Michelle Ryan, Medicare Insurance Broker

Answer: You can apply for Medicare 3 months before your birthday month up to 3 months after your birthday month. This gives you s total of 7 months to apply and it will be effective the 1st of the month of your birthday or the first of the month after you apply.

Answer: No it does not! It covers a portion of the cost, you have a co-pay, up to 100 days. After day 100 you are responsible for the costs.

Alternatively, you can get a Hospital Indemnity plan written to cover the "Skilled Nursing Facility" copay amount paid directly to you. But, that is only goung to help with the first 100 days. For ling term coverage, you can get a Long Term Care policy OR a policy that covers Skilled Nursing care in your home. Cost varies greatly between these types of plans so it depends on what you are looking for specifically.

Answer: The biggest disadvantage is that those plans can and often do change annually. They can also go away leaving one looking for an entirely different plan and sometimes a different carrier.

Answer: Short answer, yes. But, either you would need to be there to make final decisions OR she would need a medical power of attorney.

Answer: No you do not. It will automatically convert to regular Medicare. However all of your initial enrollment options open back up. So if you wanted a supplement and nodded your guaranteed issue right, you have another one bite that you are 65 and in regular Medicare and not disability.

Answer: It is a form giving the agent permission to discuss only the plan types marked with you during your appointment. It is to make sure agents are only discussing plans you are interested in. Currently Centers for Medicare & Medicaid (CMS) requires then 48 hours in advance unless you called them, then they can get the SOA at the time you call in.

NO CALL CENTERS ARE NOT EXEMPT.

Answer: In this situation, I feel like the only disadvantage would be if you were working with a captive agent. A captive agent can only write for one specific carrier. And if you worked with an independent broker, they would be able to write a policy with multiple, if not all of the carriers in your area, so the only disadvantage would be working with somebody that's captive. However, having a broker that you feel like you can trust, who's going to put you in the best plan for you. And not being concerned about income or bonuses is super important.

Answer: In my opinion there is only one way. You NEED a local broker that you trust to help you navigate your options.

Answer: With you Medicare Supplement Plan F, the only thing you are responsible for paying is your Part B premium and the premium on your Plan F. Outside of that IF Medicare pays their portion, then your Medigap plan will pay the rest.

Answer: There is not a short answer to this, the answer depends on several things. But the most important is to know if the services is "medically necessary". If it is not, none of the other conditions matter as it would not be covered. Location of the ship in relation to US waters or a US port is the other important determining factor. Also, rather or not the doctor providing services is authorized to un US law.

There are also, plans specifically for travel that would cover care that you could look into, if this is a concern of yours.

Answer: That depends on what type of plan you are choosing. First, you need to meet with a local broker that does a thorough needs analysis before recommending any type of plan.

If you choose a Medicare Supplement, a Prescription Drug Plan (PDP) is also STRONGLY recommended and will need to be reviewed annually; However, a Medicare Supplement plan is there with you until you cancel it or until you are no longer with us. Medicare Supplement plans only have certain guaranteed issue periods, depending on which state you live in. If you are outside of YOUR guaranteed issue period you will need to go through underwriting before a policy will be approved.

If you choose a Medicare Advantage plan, regardless of which type or carrier, you should be meeting with you agent annually. These types of plans change annually as do their formularies so a thorough needs assessment should be done annually to make sure the plan is still a good fit for you and your specific situation. These policies are guaranteed issue annually from Oct 15 - Dec 7th (AEP), Jan 1 - Mar 31 (OEP), and for qualifying life events.

Answer: Rather or not you have a Supplement plan does not determine if Medicare is going to pay for it. IF it is prescribed by the doctor and is medically necessary then it will be covered by Medicare part A or B dependent on whether you are in the hospital or not. And then your Supplement plan becomes a factor and will pick up and pay what it is contracted to pay.

Answer: The answer to that is simple. A thorough need assessment should be done to determine what you NEED in a plan. This is why working with a local, trusted broker is so very important.

Answer: Some do not all. This is just another reason why it's very important to meet with your trusted local agent annually to go over the plans for the coming year to make sure that your plan still fits your situation.

Answer: The easy answer is annually during the annual enrollment period, Oct 15 - Dec 7th. It should also be reviewed if you have a life change such as moving, getting married, or qualify for a subsidy of any type, among other things. It is always best to ask your agent if a specific change will effect your plan.

Answer: I can see how that may be confusing. As of 2025 there is not a coverge gap any longer. There is a deductible (if your plan has one), initial coverage where you pay for a portion of your prescriptions up to the maximum out of pocket of $2,000. Once your out of pocket costs reach $2,000 (in 2025) your plan then covers your covered medications at 100%.

So, if your cholesterol medication is covered by your plan, it will count toward your maximum out of pocket.

