Kristen Skinner, Medicare Insurance Broker

Answer: Yes and no. It depends on what plan you have and if the plans network has the chiropractic option included. Sometimes there are just some Chiropractic doctors that do not accept Medicare.

Answer: Typically no. If you do not have enough working hours you can not enroll in Medicare. You can sometimes enroll in an ACA plan through the Marketplace. I have one client who is in her seventies and she could not enroll in Medicare, but has an ACA plan.

Answer: No it does not. That is something you would have to cover out of pocket. So it is good to go to a financial planner and figure out how to make sure you can plan these costs.

Answer: Yes you can. However, you have to go through medical underwriting. Which often times will get you a higher premium or the company will decline you altogether.

Answer: Medicare is what is offered to seniors who turn 65. However, it can be offered to people before 65 if they have disabilities, ESRD, or Lou Gehrig Disease. Part A covers their hospital benefits and Part B covers doctors, lab, and skilled nursing. Typically called the RED, WHITE, AND BLUE card, which is your Medicare card.

Medicaid is offered most of the time through the state if you are below 150% of the poverty level. Medicaid offers free health benefits to its consumers. You have to apply for Medicaid.

Medicare is most often time an automatic enrollment if you qualify for any of the circumstances listed above.

So think Medicare (Senior) and Medicaid ( Below poverty level).

Answer: Hello. Well technically they should. However, this is something embedded in CMS rules and regulations. It is beyond our control what the government does with Medicare. Just make sure you voice is heard, in meetings or by voting.

Answer: Call the customer support number on the back of the card. That can help usually, If not you can call Medicare.

Answer: Sometimes you have to be in their network for them to work. And you can have more than one copay in a year. However, you do have a cap on most of the plans. Your out of pocket can not exceed a certain amount and then the plan will pay 100%. So the copays and limited networks are really the major disadvantages.

Answer: Typically 80%. You are in charge of the 20%. Up to plan limits . So I would check with the Company and the plan itself. This would be the Plan N and G cover foreign travel.

I would still recommend traveler's insurance.

Answer: At least for the year. But as far as keeping them any longer than 2 years, I do not think that is necessary.

Answer: I think if the doctor says it is medically necessary, however, do not quote me on that. That may be the only exception.

Answer: No. I do not think so.

But you can get an ACA plan if you are not offered Medicare. However, you can alway call Medicare or go to the social security office to find out.

Answer: Well you have to pay a $202.90 premium first of all to have Part B. Which is unavoidable if you want full coverage besides hospital. And then the Part B deductible of $283 to pay before it starts to pay and 20% coinsurance overall. The best idea or plans to avoid the excess charges are a Plan G or Plan N. Plan G will pay 100% after the you pay the Part B deductible. PLan N is similar, however, you could incur a small $20 doctors copay or an ambulance copay of $50. Medicare Advantage covers the extra 20% out of pocket with small copays, and often includes free dental, vision, and hearing aid help.

Answer: Honestly it may not matter if you change to an advantage plan or a standalone Part D. They all work similar now. If you want to change make sure you call the Pharmacy and the Company you want to change to and price the drugs. Because it may not be that different.

Answer: No that is true. However, in 2026 it is $2100. You do have a deductible to meet on most plan also of $615 if you have Tier 3-5 drugs.

Answer: If I had a lot of pre-existing conditions, or traveled a lot, I would not choose an Advantage plan. Because typically you have to be in network and they have some copays that can add up if you are ill a lot.

Answer: If you have an Medicare Advantage plan or stand alone drug plan, you will need to change those plans once you move to California. You can use the Special Enrollment Period for moving to another state. If you have just Original Medicare or a Medigap plan, then they should be accepted in California without changing.

Answer: No Medicare does not cover, as a whole, vision. It will cover if you have medical surgery like cataracts. But if you need a vision plan to cover glasses or contacts, on average Medicare does not cover that.

Answer: You will still have Medicare at 65 even though you are delaying your social security. You can delay Part B if you are still employed and have credible coverage. However, if you do not have that option, you have to have Part A and Part B to get an Advantage plan or Medigap plan. And if you do have employer coverage, medicare will be the secondary and the primary will be the employer's insurance. Keep in mind if you have credible coverage with your employer you will not be penalized for not taking Part B or D. If you do not have this option ,and if you do not take Part B and Part D when you turn 65 you will be penalized.

Answer: Tell him that your plan is a "pay up front, pay less later plan." And this is what you have chosen. An Advantage plan just costs more if you are hospitalized . It is your choice.

