Ray McCauley, Medicare Insurance Broker

Answer: because the carrier will only give you information on their plan. To get the best plan for you personally you need an agent to compare all plans that are available with you

Answer: copay is a dollar amount you pay for a specific service. a dr visit copay may be a set 5 dollars. a deductible is the dollar amount you must pay out of pocket before services are covered by the plan in a calendar year

Answer: because they found themselves limited to the doctors and specialities the plan offered. also because they had to pay co payments and coinsurance each time they used the plan

Answer: It is a misconception that you cannot get a CT scan after age 78

insurance coverage—particularly for preventative screenings like lung cancer—often stops at age 77 or 80 because the risks of radiation and contrast dye outweigh the benefits. Doctors carefully evaluate eligibility due to increased risks of kidney damage, cancer, and lower likelihood of acting on findings.

Answer: Original medicare does not cover hearing aids. However, several advantage plans cover anciliary products lic

Answer: Yes, Medicare covers the cost of blood thinners (such as Eliquis, Xarelto, and Warfarin) but you must be enrolled ina Medicare Part D plan or a Medicare Advantage Plan with drug coverage. Medicare part a and part b do not cover them.

Answer: Reduced cost of prescription drugs. maximum out of pocket is 2100 dollars as your responsibility versus no max

Answer: Medicare covers diagnostic breast MRIs and ultrasounds (Part B) if deemed medically necessary by a doctor to investigate symptoms, follow up on abnormal mammogram results, or for high-risk screening. Routine screening ultrasounds for dense breast tissue alone are generally no longer covered as of 2024

Answer: Their are savings to the system when Preventive Care for vision dental and hearing are utilized before the symptoms become chronic. Its a situation either pay now or pay more to fix later

Answer: if it is a medicare supplement yes. if its a medicare advantage it will only cover out of network if it is an emergency

Answer: for 2026 they have already been sent out. They will come out again, September and October 2026 for 2027.

Answer: they do. They offer a lot of ancillary benefits that regular Medicare does not cover. Also, they will cover a lot of co-pays and lower your expenses less than what you would pay under original Medicare and they offer drug plans embedded in them.

Answer: I wouldn’t say ban them. But my real question is how effective are they because everybody uses celebrities and personally I have never bought anything because of a celebrity endorsing it seems like a waste of money to me.

Answer: Yes, this is covered under part C of a medicare advantage plan. Because it is recomended by the cdc to have done, medicare pays for it

Answer: it doesn’t. Medicare does not cover painful trial. Only things are approved by Medicare. This would be completely out of your pocket.

Answer: original Medicare does not cover Chiropractic. If you have a Medicare advantage plan that will cover it or a medicare supplement that will cover it. It will only cover so many visits depending on the plan.

Answer: yes, if it drops to a substantial amount, he may be eligible for Medicaid or Medi-Cal in California that will lower his cost by possibly eliminating his Medicare part B premium and co-pays on a plan as well as his prescription drug cost could be eliminated. On the other hand, if it raises substantially, it could increase his part B premium.

Answer: no, you’re playing on has it or doesn’t. A Medicare supplement plan will allow you to see any doctor in the whole United States that accept original Medicare. It will also give you up to $50,000 worth of coverage outside the United States a Medicare advantage plan will allow you to have emergency coverage worldwide so in most cases you don’t need other coverage.

Answer: yes. in order to do so we would ask for a power of attorney from their caregiver to discuss plan options

Answer: why do you believe that Medicare advantage plans are taking over the system people have the option of getting a Medicare advantage plan or a Medicare supplement whatever they choose is depending on what they believe is best for them. As long as they make informed decisions, there’s no bad decision.

Answer: its sent by medicare. they track all yiour expenses and let you know what you are responsible for paying

Answer: maybe. If you have moved to a service area that does not have a Medicare advantage plan you do have a window of opportunity to get into a medicare supplement guaranteed issue or if your Medicare advantage plan has gone away. You also have a guaranteed opportunity to get into a medicare supplement.

Answer: yes. if you have given your daughter power of attorney to handle your healthinsurance decisions, she can act on your behalf

Answer: original medicare does not. sub advantage plans due is important to have an agent. Explain the benefits of each plan. Let him know what your needs are.

Answer: yes, you can go back to original Medicare. However, depending on how long it’s been since you stayed on that original Medicare banish plan it may prohibit to you from getting guaranteed issue medicare supplement if you decide to go that route.

Answer: there is no longer a donut hole. There is now a maximum out-of-pocket for cover prescription drugs covered under your plan of $2100. You can spread that $2100 out over the course of the year.

Answer: not necessarily. It depends on the state that you live in and the time of year. Civil states have what’s called a birthday rule that allows you to change from one medicare supplement plan of like kind or less at your birth month without medical underwriting.

