Robert Pennington, Medicare Insurance Broker

Answer: If you move to a new state, your Medicare enrollment timeline should not be affected. If you already have a Medicare Advantage Plan, you need to notify your provider of address change and to make sure they provide coverage to that area. If you have a Supplement, your provider just needs to know your new address.

Answer: Yes. Most of the time this is handled by your PCP. Medicare Advantage enrollees are required to obtain prior authorization for some services, such as inpatient hospital stays, skilled nursing facility stays, and chemotherapy. This process is to ensure services are medically necessary and to control costs.

Answer: “FREE” Medicare Advantage Plans mean that private insurance companies don’t charge a monthly premium. While these plans are advertised as free, you still have to pay the standard out-of-pocket costs, including deductibles and co-payments. You still have to pay the Part B premium directly to Medicare.

Answer: Sounds like you have a Medicare Supplement with a monthly premium and also having to pay out of pocket for a Prescription Drug Plan and Dental, Vision, and Hearing. Most Medicare Advantage Plans cover all these benefits with a $0 Premium plus additional benefits.

Answer: Up front, you have the most flexibility with a PPO Plan. With a HMO Plan, you have got to have a Dr. to manage your care and make referrals out of network unless it is an emergency. With a PPO Plan you can see any Dr. or Specialist of your choice in network or out of network. You will pay a little more out of network.

Answer: No, you cannot collect both your own Social Security benefits and your deceased spouse’s at the same time. If you qualify for both, you will receive a single monthly payment that is the larger of the two amounts.

Answer: Medicare is extended to younger Americans if they qualify for a disability. After being declared disabled for 24 months they would qualify for Medicare Benefits. It would not be cost effective for a younger American to be on Medicare until they reach 65.

Answer: When you become eligible for Medicare, you qualify for Part A which covers hospital needs and is given to you. Part B covers your day to day medical needs and is currently $185 per month deducted from your SS. Part A & B together make you eligible for a Medicare Advantage Plan or a Medicare Supplement

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Answer: Medical Power of Attorney is one of the best options a Senior can make. If a Senior has a life threatening medical condition or becomes mentally incapacitated and is incapable of making needed decisions for themselves, a family member or loved one can be appointed Medical Power Attorney to make their pre desired decision for them.

Answer: If you really want to save money on a Medicare Supplement, I would suggest making a change to a Medicare Advantage PPO Plan where A,B,C,D plus other benefits are included for a $0 premium.

Answer: Medicare Supplements Part A and B DO NOT cover any dental needs. You have to purchase a separate dental plan for any dental coverage. A Medicare Advantage Plan includes dental coverage with dollar amounts that can be used in network and perhaps a lesser amount out of network.

Answer: That really happened. The donut hole vanished in 2025 and was reduced from $8000. To $2000. It will be $2100 in 2026.

Answer: There are more than 6 things Medicare doesn’t cover: Rx Coverage, Dental, Vision, Hearing, Routine Physicals, Podiatry, Chiropractor, Cosmetic Surgery, Massage Therapy,

Private Duty Nursing.

Answer: Medicare may cover medically-necessary health care services you get on a cruise ship if:

If the doctor is allowed to under certain laws to provide medical services on the cruise ship.

The ship is in a US port or no more than 6 hours away from a US port, when you get the services regardless of whether it’s an emergency. It’s best to get travel insurance.

Answer: The Max Out Of Pocket (MOOP) applies to the monies that are paid for copays for medical services during the year. If the MOOP is met during the year then you pay no more. Rx copays do not apply.

Answer: There are Medicare Advantage D-SNP Plans for diabetics that have a 0$ premium. These Plans have a $0 to minimal cost for Rx. In addition, If you qualify for Medicaid benefits, this would also be a further reduction for Rx. With the new Rx structure for seniors, the most that you would pay, out of pocket, for the year is $2000.

Answer: A Medigap Plan has no net work and allows you to go to any Provider that accepts Medicare. A Medicare Advantage PPO Plan allows you to see a Provider in or out of network. A Medicare HMO Plan is in net work only.

