Kirk Doris, Medicare Insurance Broker
Kirk Doris
Medicare Simplified KC
Medicare Broker Licensed in MO, FL, KS, MD and OK
Contact Details
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Location
Independence, MO
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Phone
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Website
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
What are disadvantages of PPO?
Answer: PPO programs are generally the most popular options among seniors electing to use Medicare Advantage plans. The PPO options allows the freedom to seek care from a provider not contracted with the host carrier at a higher cost to the subscriber. Generally the only disadvantage is a higher monthly premium for the plan along with elevated costs when seeking care from a non-contracted provider
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.
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'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.