Answer: Special Neeps Plans are plans for people with special needs. A chronic condition such as diabetes or a cardiac condition is an example. Also if someone is eligible for both Medicare and Medicaid they would qualify for a dual sordid needs plan.

Answer: Your Medicare plan in general will not change simply due to losing employer group coverage. IF you were on the employer group coverage and had NOT enrolled in Medicare then you will need to enroll in Medicare A & B within 63 days of losing your previous coverage. Not enrolling within the 63 days will cause you to have to wait until the following January to enroll as well an incur late enrollment penalties.

If you have recently lost employer group coverage PLEASE reach out to a trusted local agent for guidance at your earliest opportunity.

Answer: Sure, there are 4 valid election periods: IEP, AEP, OEP and some SEPs. Initial Election period (IEP), this is when one first becomes eligible for Medicare. If they were on Medicare due to a disability BEFORE the age of 65 they will have one when they first became eligible and another when they turn 65. Annual Enrollment Period (AEP), this is the election period from October 15th - December 7th every year when Medicare beneficiaries can change their Medicare plan. There is an Open Enrollment Period (OEP) for Medicare Advantage enrollees only to make a one time change either to a similar plan with a different carrier or drop Medicare Advantage and go to Original Medicare with a Stand alone Prescription Drug Plan. And then there are Special Election Periods (SEPs) that, with certain life changes, will allow a beneficiary to change their plan during the year as long as they have had a qualifying life change.

Answer: Honestly, Centers for Medicare & Medicaid (CMS) does not "allow" it. Most of these ads are deceptive with some being outright lies. CMS Requires all ads to be approved and there are some I know would not be. I do not know how the bad actors get away with doing it. What I recommend is find a trusted local broker to work with so you can just ignore the ads.

Answer: Yes, some cancer screenings are covered with some caveats. For instance, depending on which cancer screening is in question will determine how often the screening is covered. Like mammograms which are covered annually for women over the age of 40 as a preventative, however, if there are signs or symptoms of cancer, then the mammogram would be considered "diagnostic" and not preventative and would be covered differently. There are other screenings that are covered with similar circumstances that would change HOW the test is covered.

Answer: I think that IF the cost of the Medicare supplement has become too expensive, the option of a Medicare Advantage plan coupled with a Hospital Indemnity policy, written properly, is a good alternative. However, a thorough NEEDS analysis should always be done.

Answer: Yes, your son or daughter can absolutely help you with your Medicare plan if you are unable to make those decisions on your own. However, a power of attorney giving them authorization to make those decisions on your behalf would be required. As long as you're still able to make those decisions and you just want their assistance to be there, then no power of attorney is required, and they can be there, of course, to help you with all of that.

Answer: There is not a Medicare RULE that says you can not have a CT scan over the age 78. However they would require it to be "medically necessary" and may require prior approval.

Answer: Delaying enrollment in Part B is not really the issue. It's delaying enrollment in Part B that could potentially cause premium penalties. If you are on your spouse's group plan and that spouse is 65 or older, the human resources or plan administrator should have sent a notification out as to whether or not that plan is creditable.

Now, if that plan is not creditable coverage and you did not enroll in Part B, there is a premium penalty that is imposed for the amount of months you delayed enrollment. If you haven't gotten notification or you just need to know, call the human resources department and just ask them if their plan is considered creditable coverage for Medicare.

If it is not, that is when we need to have a conversation. If it is considered creditable coverage, you are fine until you leave that plan, and then you have 63 days to get enrolled in Medicare A, B, or another creditable plan.

Answer: Yes, actually, a lot has changed. The Inflation Reduction Act has had a big part in changing the prescription drug plans since 2023 and will continue to make changes until 2032. So there are changes to prescription drug plans every year, and there's definitely a reason why you're seeing charges on things that you didn't normally pay for before.

Answer: The simple answer, yes, Medicare is accepted in US territories. If you were traveling to a foreign country you would not have coverage even in an emergency.

Answer: If the broker is looking or for you they will do a thorough needs analysis and multiple carrier/plan side by side comparison. You, the beneficiary, spotless be able to see the comparison and have all of your questions answered completely before following through with the enrollment.

Answer: Generally speaking an agent represents a single carrier. Agree as a broker represents multiple carries.

Answer: It sounds to me like your friend has a Medicare Advantage plan and you have a Medicare Supplement plan. IF that is not the case you may have an Income Related Modified Adjusted to your Medicare premium. It is hard to say for sure without knowing more information. But this is two scenarios where this could happen.

Answer: If you only have Medicare A & B, you will not be covered.

If you have a Medicare Supplement (Medigap) policy, you will want to take a form with you to have the doctor fill out in the event you need care, so that you can file a claim for reimbursement, but you will have to pay for the services out of pocket at the time. Depending on the Medicare Supplement plan you have will depend on rather or not and how much they will reimburse.