Answer: If this is done Hospital, inpatient, or outpatient, or ambulatory surgical center, there will be a copay. The copay will be less if in-network rather than out-of-network. The copay would be subtracted from your plan's max out-of-pocket.

Answer: The Medicare hospice covers virtually all aspects of hospice care with little out-of-pocket

expense to the patient or family. As a result, the financial burden often associated with caring for a seriously ill patient is lifted. Families making end-of-life decisions for a loved one need compassion and support, not financial worries. The Medicare Hospice Benefit helps alleviate these concerns.

Answer: The maximum a senior will pay out of pocket for Rx in 2025 will be $2000. This can be

Setup on a 12 month payment plan and be deducted from your SS each month. When you order or pick up Rx through the year, you pay $0.

Answer: The changes for 2025 will not affect prescription prices. Rather than have the donut hole and a $8000+ max out of pocket, the most any senior will pay in 2025 will be $2000. This can be set up on a 12 month pay from SS or you can pay as you go until you pay $2000 out of pocket and pay $0 for the rest of the year.

Answer: Some Medicare Advantage Plans provide Smoking and Tobacco cessation counseling to stop smoking or tobacco use in the Medical Benefits. Some provide counseling visits over a 12 month period at no cost to you.

Answer: I don’t know except it is very confusing to the senior market. Because they don’t know anything about Medicare, they often get lead into Plans and Benefits that either don’t work or fit their needs. They need a Medicare Broker and Advisor to guide them.

Answer: Medicare Supplements do not cover eye exams and would require a separate Plan to cover eye exams. A Medicare Advantage Plan covers Dental, Vision, and Hearing.

Answer: Medicare G is the most comprehensive and most expensive. Plan K is less expensive but has a higher max out of pocket. Ideal for someone in good health and able to pay out of pocket.

Answer: Someone who qualifies for disability benefits qualifies for Medicare benefits after 24 months.

Answer: If you’re retiring at age 65, you can apply for Part and B three months prior to your birth month. This allows time to to get this in place so you can research Medicare Plans.

Answer: Advantage Plans will save money if your on a PPO Plan and pays in and out of network. HMO Plans pay in network, but normally you pay out of network.

Answer: If your on A and B only, you have to purchase a separate Dental and Vision Plan. If your on an Advantage Plan, Dental, Vision, and Hearing are included.

Answer: If your on Medicare A and B only you would 20%. If your on a Medicare Advantage Plan, it usually has a copay that would be deductible for the MOOP.

Answer: SSA uses two years of tax returns to determine decrease in income to make a change.

Answer: It covers 80% of day to day medical needs and some Rx. It would not be enough if you were having to pay 20% of a large medical bill.

Answer: Only during OEP, AEP or have an SEP.

Answer: I suggest taking Part A and as long as they have creditable medical and Rx coverage, wait until they are ready to quit to apply for Part B

Answer: Hooking them up with a Medicare Broker and Advisor that can share more than one Plan and properly fit the best Plan to meet their needs.

Answer: I recommend Medicare Advantage because it covers Medicare Part A, B, C, and D plus Dental, Vision and Hearing and a multitude of other Benefits. With Original Medicare, you pay 20% of all cost plus paying for Rx, Dental, Vision, and Hearing out of pocket.

Answer: The fact that don’t have copays when using their Plan.

Answer: That it is unaffordable and limited coverage.

Answer: I don’t find any disadvantages as long as a PPO Plan is being used. I don’t use HMO Plans unless it’s a Chronic Illness Plan.

Answer: I have along time elderly client that called me today upset because I was the only one she felt she trust in what she was facing and didn’t want to lose me as her Agent and Advisor. She is having to move from NC to TX so her daughter can give her the care she needs. I told her to worry no more, because I can handle her Medicare coverage needs when she moves to TX and I will still be her Agent. She was one happy lady.

Answer: I am a senior myself and have been a Medicare Broker and Advisor for 25 years. I have personally been through or have worked through most any situation that a senior may be dealing with. I enjoy working out these situations from my personal experiences.