Answer: Star ratings are based on reviews given input is primarily given by plan recipients. Doctors providing service, pharmacy interaction, etc. are a better score from those using the plan is a good indicator of how well the plan takes care of its clients.

Answer: NOT NECESSARILY, CHECK YOUR CURRENT PLAN AND SEE IF THAT DRUG IS COVERED. IF ITS NOT YOU WILL WANT TO LOOK AT A PLAN THAT DOES

Answer: No. A medicare advantage plan most often offers vision coverage for eye exams and eyeware but original medicare does not. original medicare will cover for eye surgery.

Answer: No, unless you want to pay deductibles and high out of pocket costs which can be better contained under a advantage plan or better yet under a medicare supplement

Answer: by October 1, you would have received your annual notice of change. I would call the last week of September to your agent and be on the books for after October 15 to discuss any plan changes.

Answer: question? was it a educational seminar or sales seminar? an educational tseminar is designed to hehoulp you understand the basics of medicare without the sales pitch so that you can begin to formulate a plan to choose which route is best for your specific situation and needs.

Answer: The best medicare supplement companies are… ones that have consistent rates and pay their clients bills promptly

Answer: Yes, you have 60 days from losing credible group coverage to get into a medicare supplement plan gaurunteed issuance

Answer: no. Not as long as you have credible coverage with your employer you will not receive a penalty if you sign up for medicare within 60 days of leaving employer coverage.

Answer: you have more flexibility as far as choice of doctors under a PPO. The trade-off is you may have unknown cost under a PPO when you go outside the contracted doctor list out-of-pocket expenses will be much more so I would say if you do not need to have more doctors or doctors that are outside a Disney doctor group to go with the HMO.

Answer: generally once per year at AEP. During AEP you can change your plan as many times as you want before AEP closes. Other than that, there are special enrollment periods throughout the year that may come up that would afford extra opportunities.

Answer: yes. you need to notify medicare of your new address.. you also need to notify your carrier if the carrier does not have a plan in that area available you need to notify your agent so they can write you an appropriate plan for that area

Answer: yes, the 2026 Medicare rules, cap out drug expenses at 2100. They allow you to spread out your expected expenses based on the drugs you start out with over a 12 month period so that you don’t have to meet a big deductible and coinsurance first it allows you to budget better that does not lower the cost of your

Answer: Medicare covers up to eight face-to-face counseling sessions for smoking cessation per year, provided by a Medicare-recognized practitioner, and can also cover prescription medications for quitting. You may be eligible for counseling and other services through Medicare Part B, and prescription medications are often covered by Part D or a Medicare Advantage plan. Counseling sessions are typically provided at no out-of-pocket cost if your provider accepts Medicare assignment.

What Medicare Covers

Counseling Services:

Medicare Part B covers up to eight individual or group counseling sessions over a 12-month period, for up to two separate quit attempts. These sessions are considered preventive care and are available for regular tobacco users.

Prescription Medications:

You may be covered for certain prescription drugs that aid in quitting smoking, such as bupropion (Wellbutrin) or varenicline (Chantix), under your Medicare Part D plan or a Medicare Advantage plan with drug coverage.

Over-the-Counter (OTC) Products:

Medicare generally does not cover over-the-counter smoking cessation products like nicotine patches or gum, but this may vary with your specific Part D or Medicare Advantage plan.

How to Access These Benefits

Contact your Doctor: Start by talking to your primary care physician or other Medicare-recognized healthcare provider.

Check Your Plan Details: Review your specific Medicare Part D or Medicare Advantage plan's drug formulary to see which prescription medications are covered and what your out-of-pocket costs will be.

Use the Medicare Plan Finder: You can also use the Medicare Plan Finder tool on the Medicare.gov website to find out how Part D and Medicare Advantage plans in your area cover specific medications.

Important Considerations

Accepts Assignment:

To receive counseling sessions at no cost, your healthcare provider must accept Medicare assignment, meaning they agree to be paid directly by Medicare and not bill you for more than the approved amo

Answer:

Yes, as long as it is designated as medically necessary UHC and all medicare advantage plans are required to cover occupational therapy. By law medicare advantage plans have to cover the same services as Original Medicare and original medicare covers outpatient OT

Answer: although you dont have to sign up again. you will have another opportunity to change plans as a special enrollment period

Answer: If you want a greater choice of doctors go original medicare. if you want lower expenses and extra benef its that original medicare doesnt offer then go medicare advantage

Answer: limitted doctor choice to the plans list. Higher out of pocket costs than medicare supplement plan options.

