Lea Vollmer, Medicare Insurance Broker

Answer: Yes, but which one would depend on the carrier? A good agent should check all your current RXs to make sure the plan you are enrolling in covers your doctors and medications.

Answer: If you can afford it, and if an illness runs in your family history. I strongly suggest getting a policy. Most people know if their parents had an illness that might be hereditary.

Answer: You need to report it to Social Security, so they can verify it and lower your rates. If your income falls below the IRMAA, it will be taken away. However, it does not happen automatically.

Answer: A co-pay is usually a payment for a specialist visit or some kind of service you get. Whereas the deductible is something you have to pay in full before you start making only the copayments.

Answer: Yes, if you are in good health and do not visit the doctor much, you pay as you go. That is what I call the Medicare Advantage side of the street, Pay as you go. If you are in a supplement plan with Original Medicare, you pay regardless, even if you never go to the doctor that year. I call this the snowbird a la cart side of the street. And make sure you have part D. You can only be on one side of the street or the other.

Answer: Because if you are on expensive medications, you only have to pay $2000 a year, which reduces some people's RX costs by a lot

Answer: RX is capped at 2000 dollars a year now. So, once you meet $2000, your RX is free; this applies to covered drugs only.

Answer: That's all they know how to sell. If you are in bad health and over 65, your rates may be too high to get into a supplement, or you may have a condition that is a knockout for a Supplement. The best time to get into a supplement if you are in poor health is at 65; everyone comes in at the same rate, no matter your health condition.

Answer: That is what a good agent helps you do. And if the medication is new, it might not be cheap anywhere. So, I suggest you look for a state RX program and check GoodRX.

Answer: Fill out the part B application at your local Social Security Office or online at SSA.gov. This lets Social Security know when you want to start your benefits and how you are going to pay for your Part B premium. Benefits only start on the 1st of every month. So, if you know you are going to retire in July, you can fill out the Part B application and set up payment arrangements, and start date of July 1. Make sure you do not have a lapse in coverage after you turn 65, or you will have a fine.

Answer: Part B covers doctor's visits, tests, equipment, medically necessary services, ambulance, mental health, therapy, and preventive services. So, it is enough if you never go into the hospital; that is what part A is for. And Part D is for your drugs. If you do not have Part A, B, and D, you cannot enroll in a Medicare Advantage plan.

Answer: Yes, Medicare covers Asthma and COPD, and the machines. You might have to pay copays or co-insurance for your office visits, medications, and durable medical equiptment.

Answer: Yes, as doctors become more popular, they have a regular client base, and more patients over time, they can service plans that pay them more. Usually, they can pick and choose the plans they accept, so I find they accept PPO plans and few if any, HMOs. If they are really great doctors, they only accept OM, Original Medicare.

Answer: That is the difference between having a good agent and a bad agent. Your agent should have read you and or shown you the summary of benefits, which gives you the details of your plan. Once again, this goes back to not having a good needs assessment. You need to ask questions: how much is my coverage, and what does it cover? I don't think people put value in having a good agent. That person gets paid every year for your renewal. Why are you paying that person? I am so sorry that happened to you. That is part of the reason I want to be a Medicare agent: to help and protect those who need a helping hand. Call me Lea Vollmer

Answer: MOOP is the most you will pay for your Medicare expenses for the year. If you are in a Medicare Advantage Plan, you have a set MOOP according to the plan and carrier. For OM, Original Medicare, the maximum out-of-pocket is your Supplement premium and Part D premium times 12. If you are not using your Medicare a lot, I suggest the pay-as-you-go side, the Medicare Advantage Plan. If you use your medical a lot and have health issues or travel, and can afford it, it might be beneficial for you to get a supplement with Part D when entering Medicare at 65. Having an agent who does a good needs assessment and is honest will point you in the right direction. Lea Vollmer

Answer: Good Luck. I have been on hold for hours with them. LOL That is the benefit of having an agent like me. You call me, and I help you navigate and answer your questions. What is your question for Medicare?

Answer: If you have work insurance, you do not have to have part B. But if you do not have insurance, you will be fined if you do not get part B and or D, by 65 or 3 months after turning 65. You need to fill out the Part B form at the Social Security office or online at SSA.gov, which tells Social Security how you want to pay your Medicare Part B premium. I would love to help you.

Lea Vollmer

Answer: They can be, it depends on the presenter, and if it is an educational event vs a marketing event, they cannot sell you anything or even mention plan benefits for any carrier if it is an educational event. If it is a marketing event, they can discuss the plan's benefits and enroll.

