Juan Beraldi, Medicare Insurance Agent

Answer: Medicare only covers medically necessary services. Since the question specifies cancer risk based on family history, the testing will not be covered as it is not a current condition. Medicare does cover other preventive testing, and some of these tests are guided into cancer findings.

Answer: Each company plan comes with its own set of rules and tools to check which meds are covered, how much they cost, and if you’ll have to pay extra. You can look into this online or give the insurance company or a licensed agent a call.

Answer: Most, but not all, Medicare Advantage plans cover hearing aids with either a copayment or allowance. For more information, refer to the Evidence of Coverage or Summary of Benefits of the plan you purchased.

Answer: Yes, it will be covered at a $0 copayment if it is provided as a preventive screening service or at a 20% copayment if it is a diagnostic service under the Part B of Medicare.

Answer: The coverage of inhalers and nebulizers varies. Some of these devices are covered by Part D (prescription drugs). The list of these medications will be available on the insurance plan formulary by name, and some of them may not be covered.

Answer: Regrettably, HMO plans restrict access to medical services from providers outside the network. The sole exception is when a referral is issued by your Primary Care Physician, who must provide a specific reason for the referral to an out-of-network provider.

Answer: To remain informed about Medicare policies and available options, it is advisable to consult with a licensed insurance advisor, a S.H.I.P agent, or refer to the annual Medicare and You publication.

Answer: Certain Medicare Advantage plans may have a zero premium, but they are not truly “free.” The premiums for these plans are directly paid to the insurance company selected by the member by Medicare.

Answer: All Medicare supplemental plans undergo annual premium increases as individuals age. Premiums are determined by factors such as gender, age, out-of-pocket expenses, and state of residence.

Answer: Medicare does not provide coverage for hearing aids. However, certain insurance companies offer coverage for hearing aids through Medicare Advantage plans in select states, subject to a copayment.

Answer: The cost of healthcare in the USA is very high and the amount we pay for Medicare coverage cannot pay for all services. For Medicare to pay a higher amount to lower our out-of-pocket, they will have to increase the Medicare premium and amounts we pay on our taxes.

Currently the Medicare premium is $185. They also pay 80% on the medical expenses (Part B) and have a Part A deductible (Hospital) of $1632 for hospital stay up to 60 days.

If you'll like more details about it's coverage and how to lower your out-of-pucket, you can call me and I can explain in more details

Answer: There are many plans available. An agent can compare plan options, look at your medication and the doctors that are important to you. Benefits are different based on your specific needs and wants and information can be overwhelming. Agent like myself, have to be familiarized with all plan options to be able to explain and compare plans so you can make the right decision. Also, a great experienced agent will be available for you, not only at the time of enrollment, but also while you are in the plan. This is also true when problems arises in the future. There is no perfect plan out there, a real agent will be available for you all the time. I’ve been doing Medicare for the part 20 years and I can guide mot only at the beginning but also throughout you life. Plans are many but there is lack of guidance and support. You can call me if you have any other questions

Answer: You should start your Medicare as soon as your employer coverage expires. You need to sign up for Medicare Part A (Hospital) & part B (Medical). You sign up online, by phone, or in person with Social Security. If you are already getting a Social Security benefit, they will enroll you in Medicare automatically, but if you’re not planning to get Social Security yet, then you will need to contact them and enroll. Your new coverage should start on the 1st of the month after you lose your employer coverage.

Once you get this done, then you can enroll in a supplemental plan or Medicare Advantage, and a prescription drug plan. Your plan choice will start together with Medicare if you enroll before the effective date of your Medicare coverage.

I can go more into detail regarding the difference between a Medicare Advantage plan and a supplemental plan. You can contact me and we can set up an appointment.