Penny Wegner, Medicare Insurance Agent

Answer: Yes, but differently. Your Part D, prescription insurance, covers inhalers for asthma and COPD. Your Medicare Part B covers nebulizer machines and medications for use of it under Durable Medical Equipment (DME).

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Great question! This is something that confuses a lot of people.

I often explain it like this: remember when you had employer health insurance? If you were in a car accident or had a work-related injury, you usually needed two separate appointments—one for the injury, and another for an unrelated issue like gout or high blood pressure. That’s because they were billed differently.

The same concept applies with Medicare.

Medicare does cover a free annual wellness visit, but it’s strictly for preventive care. That means checking your height, weight, blood pressure, reviewing medications, and discussing ways to stay healthy. However, if during that same visit you bring up a health complaint—like joint pain, fatigue, or anything requiring diagnosis or treatment—then it becomes part wellness visit, part medical visit. That second part can be billed, and that’s likely why you received a charge.

To avoid surprises, it’s always a good idea to clarify with your doctor’s office before your visit: “Is this going to be billed as a wellness visit only, or will anything else discussed be billed separately?”

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Answer: As a Medicare agent, I work with clients who often have 10, 15—even 17 prescriptions. Some are dealing with cancer, others with Parkinson’s or other serious conditions. The truth is, navigating Medicare Part D or prescription drug coverage shouldn’t be overwhelming—if you have the right support.

That’s why having a great relationship with a knowledgeable insurance agent is so important. Each year, plans can change. Formularies shift. New medications may be needed. But if your coverage is reviewed carefully each year, many issues can be avoided before they start.

And if something does come up? You won’t be alone. A good agent will be just a phone call away, ready to walk you through the next steps.

Answer: This year, Medicare beneficiaries with income above $106,000 (for single tax filers), $212,000 for joint filers, and $106,000 (for married people who file separately) will pay the surcharge. For these beneficiaries, total Monthly Part B premiums will range from $259 to $628.90.

Now income earners that fall under that pay a part B premium out of there Social Security check this year of $185. Next year it will increase to $206.50. A $21.50 increase.

Part A you have no cost if you have qualifying hours into Medicare. Otherwise, this year you would be looking at an additional cost of $285 or $518.

Answer: Here is a quick breakdown of your Medigap Plan F for emergency for visits. *Your plan generally covers 100% of out-of-pocket costs for Medicare-approved services.

*You will not have any copayments or coinsurance.

*No Excess charges. Meaning the plan covers anything over and beyond what Medicare approves.

Answer: I would have a couple questions for you before answering the question fully. Is this truly a bill or an EOB. I do advise my clients to make sure that their bill has gone through Medicare and their insurance before panicking as well. Advantage Plans do have a co-pay ranging from $250 and up.

Answer: Because everything has to go through a pre-authorizion process, the doctors feel like the insurance carriers have to much control over patients health care. Medicare Supplements typically do not need referrals.

Answer: Medicare Part A and B will not change. If you have a Medicare Supplement your plan will follow you to your next state. Watch your premium, that could go up or down but coverage will stay the same. If you have an Advantage Plan you will need to contact an Agent in the State you are moving to, that Plan will change. You will want to make sure your physician's and prescriptions are covered.

Answer: There are 6 things that Medicare does not cover: Cosmetic Surgery, Hearing Aids, Routine Eye Exams, Routine Dental Work, Long-term Care, and all most all prescription drugs.

Answer: Medicare PPO plans allow you flex between healthcare systems and not select a provider at the time of enrollment. You also do not need referrals for most services. HMO on the other hand you need referrals, you to select a primary provider and most stay in network, unless an emergency. Ex. I have a client with Parkinson's Disease, he is best suited for the PPO because there is no Provider in our County that provides specialized care for him only Neurologists that the HMO want him to go to. On a PPO, he can see his Primary in town but have a family member take him to another provider out of network that does specialize in Parkinson's 60 miles away to a doctor of his choosing.

Answer: What type of plan is right for me (Medicare Supplement or Medicare Advantage Plan)? Are my doctors in the network and are my prescriptions covered? What plan(s) allow me to travel (snowbirds)?