Rodolfo Rojas, Medicare Insurance Broker

Answer: It means that in 2025 you no longer have any donut whole. The Donut hole was a coverage gap in the prescription drug plans. It was confusing. Today, you don't have to worry about it anymore. The Inflation Reduction Act introduced that you have an out of pocket cap of 2000. 00 If you get to this amount, you don't pay for your medication anymore. . The medication has to be in the plan that you are on.

Answer: To legally manage your parent's Medicare benefits when they have dementia and are unable to make their own decisions, you'll need to obtain either a power of attorney (POA) or become their legal guardian or conservator. A POA allows you to act on their behalf if they are still capable of signing legal documents. If they are incapacitated, you'll need to petition the court for guardianship or conservatorship.

Answer: It depends on what type of Medicare do you. If you have Medicare Advantage-C- yes.

If you are in original Medicare, which is A and B, depends on where you go. You may have 20% coinsurance. An agent would have to do a need analysis to provide you with correct information.

If you have MediGap, you are covered.

Answer: Hello,

It depends on what coverage you have.

Regular Medicare, Medicare Supplement, or Medicare Advantage.

If you have Medicare Advantage, you will have special enrollments, or you use your Annual Enrollment every year to make changes.

Best to call and agent and allow us to go through your options.

Answer: Yes, best to do a need analyst to make sure you're choosing the most indicated plan. Most all the preventative procedures are covered. Make sure your medicines are in the formulary and that your doctor is in the network.

Answer: It depends on what plan you are choosing. Every state has different coverages. The 350 co-pays is just for the plan you are looking at. There may be better options for you. :-)

Answer: Original Medicare does not, but part C- Medicare advantage has s certain amount you can use for the purchase of the hearing aids.

Answer: Part A, with Original Medicare, you will have a deductible of $1,676 for the first 60 days.

If you have to stay longer, you would have $419 per day, 61-90.

I would suggest a Medicare Advantage, because your cost will be less.

Answer: It varies on what coverage you would like. If you are in decent health, I would suggest Medicare Advantage. If you can afford Medicare, supplant-Median-that would be another option. You can also stay with Medicare Original, which is A-hospital, and B-Medical. However, you will have deductibles and it is 80/20 coverage.

Answer: There are numerous of types of plans within Medicare.

I would suggest you contact an agent, like myself, to allow us to do a need analysis to find the correct plan for you.

Original Medicare, Medicare Advantage, Medicare supplement.

Answer: Do you have part D or Medicare Advantage that has it included?

This year, theirs a Cap of $2000 Max cost. You still need to make sure your medication is in the plan that you have chosen.

Speak to an agent, and they can make sure that all your medications are in the formulary.

Answer: Biggest mistake? That is a broad question. It depends on the individual, I would say not talking to a broker who does deep dive into your needs. It depends on your health, some people would benefit from getting some of the money that the government takes for your part B, others benefit in focusing on certain health coverage.

Answer: The Medicare Advantages are going forward. The plans are for a year, so every year you have to choose to stay in your plan or choose another. Every year there are new plans in Medicare Advantages. The people who have Medicaid and Medicare may not qualify for a plan due to the incorporation of Medicare moving to care management, which means they would have to choose a new plan.

Answer: Most plans offer Silver Sneaker or a different system of gym membership.

When you say you pay for Medicare, you're referring to what the government takes for your pay B, which everyone who has Medicare pay for. The other part is to make sure you check with an agent to make your you're getting all the benefits offered in your area, zip code.

You are welcome to contact me and, with your permission, will do a dive on your system.

Answer: Medicare is updated every year. For example, next year's Medicare Advantage plans will not provide food allowance. This is going to upset many seniors. However, if an individual has a chronic conditions, like diabetes, Cardiovascular....they will. I believe that people with Medicaid and Medicare will have a food allowance.

There are many regulations that feel unfair.

Answer: What type of Health Coverage do you have?

Is the SS taking a certain amount for your Part B from your check? This year, is $185?

What type of health insurance do you have?

Answer: If he has a Medicare Plan, yes.

They depend on location.

Do you live in a small town? Where there are more people, the benefits will be higher.

If your friend has Medicaid as well as Medicare, he would be able to have more benefits.

Answer: Hello, unfortunately with HMO, you will have to get a referral from your primary care to go to an in - network provider.

If you go out of network, you will have to cover the cost yourself, unless it is an emergency.

how long have you been with this HMO?

Answer: I love assisting people with their plans. In today's health word, there are constant change.

I love using my caring persona to assist people, but for commission, but because it makes me feel wonderful to assist our community.

