Lenora Sikkenga, Medicare Insurance Broker

Answer: People who qualilify for both Medicare and Medicaid are considered dual eligible. In this instance, Medicare would be the primary insurance for primary doctors and hospitalization and Medicaid would fill in the gaps.

Answer: Yes .Maximum out of pocket expenses can change every year and usually do. The amounts are either set by the government or by the insurance carrier.

Answer: Yes. Medicare Advantage plans are based on county by county. You are only eligible for plans that are available in your county. Some rural counties have no options for Medicare Advantage plans.

Answer: First and foremost, notify Medicare and your carrier of your move. Your New York medigap plan will still be active but the premiums could increase or decrease depending on Florida insurance rates.

Answer: The best way is to contact a local licensed agent or broker that sells Medicare advantage plans. They will know what plans are available in your area and be able to see what plans fit your needs the best. Do not talk to anyone that calls you. Professional agents do not cold call.

Answer: This marketing is not allowed legally . As agents and brokers, under CMS rules, we are not allowed to cold call anyone or market door to door for Medicare advantage plans.

Answer: A Medicare agent typically works for one insurance company while a broker is independent and is appointed with multiple carriers and thus is able to compare more plans for the client . The brokers and agents get paid by the insurance companies not the client .

Answer: Yes some Medicare Advantage plans do cover acupuncture and other alternative therapies. Your summary of benefits would explain what is covered

Answer: You should have received a summary of benefits from the insurance company explaining the coverage of your plan. Reach out to your agent or insurance company if you do not have one .

Answer: The biggest disadvantage with Medicare Advantage plans is the limited network and availability. Medicare advantage plans are available in a county by county basis with some rural counties not having access to plans at all. MA plans also have limited service areas so if someone likes to travel it makes it difficult.

Answer: Medicare partB covers doctors appointments, medical supplies and preventive care. It also covers therapies such as physical therapy, speech therapy and occupational therapy. There is a monthly premium that changes every year that can be deducted from your social security.

Answer: Original Medicare does not cover hearing aids. Most Medicare Advantage plans do. However Medicare Advantage plans are available county by county. Some counties do not have access to Medicare Advantage plans

Answer: You should review your plan every year due to provide and prescription changes. Also, plans leave certain counties so you have to check if your plan is even available anymore. You should receive an Change of Plan from your carrier every year before annual enrollment with updates and changes to your plan .

Answer: Right now is annual enrollment period and that is the time to switch from original Medicare to a Medicare Advantage plans. This period ends December 7th.

Answer: Seek out a licensed agent to set up an appointment and explain Medicare to you and all your options .

Answer: Annuities provide you with a life time income and , can be drawn out for terminal illness. They provide an inheritance to leave next of kin and there are a variety of them and different times they are annuitized so you have variations to choose from to meet your needs .

Answer: Yes. If you are disabled or have end stage renal disease, you can qualify for Medicare before the age of 65.

Answer: Medicare should have always provided dental, hearing aid etc for seniors . These are things seniors need. That's where the Medicare advantage plans come in. The reasoning behind Medicare advantage plans is that it takes the risk away from Medicare and puts it in the hands of insurance companies. Also the incentive behind the health club membership in the Medicare advantage plans is that they have to pay out less if their client base is healthier. Whether Medicare can provided these same services is questionable.

Answer: Actually , Medicare Advantage can vary from county to county on availability. Some rural counties have no Medicare advantage plans available at all, only med supp and plan D. As far as regular Medicare that is the same across the board because of CMS policies .

Answer: Beginning in 2025, the annual out-of-pocket spending cap for Part D enrollment will $2000. This includes deductibles and copays and co insurance but does not include premiums. So after the two thousand dollars has been met there is no other out of pocket expense

Answer: As of January 2025, Medicare does have coverage for digital therapeutics and apps but for mental health only. As far as I have researched mental health conditions are the only ones covered. I would have to do more research.

Answer: PPO plans give you access to more providers due to the fact that HMO plans require you to use the providers in the network or the cost of your care is higher. PPO ate also more flexible when it comes to traveling .

Answer: The fact that I can help seniors make an informed decision about their health insurance needs and to make sure they get the plan that is most financially suited for them