Michael Caldwell, Medicare Insurance Broker

Answer: Medicare can be confusing. I really enjoy helping seniors navigate those murky waters by helping them apply for Medicare and get the right plan for their specific needs. I like getting to know my clients and their stories, their goals for the golden years and helping them reach those goals with sound financial advice.

Answer: The biggest mistake seniors make when enrolling in Medicare is delaying enrollment or missing their initial enrollment period. This can lead to lifetime penalties on Part B premiums and can also impact access to free Part A coverage.

Answer: Medicare covers cataract surgery that uses standard intraocular lenses (IOLs) and the procedure itself, but it doesn't always cover the cost of more advanced or customized lenses like multifocal or toric lenses. Your friend's preferred lens might have fallen into this category, requiring her to pay the additional cost out of pocket.

Here's a breakdown:

Medicare Part B Coverage:

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Medicare Part B generally covers the cost of cataract surgery, including the removal of the cloudy lens and the implantation of a standard IOL.

Standard vs. Advanced Lenses:

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Medicare typically covers standard, single-focus IOLs. Advanced lenses, like multifocal or toric lenses, are often not covered, requiring patients to pay the difference.

Out-of-Pocket Costs:

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If your friend's preferred lens was not a standard IOL, she likely would have had to pay the difference between the cost of the standard lens covered by Medicare and the cost of her preferred lens.

Medicare and

Glasses:

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Medicare Part B does cover one pair of glasses with standard frames (or one set of contact lenses) after cataract surgery. However, Medicare doesn't usually cover the cost of glasses or contact lenses unless it's related to cataract surgery with an IOL.

Medicare Advantage:

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Medicare Advantage plans must cover the same services as Original Medicare, but they may have different rules for vision care. If your friend has a Medicare Advantage plan, she should check with her plan for specific information on coverage for glasses and lenses after cataract surgery.

Answer: Yes, some Medicare Advantage plans may offer coverage for acupuncture and other alternative therapies beyond what is typically covered by Original Medicare. Original Medicare covers acupuncture specifically for chronic lower back pain. While all Medicare Advantage plans must cover the same services as Original Medicare, they can choose to offer additional benefits, including expanded acupuncture coverage.

Here's a more detailed explanation:

Original Medicare Coverage:

Original Medicare (Parts A and B) covers acupuncture only for chronic lower back pain.

Medicare Advantage Plans:

Medicare Advantage plans (Part C) are an alternative to Original Medicare provided by private insurance companies.

Expanded Coverage:

Some Medicare Advantage plans offer additional benefits, including acupuncture for conditions beyond chronic lower back pain, or other alternative therapies like massage or biofeedback.

Plan Specifics:

The extent of acupuncture and alternative therapy coverage can vary significantly from plan to plan.

Verification:

You should always check with your specific Medicare Advantage plan provider to determine what is and isn't covered.

In-network Providers:

Many Medicare Advantage plans may require you to use in-network providers and may have referral requirements.

Answer: No, Medicare itself does not drop people for health reasons. Medicare is a federal health insurance program, and your health status does not affect your eligibility or enrollment in Medicare Parts A and B. However, Medicare Advantage plans (Part C), which offer additional benefits and may be preferred by some, can disenroll beneficiaries for certain reasons, not including health status.

Answer: Climate change-related health issues, including those caused by extreme heat, are likely to significantly influence Medicare policies in the coming years. This includes increased costs, changes in coverage, and potentially new initiatives to address these challenges.

Answer: No, Original Medicare does not cover the cost of hearing aids or routine hearing exams. You will typically need to pay for these services out-of-pocket. Medicare Advantage plans may offer some coverage for hearing aids and exams, but the coverage and costs vary significantly by plan.

Answer: No, Medicare will not cover everything your current employer plan does, even if you're eligible for Medicare and still working. Medicare is designed to work with other insurance, and how they interact depends on your employer's size.

Answer: Yes, Medigap Plan C can help with the cost of your bloodwork if it's covered by Original Medicare. Since Plan C covers the Part B deductible and Part B coinsurance, you won't need to budget for the costs of those, according to Healthline. However, it's crucial to understand that Plan C is no longer available for new Medicare enrollees after December 31, 2019.

Answer: Medicare generally doesn't cover long-term custodial care in nursing homes or assisted living facilities. If you anticipate needing such care, you'll need to explore other funding options. Your best bet is to talk to a profressional who can walk you through your options.

Answer: Yes, while the core benefits of Original Medicare are standardized across all states, some aspects of Medicare plans and enrollment can vary by state, particularly for Medicare Advantage and Medigap plans. Your best bet is to talk to a profressional who can guide you to the right answers for your specific state and situation.

Answer: If your out of annual pocket for the particular prescription is over $2,000, then yes, it should help.

Answer: Annuities play a crucial role in a comprehensive retirement planning strategy by providing a guaranteed income stream, mitigating longevity risk, and potentially diversifying retirement portfolios. They can help ensure retirees have a consistent source of income to cover essential expenses, even if they outlive their savings.

Answer: It's a great question. I would go one even further. Not only why does Medicare allow insurance companies to bombard seniors with confusing mail, tv and radios, but why does Medicare allow insurance companies to blow up seniors phones.

In most cases, it's not the insurance carriers themselves actually doing any of it. It's lead vendors that are responsible for almost all of it. The lead vendors get seniors to give them their information through what is often false or misleading advertising. Then they sell that information to insurance brokerages and agencies. It's the vendors who make the ads, buy tv and radio air time and internet and social media ads, send out the mailers, run the call centers, etc. The agents, the agencies and the brokerages often don't know what is being promised in these ads or by the operators in the lead vendor call centers.

Medicare has taken steps to crack down on the lead vendors, but they need to do more. Seniors need to call their Congressmen and Senators.