Basically, I care that they are happy with their coverage, but I the same time know what is being offered to them and using an analysis to find the right fit.

Answer: Yes, if you receive disability for over 24 months, and you are turning 65, you will be eligible for Medicare. Are you currently getting Medicaid?

You should get a package from Medicare. This package should arrive around 3 months before you turn 65. You will automatically be enrolled in A and you have the option to keep B.

It depends on what other coverages you have.

I would suggest contacting an agent like myself, so we can do a need analysis and provide you with choices.

Answer: Yes, CGM is covered under Medicare Part B under durable equipment.

Including popular brands like Dexcom and Freestyle libre.

If you are in Medicare Advantage, you will qualify for a Chronic Plan, which has many more benefits.

Your doctor must prescribe your CGM.

It would be best to talk to one of us, we can make sure your doctors are in the network and that your medications are covered. It depends on which Medicare Advantage are in your area.

You are welcome to contact me, t775-350-1565. Leave a message, I will reach out.

Rudy Rojas

Answer: If you missed the initial enrollment, you can use a special enrollment to get started with your Medicare.

Do you have Part A and Part B? Are you thinking about Medicare Supplement or Medicare Advantage?

Answer: There is no donut hole any longer. Your deductible, the initial coverage and ones you get to 2000, you don't pay anything else for prescriptions that are covered in your plan.

Answer: Zero premium for a specific plan is just for the cost of the plan that you have chosen.

The plan has charges for specific services. For example, your primary visits, most likely are zero and the specialist may be $25.00

It just depends on the plan that you have chosen.

Some plans may cost you a certain amount, but it may have fewer charges for a specific service.

Answer: Medicare Advantage does provide you with a certain amount for hearing aids.

Original Medicare, which is part A and Part B, will not that type of coverage.

What state are you in?

Answer: It depends on the customer's need analysis. Medicare Advantage has numerous of plans in specific areas. It is the agent who you are working with to answer all questions and make sure the Medicare beneficiary understands all the covered services and not covered.

Medicare Advantage may cost you a monthly of zero, which is not what social security takes for your Medicare Part B, is for the plan, but it may have certain cost share, and copayments.

It also has many extra benefits.

Make sure you work with an agent that will check all your needs.

Answer: It is okay, but if you find the right agent, stick with them.

They all should have the capabilities to find the right plan for you.

However, not everyone is equal, so people will go out of their way to assist you.

Just make sure you provide the agent with answers to your needs.

Answer: Is your biologic medication covered right now? Cosentyx is covered in some part D plans or Medicare Advantages. However, you have to make sure they are in the formulary. Your deductible for 2025 is 2k, which means you will not pay anything after you get to that amount, but the medication has to be in formulary.

Answer: You have Part A and Part B

Medicare will cover your knee replacement if it is deemed as a necessary step.

If your knee replacement is done at an inpatient hospital., Medicare part A will cover the cost.

Plan G will cover the $1,676 deductible.

Most likely this would be the process. If you get it done at outpatient, not having to stay overnight, you will be responsible for B deductible in plan B, which for this year is $257.00

Answer: You should consider Medicare Supplement, they just cost more.

you can also get a travel medical insurance.

If you do the Medicare Advantage, you should pick a PPO plan.

Answer: You will need to do this through customer service with the plan that you are in.

For example, if it was Humana, you will need to call them and start the process.

You have to get your doctor to provide information on why you have to have this medication and service.

Answer: You will have to get a D coverage, which is a prescription.

You will be responsible for your part B, which is $185 premium this year, which the government take from your check. Furthermore, you will have a deductible of $1,676 for your part A, hospital.

You will be responsible for 20% of the cost of all procedures that are not included.

If you can afford all that, go for it. Medicare Advantage is what I would suggest.

Answer: It depends on what plan you have.

Make sure someone goes over all the cover services. Mostly, you pay a certain amount a month, and you will not have to pay co-pays-out of pocket charges that original Medicare does not cover for medical coverage.

copays, coinsurance deductible and some hospital costs.

Answer: You could possibly change, but not knowing all the details is hard to say for sure.

How long have you been in Medicare? If you change to Medigap, and you pass the original enrollment, they have a right to ask to do underwriting for your health.

They can also deny the coverage. The guaranteed Issue Right lasts for 12 months.

Have you looked at the Chronic Medicare Advantage plan?

Answer: Make sure they are covered under the plan. The best way is to call the insurance company and make sure your test is covered.

Stay with your plan network, make sure the lab is in your network, and request an estimate.

I would contact your plan of care and make sure that you know if it is covered. Make sure that you check your plan coverages, some are preventive and some are diagnostic, which would need co-insurance.