Answer: As far as home health is concerned, unless they are on hospice, medicare does not cover that anymore. I do have plans that would cover home health care up to a year. It can pay up to $1200 a week or less.

Answer: It depends. If you are still employed and the employer still offers you insurance even though you are aging into 65, then you will not be penalized because you had credible coverage through an employer. If it is not credible and you are not still employed by an employer, then yes you can get a penalty for not enrolling in Part B and Part D. You may not be penalized for not taking Part D if you are a Veteran or Native American because you get your benefits through the VA or the Native Americans.

Answer: No. Medicare only covers up to 20 days in a Nursing home. That is why it is crucial to add a plan that helps take care of those extra costs. Nursing homes can cost up to $5000 a month or more. It can dip into your retirement quickly.

Answer: I make them fill out a Senior Fact Finder which lets me know what kind of plans they already have in place and what plans they need. Like are they a likely candidate to go to the hospital frequently, do they take a lot of medications. All of these are important to letting me know what kind of plans they might need. Then I make sure I look up all of their doctors and prescriptions and make sure they are in network or are covered. I go over the deductibles, MOOP, and what the plans do not cover. I have to make them fill out a Scope of Appointment first that gives me permission to do all of this.

Answer: The best way of course to me is to make an appointment with the agent. They have knowledge that googling can not compare to. However, if you do not want to contact anyone, then you can go to Medicare.gov and put all of your information in. That should help and be somewhat accurate. I am having issues with clients of mine getting the right information on the prescription drug cost if it is a Tier 3-5 drug. I would call the company direct if they have expensive drugs.

Answer: Yes. If you feel they have enough experience in the field, then yes. I know with Healthmarkets, when I was a rookie, what helped me is that I had my peers to help me answer important questions. That was helpful. Until I really learned Medicare and the plans.

Answer: Yes. This is a year-round enrollment that is possible if you have a 5 star plan in your area, and you want to enroll in that plan.

Answer: Unfortunately no. however, AARP has special services that cater to caregivers. If you have a Medicare Advantage plan then sometimes you can call customer support and see if they have any options for you.

Answer: It depends. I am not sure. It would be how the Employer sets up the insurance. I would call your HR department to see if you can continue. If not, you would be eligible to enroll in a plan with a Special Enrollment Period, where you can enroll in a plan with Medicare . You may have to prove credible coverage.

Answer: Well first I tell them that they still have to pay their Part B premium; which is a part of Original Medicare. And then if they have a "zero premium" plan, then they have co pays. I always give them the MOOP on those plans also.

If you carefully explain and go over everything, the client usually understands better.

Answer: If you still have Employer insurance offered and you are also on Medicare, usually the employer's insurance covers the claims first. The Medicare is secondary. So Medicare will cover pre existing conditions, and most preventative screenings are free.

Answer: Yes and no. It does cover your hospital but you do have a deductible to meet and then if you only have original medicare, it will cover 80% and you are responsible for 20%. You should look into a supplemental Medicare Advantage plan or a Medigap plan.

Or you may want to also get a Hospital Indemnity plan that would help cover those expenses.

Answer: Medicare Part B is the part that covers doctor visits, labs, skilled nursing, etc. Also it the amount you pay for either out of your Social Security check or directly. You have to apply for Part B. Is is roughly around $206 a month for most Americans. You will pay a higher premium if you make more $$.

Answer: If you have a Medicare plan or Medigap plan , you can go to the companies website and request the Summary of benefits for what is covered as preventive services. Or directly call them and request that to be sent to you.

Answer: I would ask the doctor who prescribes the Lab work if it is cheaper to go directly to the labs rather than have the lab work done at the doctors office. Or call your Medicare Advantage plans customer support.

Answer: I would call your plans customer support number or call 1-800- Medicare. I am assuming yes, but it is better to call first. Some plans will work differently.

Answer: I would think so, but all Medicare Advantage plans may work differently. You might want to call your customer support and inquire. Also, you may want to call 1-800-Medicare and ask them also.

Answer: Medicare Part D will help with drugs. It is either included in a Medicare Advantage plan or a standalone Part D drug plan.

Answer: Not necessarily. It is a good time to look at other options. There is what is called OEP which is where you can change to a different Medicare Advantage plan. This is something an agent will be good to look at .

Answer: You can apply for Part B and 60 days before your Part B effective date you can enroll in a Supplement plan or a Medicare Advantage plan. You may have to show that you had credible coverage from an Employer so you will not have to pay a penalty.

