Kathy Detweiler, Medicare Insurance Agent

Answer: With original Medicare, they pay 80% and you would be responsible for the remaining 20%. This is why a lot of seniors get additional coverage to cover the cost of that remaining 20%.

Answer: Yes, if you are enrolled in a Medicare Advantage Plan or a Medicare Part D prescription drug plan, you will receive an Annual Notice of Change (ANOC) every year, typically by September 30th. This document outlines any changes in coverage, costs, or service areas for the upcoming year.

Answer: Medicare covers genetic tests and screenings only in limited situations, primarily when a doctor orders them as medically necessary for diagnosing or treating a specific condition you have.

Answer: Original Medicare parts A covers your hospital charges at 80 percent, leaving you responsible for the other 20 with no cap. Same with part B, your medical is covered 80 percent, with you left with the 20 percent.

You also must have part D, prescription drug plan

Dental, hearing, and vision would be a separate insurance.

It allows you to see any doctor or go to any facility that accepts medicare.

Medicare Advantage has co-pays and deductibles but with usually little or no premium. Your prescription drug plan is included along with dental, hearing and vision.

There are networks for your doctors and facilities.

Answer: You can call CMS and request a replacement.

They can help you get the replacement card. Also a licensed agent can look it for you and give you your Medicare ID number until the replacement arrives.

Answer: Special needs plans are plans that are for people either on Medicare/medicaid or people with certain chronic conditions. These plans offer special benefits that aren't available in regular MAPD plans.

Answer: You can apply for LIS also known as Extra Help. That will lower your drug costs significantly. You apply online. Contact an agent and they can help you apply.

Answer: Yes, Medicare covers inhalers and nebulizers.

Nebulizers are covered as durable medical equipment (DME) under Medicare Part B, while inhalers are covered as prescription drugs under Part D or a Medicare Advantage (Part C) plan that includes Part D coverage.

Nebulizers and necessary medications used with them, as well as replacement parts and repairs are covered under Part B, which covers DME for home use. You must have a prescription, and the equipment must be obtained from a Medicare-approved supplier.

Prescription inhalers themselves, which are covered as a prescription drug.

through Part D or a Medicare Advantage plan that includes prescription drug coverage. Coverage and costs vary by plan, so check your plan's specific details and formulary.

Answer: As we age, we know that it is just a matter of time until we face a health issue. It is better, if a person can afford it, to go with a supplement for the peace of mind of knowing that they offer stable, predictable out-of-pocket expenses, so you don't have to worry about a large bill in an emergency.

Also with a supplement you can see any doctor all over the country as long as they accept Original Medicare.

Answer: Unfortunately this can happen because doctors and healthcare providers can leave a Medicare Advantage network at any time due to contract disputes, lower reimbursement rates, or administrative burdens associated with the plan. This is why it is so important to do a plan review to make sure your doctors are still accepting your Medicare Advantage plan.

Answer: You want to take into consideration if you want a Medicare Supplement, which will fill the gaps of just having traditional Medicare. A Medicare supplement will allow you to see doctors all over the country and use any facility that accepts original medicare.

There are monthly premiums you will have to pay.

You must also sign up for a Prescription Drug plan to avoid penalties for not having one. You need one whether you stay on Original Medicare or go with a Medicare Supplement.

Neither of these offer hearing, dental or vision, you will have to get separate policies for those additional benefits.

Your other choice is enroll in a part C plan , also known as a Medicare Advantage plan. These usually work like your employment coverage, with deductibles and copays and maximum out of pocket. Most of them have 0 or low premiums, include the prescription drug plan and offer hearing, dental and vision.

In the end it is up to you as a consumer to pick what is best for your lifestyle, on how healthy you are and what extra benefits you want or need.

Medicare is complicated so reach out to an agent and see how they can guide you for a plan best suited to your needs.

Answer: Extra Help is a Medicare program to help people with limited income and resources lower their Medicare Part D prescription drug costs, such as premiums, deductibles, and copayments. If you qualify, Medicare pays for most of your drug costs, and you are exempt from the Part D late enrollment penalty. You can apply online through the Social Security Administration website, by calling the Social Security Administration, or with the help of your local State Health Insurance Assistance Program (SHIP).

Answer: No, you must use your Medicare Advantage card and not your Original Medicare card, because the Advantage plan is your primary coverage and Original Medicare will not pay for services while you are enrolled in the Advantage plan. If your provider does not accept your Advantage plan, you will need to find a provider who does, pay for services out-of-pocket, or wait for an eligible enrollment period to switch plans.

Answer: No, not everyone pays the same. Depending on your income, you could pay more for your Part B premium.

Also you may pay a Part A premium if you or your spouse didn't work and pay Medicare taxes for at least 10 years (or 40 quarters).

Part D premiums are based on the plan you choose and if you have to pay a late enrollment penalty.

Answer: Medicare covers numerous screenings for free, including an annual wellness visit, various cancer screenings (like colorectal, breast, and cervical), diabetes and cardiovascular screenings, and tests for depression, obesity, and sexually transmitted infections. Other free services include certain vaccinations like flu and COVID-19 shots, and an abdominal aortic aneurysm screening for those at risk. Some services require a specific risk factor, and frequency of coverage can vary.

Answer: There are meaningful changes coming to Medicare Part D in 2026 that could lower what you pay for prescriptions — but it’s not a guarantee, and the impact will vary depending on your specific medications, plan, state, and overall drug-spend.

You want to check your prescriptions to see if they are in the formulary of the plan you will be using in 2026.

Answer: The Medicare Part D "donut hole" was officially eliminated as of December 31, 2024

Now the most you will pay for medication is 2,001 for 2026.

Part D prescription drug deductible

The Part D prescription drug deductible is set by the federal government. In 2025 the amount is $590. In 2026 it will increase to $615.

Answer: No. You don't have to pay taxes on Medicare. It is not considered income. So it is not taxable.

Medicare is the U.S. federal health insurance program for people 65 or older, and for younger individuals with certain disabilities or medical conditions.

Answer: You can change your Supplemental/Medigap coverage at anytime, but if you aren't new to Medicare, you may have to do medical underwriting.

Answer: Yes, because a critical illness (like cancer, heart attack, or stroke) often brings hidden costs — co-pays, deductibles, and living expenses while you recover. Even with Medicare, those bills can add up fast.

Answer: Prescription Drug Coverage. Dental, Vision, and Hearing. Medicare pays 80%, and you are responsible for 20%, so there is no fixed amount for the medical services you receive.

Answer: Working with a Medicare agent gives you clarity, confidence, and a caring guide in a system that can often feel overwhelming.