June Anguiano, Medicare Insurance Broker

Answer: Yes you can, and many people choose to do so. Medicare is for your health coverage needs. If your employer qualifies as having creditable prescription drug coverage, you may even be able to delay or pause your drug care coverage if you also have that benefit through your job. A confirmation through your HR department and you can avoid those Part D late enrollment fees!

Answer: Original Medicare does not cover routine foot care. For any foot care to be covered by Original Medicare, it would need to be classified as medically necessary like an injury or infection. If you have a high-risk systemic condition, that, too, would be considered medically necessary. If this is something that you are looking for in your health coverage, some Medicare Advantage plans offer this extra coverage.

Answer: Yes, you could switch, but if you are enjoying your plan, there are other ways to address the expense problem. It may be wise to try applying for financial aid through LIS (Low-Income Subsidy). If it's easier to smooth out the prescription cost through a Medicare 12 month payment plan called the Medicare Prescription Payment Plan (MPPP), that could be looked into also. If switching plans is the way to go, then the Annual Enrollment Period for making those changes is between October 15 and December 7.

Answer: By September 30 you would have received a letter from Humana, called an ANOC (Annual Notice of Change), about what changes that would be taking place with your coverage. You could also receive a letter by October 2 called a Plan Non-Renewal Notice. If your specific plan is not continuing into the next year, and you received an ANOC, it is possible that you're being transferred into a similar plan automatically. If you get the Plan Non-Renewal Notice, you will auto-revert to Original Medicare if no action is taken.

If you do not remember receiving or accidentally threw out those letters, there are four ways to check if your plan is available for the next year. The Medicare Plan Finder will list non-renewed plans as "Not Available" on the website. The call center at 1-800-Medicare could look it up for you. Your Carrier's Member Portal will have all mandatory correspondence available for view online, including the ANOC or Plan Non-Renewal Notice. You can also call the customer service on your member ID card.

Answer: Original Medicare does not cover self-administered prescriptions. If you have a standalone Part D plan or if you are on a Medicare Advantage plan that covers your prescription drug needs, then, yes. What's important is reviewing the plan's formulary each year to see where that drug falls in the coverage tier so that you can understand any required co-pays or cost-sharing.

Answer: Best case scenario is your current insurance carrier has the same plan in the new state. As long as you are not changing carriers and plans, then what is likely to happen is that you will get a rate adjustment based on your new zip code.

If you need (or want) a different carrier, the issue will be whether or not you get guaranteed issue protections. If you do, GREAT! If not, then you run the risk of not having a Medigap plan that will accept your current conditions OR a Medigap plan that is very expensive.

Best course of action is to "look before you leap." Before deciding whether or where to move, compare local rates and state-specific under-65 Medigap rules in the destination state.

Answer: I understand that is frustrating. But to answer your question, yes, that is allowed. Medicare has systems in place to keep costs down. If your doctor believes that the lower cost medication is harmful to you or medically inappropriate, you do have the right to appeal.

You or your doctor would ask your plan for a Formulary Exception through a standard request online, phone or mail. Your doctor can also give you or send in for you a statement or a Letter of Medical Necessity. The last thing to do is wait. It should take around 3 days. If that's too long to wait, you can send an Expedited Request. If it's still denied, you can file a Level 1 Appeal. You will have 60 days from the denial date to submit that formal appeal (Redetermination) through the drug plan.

Answer: Since you are not drawing Social Security benefits, you are receiving the bill for your Medicare directly. Their billing cycle is quarterly. Medicare has several ways to pay through an auto draft from your bank account (Medicare Easy Pay), going to Medicare.gov to pay directly online, by mail if you like sending checks or money order, or you can go through your bank to set up the bill pay. Once you start drawing Social Security benefits, Medicare will automatically deduct your premiums from that.

Answer: For those who choose to have a Part C plan, they receive extra benefits as part of being members of that plan's network. The OTC card typically is a prepaid card that allows its members to buy eligible health and wellness products at no additional cost. When your broker explained to you your health plan, they should have shown you your plan's Evidence of Coverage which tells you if they have an OTC card and what is considered eligible. You could review that document (also called a Summary of Benefits), log into your member portal for your health plan, reach back out to your broker, or call your plan's Member Services line.

Answer: When you turn 65 (or if you're older due to retirement) and enroll in Medicare Part B, you enter a period that will allow you guaranteed acceptance into a Medicare Supplement plan. This is good news if you know you have a pre-existing condition because you will not be turned down. It's a specific window of time that comes with that first enrollment into Part B. Outside of that window of time, the only other way to bypass medically qualifying for a supplement plan is by experiencing an event where you lose your health coverage at no fault of your own, or if you are in a 12 month trial period to see if you like Part C. If none of that applies, your pre-existing condition may be a determining issue.

Answer: Medicare can feel very complicated and frustrating when you are left to do it on your own. That doesn't mean it can't be done. Many people learn and figure it out. But having the peace of mind that you have your medical properly set up and (if you're working with a broker) a plan you may not have found without the insights of someone who understands the industry, can and does prove to make the process better each year that you review your coverage.