Answer: Special Needs plans are typically plans that cover Dual Eligible clients, who have Medicare and Medicaid. Or a Chronic Condition like Diabetes, or Heart issues.

Answer: No. If that was the plan you wanted to begin with, it does have the best out of pocket costs for medicare, then it is just the premiums you are upset with. You can look at the Medicare Advantage plans, which increases your out of pocket costs, when AEP comes around again. Make sure you are choosing the plan that is right for you and you know the difference.

Answer: If it is a prescription you would have to have a Part D drug plan. Or it may not cover it. You can check on Medicare.gov and put the name in and it should show if it is covered on a plan or not.

Answer: It depends on what plan you have and how it works. Did you check to make sure the doctor is in network. Or do you have a Medigap plan compared to a Medicare Advantage. If so this could mean the difference between paying for a higher premium plan.

Answer: You can go to Medicar.gov and put the prescription information in and see if there is a drug plan that will cover the costs. It should say in the plan details itself.

Answer: You may be able to qualify for Medicaid or a level of medicaid that pays for the Part B premium. I would check with your local state office.

Answer: Yes. Because they have the answers that you may not have already. And they can help you find a different plan if this one does not work for you. What they send you in the mail sometimes does not go over all of the information you need.

Answer: I am not sure. It will probably be harder and harder to get prescriptions filled without using a phone app of sometype. Paper will more than likely go away. Tele doc is becoming really popular.

And robotic surgeries are becoming really popular. Not sure what you think AI may take the place of.

Answer: It does not typically. Usually Cruise ships have their own doctors and doctor facilities on board the ship. However, I always tell my customers to purchase Traveler's Insurance. Because most Traveler's insurance will cover if they are out of the country if they have a Medigap or Advantage plan.

Answer: I would definitely get ahold of an agent to do that. I know you can google a lot of the answers, however, having an agent helps a lot.

Answer: That depends. If there work is still paying for a medicare plan and it is credible coverage they should delay Part B. But only if it is a good plan. Some plans with Medicare, like Medicare Supplemental or Medicare Advantage are just as good as the employer plan. Otherwise they can take the coverage through the employer; delay Part B, and still have credible coverage and not have to take a penalty. Again consult an agent first before you do any of this .

Answer: Yes. SO unfortunately if that agent did not take you through the whole process, that can happen. You can change now, during the AEP , or OEP. And always ask for them to look up your doctors.

Answer: This is something I really can not help you with since this has nothing to do with Medicare. You should call Social Security or call a financial advisor.

Answer: If you have an Advantage plan typically the wellness visit is free. You can look at your summary of benefits to check and see what is covered at no cost.

Answer: Sometimes the Medicare Advantage plan is not accepting at some facilities . WIth Original Medicare you are accepted anywhere they accept Medicare.

Answer: No you do not have to sign up for medicare again. But you do have the option to change to a Medigap Plan. Which is different than the Medicare Advantage plan. So just make sure if you want to change to that plan you can. Plus you have your original 7 month IEP , so you can change to any other advantage plan at that time without having to be in the AEP. Plus, you can go back to original medicare.

Answer: When you first age into 65 a lot of seniors do not know about the penalties for not taking a Drug plan or Part B. This is not good considering they do not know about these things unless an agent tells them. The Part B penalty is because they did not take Part B when they were first eligible for medicare and it is the same with Part D. Always connecting with an agent when you age in is the best thing.

Answer: I would make sure you put in all your medications at Medicare.gov first. And then see which plan are the best for you. Some drugs may not be on any formulary and that is when it gets expensive. Otherwise the max out of pocket for drugs are $2100 for next year. Once you meet that out of pocket, then you have zero cost .

Answer: I am a big fan of it. We have great Hospital Indemnity plans . And with the Advantage plan, with dental and vision added usually, it is a great combination to save the consumer monthly. Plus the costs do not go up as much as the supplemental costs. Its a win/win situation for the consumer. The indemnity adds piece of mind, that should anything happen that is a high copay , the client will be reimbursed so their is very little out of pocket.

Answer: Life Insurance can contribute piece of mind when it comes to burial cost, paying off debt., etc.

Even if it is a small amount, life insurance can help with any bills the deceased may have outstanding.

Answer: I have had only one client meet his maximum out of pocket on an advantage plan. He was very sickly and had to go to the hospital over 5 times. He survived. But as you can see, in order to meet the max out of pocket costs, you have to be very ill. Otherwise you have minimal copays on the Advantage plans. The Medigap has less out of pocket costs.