Answer: I would suggest doing a needs analysis every time you look at plans. Needs change, and it is a way of balancing what is important and the cost involved.

For example, if you are in good health, you may want to look at plans that may have a higher monthly cost, but you may pay less when you need service that may include co-pays or co-insurance.

Answer: Need analysis. You have to decide what the customer wants and decide with me by looking at the different options. Is he in good health? Can he afford a supplemental policy? Does he understand the supplement model?

Answer: If you have a PPO, you will just need to make sure it is in network; you don't need a referral.

You will have to pay more if you go to a dermatologist that is not in network.

I would call your plan customer services, but you don't need a referral in a PPO.

Answer: You can wait. However, you will receive a letter from Social Security, and they will provide you with your information for Medicare. You automatically get part A, and you can refuse the

Answer: There are two ways: you can call Medicare directly at 1-800-MEDICARE (1-800-633-4227). Or you can if you have an account in CMS, Medicare. You can request a replacement.

Answer: You do not need to change your Medigap plan. Original Medicare will move with you.

Your Medigap premium could change; you would need to check with the carrier of your plan.

Answer: Medicare Part B covers flu, pneumococcal, Covid-19, and hepatitis B vaccines; injuries/exposures like tetanus and rabies; and other conditions.

On the other side, part D covers shingles, respiratory syncytial virus, tetanus, pertussis and other recommended vaccines that are recommended.

If you are in Medicare Advantage, they have to cover all these as well, but check with your customer service.

What coverage do you currently have? You are welcome to reach out for consultation.

Answer: You are welcome to do so. However, the carrier agents will not go through all of your options. Most carriers have numerous of plans withing your zip code, which they can use look up.

An agent like my self, will go through a need analysis and use all your points to provide you with what is available in your area as well as other carriers?

Answer: You did not make a mistake. That is the coverage that you thought would be best for you.

You may want to check out some PPO plans that will allow you to see out of network when you are traveling. You could not even have a premium. If your health is good, I would suggest these. The benefit of original Medicare is that you can be seen anywhere in the US that takes Medicare, which you also have the backup of a Medigap, but they are expensive and you also have the Part B Premium.

Call me and we can do a need analysis.

Answer: After you get to catastrophic phase, you don't pay for medications that are included in the formulary.

Answer: Good question. By talking to a licensed agent, they can assist with the carriers that carry in your state. For example, Lumina will have several Medicare Advantage plans in your area. These plans are legal and have to be approved by CMS. Just make sure you work with an agent who can provide you with all of your options. You are welcome to give me a call.

Answer: I would suggest that you first check if your doctor required that you get home care service.

It needs to be provided by Medicarecertified agency.

I don't know whether you have original Medicare or you have Medicare Advantage or a supplement, in which you would need to reach out to them.

You should have gotten a summary notice of why your claim was denied. It should have an explanation of how to appeal their decision. You can use form 20027, Medicare Retermination Request.

I would get documentation from your doctor stating that you need this type of care.

Answer: If you like, you can stay with just A-Hospital coverage. If you don't get Part D, which is prescriptions, you will be charged a late enrollment penalty, which is 1% of the national base premium you were eligible for for Part D.

Part A will have no monthly cost. If you have to go to the hospital, part A deductible of $1,676 for

Each time you stay at the hospital for the first day to 60 days. You will be charged $419 for each day after 61 days.

By not having Part B, you will not be charged the $185 a month.

Answer: If it is mandated by your doctor, Medicare covers it. Meaning is necessary for you to function. This is covered by part B of your Medicare

If you only have Medicare, there is a deductible of $257 for this year. And if there are co-payments, you will be responsible for 20% of the cost.

Answer: Yes, you can generally pay with your HSA account to pay for certain premiums.

You could not use it if you were in Medicare supplement though.

Answer: That depends on the medication. If they medication is in the formulary, after you reach you reach $2000 out of pocket expense, then you will not pay anything for this year. But it has to be in the formulary.

Answer: It just means that if you sign up for a Medicare Supplement, you don't have to go through underwriting depending on your health. When you first enroll in Medicare Part B, you have a six-month window to enroll in a Medigap policy with guaranteed issue rights.

Keep in mind, though, that supplements are pricey.

Answer: Part D coverages are for prescriptions. If you are in a Avantage plan, you don't need to have get part D, for it is included. However, if you have original Medicare, you will also need to have Part D.

Answer: Yes, you have to get a new plan if you are in Medicare Advantage. If you are only with Medicare Original, call Medicare to update your address.

Answer: Just depends if they are in Network and which plan do you go with. If you decide on a PPO, you can keep your doctors even though they may be out of network; you will have to pay more.