If you are on a Medicare Advantage plan you do not have coverage outside of the US.

There are policies that can be purchased for travel specifically that would work like traditional health insurance world wide. Aside from that you would pay out of pocket at the time of services then file a claim upon return with your insurance carrier.

Answer: I feel like it is VERY important to at least meet the agent you will be working with. That being said a virtual meeting can be done by Zoom or Microsoft Teams with cameras ON so you can still have a "face-to-face" meeting. This also allows for screen sharing so the agent can still visually compare plans for you. However, a STRICTLY PHONE call remote meeting is not something I recommend for anyone discussing Medicare insurance options. There are just too many scams, a lot of information to convey clearly, and comparing plans without looking at them side by side can be hard for even the youngest client not on Medicare.

In my opinion, you should always be able to put your EYES on: your agent, your plan comparison, and your chosen plan details BEFORE signing the application/contract.

Answer: Generally speaking, no marriage does not affect coverages and costs. However, some carriers offer a household discount if there is a spouse or someone else over a certain age living in the same home. With that being said, there could actually be a decrease in your premium, IF your carrier offers a household discount.

Answer: Life insurance, in the end can be used for a multitude of things. What a person's goals are play a big part in deciding if and how much life insurance to have. Things like protecting loved ones from financial hardships, covering final expenses (if they are not pre-paid), Paying off debts such as a mortgage or car loan. But, life insurance can also be used to leave behind a legacy - whether to your favorite charity or church or you leave it as an inheritance to your children or grandchildren. In the end, life insurance can provide peace of mind.

Answer: When it comes to unauthorized plan changes, YES! There are so many call centers that are not working compliantly. If you happen to answer one of these phone calls and inexplicably say the word "yes" the bad actor on the other end of the line will take that "yes" and use it as consent to enroll you in a plan. The biggest thing to remember about this is that a "Scope of Appointment" (SOA) has to be completed 48 hours before someone, that reached out to you, can market Medicare Plans to you.

Answer: Medicare advantage plans have a specific network that you have to stay in. Although original Medicare does not cover or of the country, 99% of providers across the country accept original Medicare A & B.

Answer: Honestly, your should have been told. This is one reason why I recommend having a dedicated agent to assist with plan selection. If the person that helped sign you up for that plan does not tell you this, they were not looking out for your best interest.

Answer: Your financial issues do not determine your eligibility for Medicare. IF, due to your financial changes, you now qualify for state medical assistance, that would give you a special election period to look at your options again. This is especially important if you are on a Medicare supplement with a stand alone prescription drug plan, as that option may now be unaffordable. Any time there is a change in your life, your should reach out to your agent to make sure it doesn't effect your plan.

Answer: A vibe density scan is considered preventative IF certain conditions are met. Such as, being at risk of Osteoporosis, spinal abnormalities, or taking steroidal medications. *Note: this is not an all inclusive list. *

Answer: They don't necessarily effect the plan directly. Discount cards offer an alternative to your plan, but the costs of the medications purchased using the discount card did not count toward your deductible or maximum out of pocket limit.

Answer: In my opinion, having to stay in a specific network. But running a close second is that those plans can and often do change every year.

Answer: Medicare covers 80% of the surgery including pre and post operative appointments. However, it only covers standard lenses. It does not cover: any premium upgraded lenses, additional needs for glasses or contacts, or hospitalization

Answer: A person who is 65 and not an agent group health insurance plan should most decibel be enrolled in Medicare A & B as well as a prescription drug plan (PDP). There is potential for a lot of out of pocket costs with Medicare A & B alone. So I recommend meeting with a licensed agent to go over all of the options available to them.

Answer: That is a tough one because it really depends on what your of plan you are on. I will answer this from a Medicare advantage and prescription drug plan side. You should be meeting with an agent annually to review your current plan and look at plans for the coming year during annual enrollment OR if you move OR develop a chronic condition. That being said, a thorough needs analysis should be done during that meeting and if it is, you and your agent will both KNOW if a plan change is the right move for YOU.

Answer: That depends on what state you reside in. Georgia does not currently have a guaranteed issue rule, meaning you could switch supplement plans or carriers at certain times without having to answer medical questions.

Answer: Most will. However it is important to remember that participation or accepting Medicare is voluntary. So it is always best practice to ask the faculty if they accept Medicare.

Answer: Navigating all of the options offered to a Medicare beneficiary can be overwhelming and it isn't always clear who covers what and how much someone could have to pay. An agent that cares about the person they are sitting down with, will explain everything clearly in everyday terms and make sure the beneficiary UNDERSTANDS the plans. Face-to-face meetings with a professional in the field makes this much easier than deciphering it online

Answer: Yes, if the medical emergency prevented the timely enrollment. You will need to provide evidence of the emergency that prevented your enrollment before the deadline.