Answer: maybe. if you have a chronic illness develop that qualifies for a chronic illness advantage plan or you are institutionalized you may qualify

Answer: Medicare itself does not cover hearing aids. However some medicare supplements and advantage plans do.

Answer: Common and normal. Dental plans that come with Hmo advantage plans are most often limitted in what dentists are contracted with and covered under the plan

Answer: Advantage plans are limitted in dr choice. You can only use drs on the plans provider list. your dr must not be on that list

Answer: Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), generally covers inpatient hospital care, doctor's services, outpatient care, some home health and hospice services, and preventive services. It does not cover everything, such as routine vision, hearing, and dental care, long-term care in nursing homes, or custodial care

Original Medicare (Part A and Part B) covers:

Inpatient Hospital Care:

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This includes care in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, and long-term care hospitals.

Doctor's Services:

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This covers most doctor services, including outpatient and some inpatient services, as well as preventive services.

Outpatient Care:

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This includes care received outside of a hospital, such as doctor's visits, lab tests, and some medical supplies.

Home Health Services:

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Original Medicare covers some home health services, including skilled nursing care and physical therapy, if certain conditions are met.

Hospice Care:

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Original Medicare covers hospice care, including pain relief, symptom management, and other services for terminally ill individuals and their families.

Preventive Services:

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Original Medicare covers a range of preventive services, such as flu shots, screenings for certain conditions, and annual wellness visits.

Durable Medical Equipment (DME):

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This includes items like wheelchairs, walkers, and oxygen equipment.

Original Medicare generally does NOT cover:

Routine Vision, Hearing, and Dental Care:

These services are typically not covered, although there are exceptions for certain conditions.

Long-Term Care:

Original Medicare does not cover long-term care in nursing homes or assisted living facilities.

Custodial Care:

This includes care that helps with daily living activities like bathing and eating.

Medically Unnecessary Services:

Services that are not considered medically necessary, such as cosmetic surgery, are g

Answer: Your part B you have been paying goes to medicare. You most likely have part C as well as that which requires a copayment for service each time you use it.

Answer: Choosing a plan without understanding all the rules. Doing so can prevent you from having options of changing later

Answer: No its not fully covered. Depending on your plan you may have a deductible and will definitly have some type of co-pay.

Answer: they are much lower out of pocket costs than having basic medicare. They also include prescription drug coverage which saves on rx

Answer: once you reached the limit you no longer have the responsibility to pay medical expenses. different plans have different max limits

Answer: Part B covers tests like blood work, Mri s cat scans etc as well as physician charges by your primary care provider as well as specialists

Answer: the cost of going out of network is more costly. The ppo can allow some doctors to service you that may not have been available under a mapd

Answer: Stay on basic medicare . however we suggest looking at a medicare advantage which will cover more than just basic hospitalization as well as provide drug coverage.

Answer: Seniors may be confused about their options and thus procrastinate. The agent should fully get to understand the clients needs and discuss options with them

Answer: Most likely the office used the wrong billing code. We would suggest talking to the Drs office or the plan

Answer: Many are new to the system and are confused about their options. We explain their various options and put a plan together that meets their individual needs.

Answer: If you can pass underwriting. Other than that you can only change upon your birth month if you reside in a birthday rule state.

Answer: previously an individual would have unlimited out-of-pocket cost for their prescription drugs so there was ultimately no cap which could cause some people to go broke the new $2000 limit gives you a pen but don’t break situation where you know you have a maximum out-of-pocket of $2000 helps you budget yourself better and they will allow you to spread that $2000 out. If you are going to meet it based on your specific drugs you can spread it out over the whole year to lower your upfront cost.

Answer: go to Medicare and request your part b coverage then call me, there are important steps to follow, and I will walk you through them

Answer: Number one is cost

every morning number two our Benefits I will help you navigate to Medicare minefield please call me

Answer: it is expensive and doesn’t provide quality care . plans are much less expensive than obama care and pre 65 plans

Answer: a medicare supplement will but a medicare advantage plan would only help with emergency care and you would need to pay for that care up front then seek reimbursement from your health insurance provider

Answer: plan G because it it limits your out of pocket medical expenses to an affordable annual deductible set by medicare

Answer: purchasing a medicare advantage plan because they don’t see the need to pay for a medicare supplement plan while they are healthy thinking they will buy a medicare supplement plan when they experience health issues but then no longer qualify for gauruntee issue

Answer: medicare does not provide long term care however i would suggest purchasing long term care now while your young to keep the premiums lower because they raise the older you are when you sign up for a plan

Answer: several carriers offer zero premium plans for medicare advantage plans. they can do this because they get paid by medicare to coordinate your medical care

Answer: call social security and get your part B in place and send me a list of your drs and rx and let’s schedule an appointment to review all your options