Kimberly Griego, Medicare Insurance Agent

Answer: No, Medicare does not pay for dental implants. This is considered a routine service, and Medicare doesn't cover routine dental benefits. Some Medicare Advantage plans may offer dental benefits that could include coverage for implants. You can get more specific information on the Medicare.gov website at https://www.medicare.gov/coverage/dental-services.

Answer: There is no limit on how much Medicare will pay for medically necessary outpatient physical therapy. This is documented at https://www.medicare.gov/coverage/physical-therapy-services. This would be for someone on original Medicare. If you have a Medicare Advantage plan, there may be limits. You would want to contact your insurance carrier at the customer service number on the back of your member ID card for specifics to your plan.

Answer: Annual physicals are not covered under Original Medicare, but they are covered under many Medicare Advantage plans. Original Medicare covers a Yearly Wellness Visit each year at no charge. You can find more information at https://www.medicare.gov/coverage/yearly-wellness-visits.

Answer: The annual enrollment period is your opportunity to review your plan and see if it still meets your needs, as well as confirm that your providers are in-network, and medications are on the formulary. Providers can cancel their contracts at any point during the year, so it is very important to confirm both on your chosen plan's online provider directory, as well as with the provider's office, that they are in the network for the plan you are choosing. Using a local agent is also a good way to help ensure that these items are reviewed fully with you.

Answer: Concierge medicine providers do not generally contract with any type of insurance, and charge a fee for access to their services. You would pay them directly for your membership access, and your Medicare would be used for anything done outside of those services, such as lab fees, hospitalization, etc.

Answer: Yes, your Medigap Plan G will cover any and all Medicare-allowed charges once you have satisfied your annual Part B deductible (currently $257).

Answer: If you choose a Medicare Advantage or stand-alone Prescription Drug Plan, you can change that once per year, during the Annual Enrollment Period between October 15 and December 7, for a January 1 effective date. There is also an Open Enrollment Period from January 1 through March 31, for a one-time change, but only for those on a Medicare Advantage plan.

Answer: You should not have any costs billed to you for an emergency room visit. Medicare will pay it's share at 80%, and your Plan F will pick up the remaining 20%.

Answer: The Medicare Savings Program helps with Medicare Part A and B premiums, deductibles, coinsurance, and copayments, depending on the level a person qualifies for. From a prescription drug standpoint, it reduces costs significantly for your higher level tier 3 - 5 medications.

Answer: Absolutely. Most local agents and brokers are doing what's in their clients best interests. The larger problem lies in the call centers, where they don't always follow the rules. Medicare beneficiaries are often switched to plans that they later find don't work with the medical providers or prescription drug plans.

Answer: Medicare Advantage plans are not "free". They are subsidized by your Medicare premiums. When you choose a Medicare Advantage plan option, the federal government is no longer paying your healthcare costs, so they provide a portion of your Medicare premiums to the plan that you have chosen so that they can manage your benefits and claims payments.

Answer: Working with an agent helps to ensure that you are getting the most up-to-date and accurate information for your specific health insurance needs. As a Medicare agent, I do many hours of certifications each year so that I am completely familiar with the plan options available to my clients, as well as what the network availability looks like. It is my ultimate goal to help you find the plan that best suits your individual needs.