Kirk Doris, Medicare Insurance Broker
About Me
30 yrs insurance industry experience with over 13 years concentrated in Medicare. Service Disabled Retired Air Force Veteran with expansive knowledge of TricCare and Veterans Administration benefits. I speak Veteran! 84% of my new business is referral based and I look forward to helping you however I can.
Q&A with Kirk Doris
I've been paying into Medicare for years, and I'm not sure why my specialist visits still cost me so much. What am I missing here?
Answer: What you pay for services with Medicare is dependent upon what coverage (if any) you have in addition to regular Medicare. If you only have part A & part B of Medicare your outpatient care is subject to a yearly deductible and then 20% co-insurance of the Medicare allowed amount in your area. If you have either a Medicare Supplement or Medicare Advantage program your responsibly under those programs would differ on the plan you were enrolled in.
I picked a PPO for the flexibility, but now every time I go out of network the bills are outrageous. What's the point of even having a PPO?
Answer: It appears from your question that you elected to enroll in a Medicare Advantage PPO offering. A principal consideration when reviewing Medicare Advantage offers is if the providers you typically utilize are in the plan network. Although PPO options afford a member the ability to seek care from an noncontracted provider - the member is responsible for a much higher copay or co-insurance for that care as well as a significantly higher maximum out of pocket exposure.
I'm on a supplemental Plan N, and I'm curious if my recent MRI is covered or if I'll get stuck with a big bill.
Answer: Medicare Supplement plan N provides benefits for all Medicare approved services to include diagnostic imaging such as an MRI. Plan N covers out-patient care at 100% after the yearly Part B deductible has been met. The Part B deductible for 2025 is $257.00.