Answer: In a way yes. It depends on what you the client wants and needs. Not the agent. Make sure they take some time to look up doctors, hospitals , etc. Advantage plans are not bad plans, it depends on the differences and what you need.

Answer: It might be better because you are not limited to a network you have to be in. However, just having original medicare means you have to pay 20% of all the costs of medicare. And that amount is not capped. Meaning you have no stop/loss limit. With and advantage plan you would have that. Or a Medigap/Supplemental .

Answer: Yes. But it would be prudent to call or talk to an agent as they may have more knowledge because they have been doing the job for years.

Answer: Yes. If you are wanting to change your plan . This is the time when you can enroll in a PDP plan or a Medicare Advantage plan. If you do not want to change your plan you do not need to do anything at this time.

Answer: You need to make sure your Advantage plan is in network with your doctors. You can usually look them up in the plans directory.

Answer: Yes. The more information you have the better off you are at making a decision. However, in Medicare, there are not that many options. So I would think just keep it simple and go with 2 agents at the most. Healthmarkets, the agency I work for, has multiple companies we can quote you with.

Answer: If you have original medicare you are in charge of paying 20% of your out of pocket costs. This is because Original Medicare pays 80% and you are in charge of the 20%. That is why it is good to add an Advantage plan or supplemental to cover those out of pocket costs.

Answer: Generally no. It does cover hospice but not home health care. Some plans like the DSNP will cover home health care, but you have to be on Medicaid.

Answer: If they have a google page or business review , check their reviews. Look up their NPN number and make sure there are no actions taken against them. Call the Insurance Commissioners office to check that company's history.

Answer: FIrst enroll in Medicare Part A and Part B if you are not getting employer benefits and are retiring. Then get with an agent to properly explain the medicare options to you.

Answer: The ones that say they offer $2400 in grocery benefits. Usually you have to be not only on Medicare, but Medicaid also.

Answer: I am not sure. I know today I get a lot of my clients stating the nurse or receptionist did not put the right codes in and they are being overcharged. So not sure if AI can change this or not or make it worse.

Answer: Credible coverage usually applies to Employer insurance while you are on medicare, or being a VA or Native American. You are exempt from Part B fines and Part D fines when you have credible coverage. If you go with taking Part B when you are 65 and you are still working and covered by an Employer plan, you will not be fined. If you do not take a Part D drug plan when you are first eligible; then you can be fined every month you do not take it unless you have Veteran benefits and/or Native American. And also if you have Employer credible coverage. I would check with your Employer if you have credible coverage before you enroll in a plan,

Answer: There is a way to add a Hospital Indemnity Plan along with a Medicare Advantage plan. These help re-imburse some of those costs associated with hospital bills. Or the Medigap allows only the Part B deductible cost and then the rest of your costs through the year are minimal. But it may be due to medical underwriting and you can get declined.

Answer: It depends. I sell in other states and hope those clients decide to keep me because I do a good job. If an agent lives near you and you like that in person meeting., then do so. Just remember they can scam you just as much as someone remote.

Answer: SMILE over the phone. Tell them about yourself. Ask them about themselves. IF possible send a picture so they can see what you look like. I always gave them my NPN number just in case they wanted to look me up, to make sure I was legit. Listen to them more often. People love to talk about themselves.

Answer: I had to take care of my Grandmother a few years ago. I just told her she needed to move in with me because she was forgetting to take her pills. She did finally give in , because she knew she needed help. But she was really scared I would abuse her and leave her in her bedroom alone. This is due to other relatives telling her that is what happened to them. I was grateful that did not happen. She had a heart attack and went to a nursing home soon after. That was difficult to keep her from leaving, but she knew it was what was best. It is difficult to explain to someone that they are loosing their freedom and they need help. As caregivers , the elderly are so set in their ways, we find ourselves arguing with them A LOT. I just gave in unless it was something threatening their health they thought they did not need. There is no real way to handle it. It is a hassle. I would say take a deep breath, listen, put your self in their shoes and go about it that way. Pray they do not outlive the long term care.

Answer: You can go to medicare.gov and plug them in to see the costs. And you can also enroll in a plan on the website. If you need more help, you can contact me. Kristen Skinner.

Answer: I really do not have any. I know if she is on a supplemental or medigap plan, she is more free to go anywhere they accept medicare. And it can allow them to have more freedom . I have not dealt with Long term care , so I am not sure how that works.