Answer: That would depend on the carrier; all of them are different. The same benefits are not offered in every area. That depends on your plan and what it states in the Summary of Benefits. Call your agent or carrier.

Answer: Yes and NO, I feel it depends on your health and how you use your Medicare. Yes, if you have preexisting conditions and can afford a supplement and Part D plan, I call this the snowbird à la carte side. Add up the Supplement premium and Part D premium; that is your MOOP for OM, original Medicare. If you are going through a lot of health issues, your expenses can be very high, and it might limit the doctors you can see if you are on a Medicare Advantage plan. I would check with your doctors and make sure they are in network with a Medicare Advantage plan, look at the MOOP, maximum out of pocket, and compare it to the amount you would pay for your supplement premium and Part D premium. I believe everyone is different in their healthcare needs.

If you are turning 65 with health issues and can afford it, I highly suggest a supplement plan with Part D. If you are healthy and do not use your plan often, I would go into a Medicare Advantage Plan. I call that side the pay-as-you-go side. You only pay if you use the plan.

I see people who have had a supplement and didn't use it often; they would save money getting into an Advantage plan. And if you are healthy and can afford it, you can price shop your supplements to see if you can get a better rate. Most people do not know they can price shop for their supplements all year round; only Part D has enrollment periods.

Answer: Call your agent or the carrier. It is covered if medically necessary. If you are an outpatient and on a Medicare Advantage plan, there will be a deductible and copayment.

Answer: Yes, Medicare covers all preventive services that are approved by the ACIP, and shingles is covered if you have a Medicare Advantage plan. If you have a Supplement plan, Medicare does not cover the shingles shot; it would be covered under your Part D. So, if you are on OM and do not have Part D, you are not covered.

Answer: Yes, however, I would compare your premium under your employer plan with the Medicare Part B premium. Some employers pay for the employees' medical coverage premiums. Then I would look at the maximum out-of-pocket and the services you currently use in your employer plan and compare it to some Medicare Advantage plans and their copayments and MOOP. Most people do not pay attention to the MOOP. That is the most you will pay for medical expenses for the year. So, if you know you will be using your insurance a lot, does it matter how you get to MOOP? If you need help, contact me, Lea Vollmer

Answer: That is a good question. You are covered for emergencies if you have an HMO, Medicare Advnatage plan. If you have a Medicare PPO plan you can go out of network, however you have to make sure your doctor accepts the term and conditions of the PPO. I usually explain Medicare this way, Medicare Supplement is snowbird/ freedom plan it allows you to travel anywhere in the USA and go to any doctor that accepts the terms and conditions. However, this can get costly over time. Medicare advantage is my pay as you go plan. You pay when you use it but it clips your wings and usually for a specific area. I know some carriers do have doctors that will see their members if the doctor accepts the terms. It comes down to a PPO or Medicare supplement and that woudl depend on your health and budget.

Answer: No, as a general rule, except for emergencies. If your Medicare Advantage plan has worldwide coverage, it will cover an emergency up to the plan's amount. OM No, unless you have a supplement plan that covers foreign travel.

Answer: There is an IRMAA Income bracket table that you can refer to see if your income falls into the IRMAA category. It looks at your past 2 years income (MAGI). You pay an additional Part B premium according to the bracket your income falls in. If your income is over $103,000 single and $206,000 married for 2025, you will pay an IRMAA. Watch for a letter from SS. If your income has changed, you can file an SSA-44 (request for reconsideration of IRMAA)

Answer: Nothing is free; it is that your Medicare taxes prepaid your Medicare Part A premiums, if self self-employed, you will pay for Part A if you did not pay your SS taxes. And you pay a Medicare Part B premium every month, which most people have deducted from their SS check.

Answer: Yes, you have 8 months to enroll in Part B and/or A, starting the month your coverage ends or the month your employment ends- whichever happens first.

Answer: Your agent should do a doctor look-up and present the plans that your doctors accept. Remember, doctors can change their minds and no longer accept certain plans. However, they must notify you.

Answer: The only time you have a guaranteed issue is when you first enroll in the Medicare program. A thorough needs assessment should have brought to your attention that a supplement would have been good for you in the beginning due to your health history

Answer: I am not sure you should be concerned with the amount of time an agent or broker has but with their integrity. I recommend an agent who will be there for you and not just there to sell you a plan.

Answer: Personalized help for any questions you might have, someone to point you in the right direction. I know how the plans work and how to advise you on a plan that suits your needs and lifestyle. Let's grow old together!