Juan Osborn, Medicare Insurance Agent

Answer: Possibly. Original Medicare includes Part A - Hospital and Part B - Medical. In general, this takes care of 80 percent of normal healthcare costs. Original Medicare requires that you pay the remaining 20 percent. Should you require care that can be expensive, such as surgery, treatments, hospitalization, etc., your portion can get out of hand. On the plus side, Original Medicare does not restrict you from using any doctor or specialist you want. Not just locally, but all over the United States. That said, you might want to see if your doctors and specialists belong to any networks called Medicare Advantage Prescription Drug (MAPD) plans. Many doctors accept MAPDs. If you are able to find an MAPD plan that your doctors accept, you could minimize the 20 percent you are paying now. Also, these MAPD offer other benefits like Dental, Vision, Prescription Drug saving's and low copayments for office visits. Remember, under an HMO plan you must stay within your network. If you like, a PPO cost more but will have higher costs when using out of network doctors and specialists.

Answer: Yes! A program called Extra Help offers assistance to low-income individuals to help with premiums, deductibles, and co-payments. You can apply on Social Security website or contacting Medicaid. Also, Medicare began a new program in 2025 that limits your annual drug costs to $2000 for the year. In 2025, this means your monthly average costs will not exceed $167. In 2026, it increases to $2100 or $175 monthly. Finally, there are many discount cards offered by pharmacies and health organizations.

Answer: Yes, Medicare does offer FDA-approved digital therapeutics (DTx) for mental health treatment. This requires a doctor's prescription. There is also coverage for remote patient monitoring that gathers physiologic data for ae and chronic conditions.

Answer: The discount you receive is from not requiring medical attention because of health reasons or an accident. Also, keep in mind that you are part of a large group that benefits from a large pool of plan participants. This allows for reduced cost per person and provides needed cost protection from serious hospitalization, surgeries, and other high cost.

Answer: Yes, most blood thinners are covered by Medicare. Part D typically covers thinners like Eliquis, Xarelto, Warfarin, Heparin, and Enoxaparin.

Answer: There are several penalty possibilities with Medicare:

1. Part D, which includes 1% of the average premium for every month without credible coverage

2. Part B has a 10 percent minimum increase for each 12-month period of delayed enrollment without minimal coverage.

3. Part A has a penalty of 10 percent of the premium for twice the number of years you delayed enrollment.

Answer: Not necessarily better but many times more popular. There are many reasons people choose a particular provider. Often times, it is location dependent as well as reputation. Since they all have minimal requirements and benefits they must meet, it is more often about meeting the clients expectations than about being better.

Answer: I would start by asking all the basic questions about their current care and all their needs, I would share with them all the plans available that include the doctors, special care, prescriptions, and any other needed programs. Together we review the remaining plans and decide on best fit.

Answer: Yes, Medicare Part B covers chiropractic care, but only for manual manipulation of the spine to correct a vertebral subluxation.

Answer: No, not everyone over 65 qualifies for Medicare automatically. Eligibility also depends on factors like U.S. citizenship, or whether you or your spouse have worked long enough in Medicare-covered employment to receive premium-free Part A.

Answer: Medicare Part A and Part B (also called original Medicare) or a Medicare Advantage Plan. To qualify, a doctor must certify you are homebound, need skilled care, and have a specific illness or injury.

Answer: Medicare appeals take 60 days under standard conditions. 14 days for expedited pre-service appeals. The one used depends on the level of review needed.

Answer: To begin with, there are more options and recent changes in the Medicare marketplace than ever before. As such, there are new carriers and new Medicare plan changes that are sometimes difficult to understand. A licensed Agent will know what information is needed to determine the optimal health plan options available. Considerations include client needs regarding doctors, specialists, medications, healthcare facility choices, special needs, cost, and more. A licensed Agent can assist clients with all of these requirements and can save them time and money in finding the right plan for their needs.