Answer: I show them both options side by side and compare the pros and cons. Then I let them decide. I also check to make sure their doctors and drugs are in the quotes so we can see if they are in network.

Answer: It always depends on what you; the consumer, needs. And if you want to pay less up front but possibly more later, or more up front or less later. IF you contact me, I would do a Senior Fact Finder to find out exactly what plan will work for you.

Answer: If you are on SSI Disability you can be eligible for Medicare in 2 years. However, if you are already on medicare at age 65 you can change your medicare plan because you are in your Initial Enrollment Period which is guaranteed issued. So if you want to look at different options for medicare I would do it while you are in the 7 month Initial Enrollment period. On the payouts for disability, I would contact the Social Security Office.

Answer: Sometimes they think Googling the advice or taking the advice of a friend or relative is better than an agent. Always taking the time to make sure you have the right plan for you. Talk to your agent . Let them know what you want .

Answer: The same I go over searching for their doctors and their drugs to make sure they have the right plan. And make sure they know the plan they are choosing or switching to is the right plan for them.

Answer: Yes and no. If you are talking about Original Medicare then it can be different due to your income. Part A is typically free if you have worked in the United States. And Part B is $206 a month, but it can be more if you make more money. And you can have a Part A premium if you have not worked long enough in the US.

Answer: That Original Medicare is enough. A lot of people have Original Medicare and they think that is enough. On Original Medicare the USA government pays 80% and you pay 20% of the out of pocket costs. But there is no Max out of pocket costs on Original Medicare. So you do not have a cap on that 20%. So 20% of 1 million dollars worth of costs can add up quick .

Answer: It depends. If the doctor fills out a form that the consumer needs home health care, then the plan may need that document to start the home health process. Each plan is different. You need to call you plans customer care number to find out exactly what it covers.

Otherwise a Home Health plan with Aetna or Long Term Care is something to consider.

Answer: Not true. If you die you Medicare, or Medicare Advantage plan will not pay for your funeral costs. So if you are worried about that , then the life insurance plan will pay.

Answer: Sometimes, depending on the plan, you may need a referral. With some of the changes next year some PPO plans require a referral now.

Answer: You can call your agent, or call the members drug plan directly. This could help. Some drugs that are not covered on the formulary are not paid for through the drug plan and are the responsibility of the consumer. There may be generic forms of the expensive drug, or the Drug company may have grants or coupons to help offset the cost.

Answer: Typically, in some cases, preventative screenings are covered at no cost. The member needs to make sure they are in network.

Answer: They all have to work the same. SO a Plan G has to have the same out of pocket as another Plan G with another company. I find that United Health AARP plans have extra benefits like dental an and vision and wellness embedded in their plans.

Answer: You can go anywhere they accept Medicare. It is not an HMO or PPO. So in other words, there is no network you need to be in for the hospital or doctors to accept you.

Answer: Not enrolling in a Stand Alone drug plan or some type of drug plan without having credible coverage for drugs. Making sure if they have certain health issues., what out of pocket they may have in a year.

Answer: Yes, but it may be due to medical underwriting. You can enroll year round however. The company has the right to deny you due to some pre-existing conditions.

Answer: Are all my medications covered? Are my doctors in network? Do you have Chronic Illness plans that would cover more of those illnesses? Do you have any plans with Over the Counter benefits?

Answer: I love love helping Seniors. I am very patient with them. I treat them like my Grandmother and my mom.

Answer: If the premium on the Medicare Advantage is $0 then indeed that Medicare plan is zero. However, you still have to pay for Part B premium with Original Medicare. To get an Advantage plan you have to have Part A and Part B .

Answer: Know the penalty for not taking a drug plan. That is the most of the complaints I get . Make sure you check your doctors and your drugs for each plan.

Answer: The USA government gives them an allotted amount of money to help pay for each consumer. So they invest that money in plans to help the consumer.

Answer: It would be great if you could just call me. There is a lot involved in answering each of those questions.

Contact me or if you have your own agent, you can reach out to them.

Answer: We can summarize Medicare for and make it more simple. When you Google things , sometimes you dont get all the information. So with a Medicare agent we can make sure you get thr right plan for your needs and make the enrollment process easy.

Answer: It depends on what you are needing. An Advantage plan helps with the 20% ou of pocket that Medicare does not cover. And has copays for specialists, hospital stay, etc.

Original Medicare does not have a limit on the 20 % out of okcket costs but you have the freedom to go anywhere they accept Medicare . With Advantage plans you want to be sure you hospitals and doctors are kn network.