving you time and money.