Pauline Weiland, Medicare Insurance Agent

Answer: Inflation is a leading factor to higher costs in Healthcare. The Medicare industry changes every year with a new budget set by congress. This is a yearly process with many moving parts. Not really my field of expertise.

Answer: All carrier formularies are different. The medication must be input for side by side comparison. So there is no one answer. It will all depend on the medications prescribed. Using a local agent will help you decide which would be better overall.

Answer: If you are over the age of 65 with no proof of credible coverage since turning 65, you may incur a lifetime penalty. There are several scenarios that will dictate what and if you owe a penalty. Best to talk to your local broker for information.

Answer: If I could be real here. Many people sign up for reasons other than their needs and requirements. All plans are not created equal and it's best to talk to a local Broker/Agent to get the facts as to how a plan is best suited for an individuals needs. Taking your neighbors advice or Doctors advice is not best suited for you. We are all different with different needs.

Answer: Social Security has a form L-564 the employers HR fills out that gives proof of credible coverage. That form will provide the information of coverage needed and no penalty will occur.

Answer: The easiest way is to work with a local agent who would already know most of this info. You could ask current Doctors what Advantage plans they accept.

Answer: there are a few ways to get provider network info. Call your agent. Check the carrier website. Ask your Doctor to check their referral.

Answer: Nothing is free. There is no extra premium you need to pay for most plans.

As long as you pay your Part B Premium to Medicare monthly you should be able to find a no cost Advantage plan. There are some plans that have nominal monthly premiums.. And you will likely have co-pays for many services on the plan, if not all the services.

Answer: Talk to your agent about your income and ask if there is a program you can apply to that will help with your premiums. If that is not the case ask about other resources in your area.

Answer: What I can honestly say is.. if you picked Advantage plan because of the Dental you did not talk to me. Medicare does not cover dental and it is an added benefit by carriers. When times are tough and carriers need to scale back they cut your benefits first. You should not enroll into a Medicare plan based on a benefit. Should you talk to an agent that leads with benefits, they are trying to sell you. When you talk to someone curious about your health needs and requirements they will find a plan to fit those needs first, and sweeten the deal with the benefits. TV watchers beware. They lead with benefits as a hook, and this may cause someone to enroll in a plan not suited for their specific needs.

Answer: When ever I get asked which insurance is best, I always answer with.. There is no best. Coverage is coverage and everything is tailored just a bit different to fit different requirements of the users. So let's talk and decide what is best for you, not best overall.

Answer: Medicare recognizes that Seniors are not all lumped into one category. Fixed income doesn't have to mean lesser care. Special Needs is just that. You have chronic conditions or low income levels and need extra help. This is one way Medicare helps seniors in need.

Answer: No referrals needed. Medicare is exploring with a pilot program to get have preauthorization before certain procedures. There are about a dozen procedures that need preauthorization

in pilot states. AZ is one of those states.

Answer: As a preventative service, Medicare would cover mammograms at $0 cost as lonf as Doctor accepts Medicare assignment.

Answer: Holistic care traditionally is not covered by Medicare. Advantage Plan carriers see the integrated medicine modalities as a counter measure to traditional medicine and include some benefits in many of their plans.

Answer: Don't try to learn everything on your own. Find a local agent to help talk you through all your decisions. Someone that represents multiple companies will be able to look objectively at your needs and find the best fitting solutions for your situation.

Answer: CPAP machines would be considered Durable Medical Equipment.

Sleep Apnea sleep studies would have to be conducted by a specialist or sleep canter.

Medicare takes care of 80% minus co-pays. Best to look into supplement (Medigap) or Advantage plan.

Answer: 80% of anything medically necessary will be covered by Medicare. Advantage plans lay out a co-pay scenario which may be beneficial. Supplements will cover the 20% which is your responsibility. Minus the copay.

Answer: That is not necessarily important. Friends will leave glowing reviews. It does show a track record. And you want someone who is consistently helping their clients.

Answer: There should be no cost to talk to your local Medicare Insurance agent. They would risk losing their license.

Answer: Those charges are not common. For me personally, I have never encountered anyone that's had one. It only applies with Original Medicare and supplements. When a provider does not participate in Medicare program, provider can charge an excess of 15%.

Answer: The only affect comes from income related provisions. You might qualify for your State Medicaid, you might lose Medigap household discount.

Answer: Yes. You have a couple options. Pay a premium to have Part A, or if you are married or widowed from someone that worked 40 quarters and paid into Social Security you can use those credits as your own to qualify.

Answer: Assuming you have Medicare Part A and Part B, an Advantage plan cannot discriminate for any reason. You are not automatically eligible for all Advantage plans. Some plans require you have your state Medicaid or a Doctor verification form of certain kinds of chronic conditions. Also if you have a State drug plan or VA, you can get the Advantage coverage with no Rx included. It's helpful to speak to a local agent representing multiple companies to best know your situation.

Answer: Working with a local agent for your Medicare needs has been proven to be more effective. Also if a problem arises you don't have to tackle it alone. As a Broker/Agent, I am able to interview a Medicare recipient and suggest best ways to handle individual health needs.

Answer: Depending on your state and county and/or lifestyle, this is a tricky answer. PPO offers flexibility, but are also a driving factor in higher costs. Look at alternatives to PPO's. The PPO's as we know them are changing drastically. The insurance industry around Medicare changes annually and you should be working with a local broker to know what is right for your situation.