Ross Landon, Medicare Insurance Agent

Answer: .My Father developed dementia and we had a difficult time finding experts that well understood and could explain the rules for going in and out of senior care facilities. I decided I would become that expert so I could help both my Mom and Dad with these perplexing questions! Once becoming Certified and gaining experience for some 14 years I was able to help numerous seniors with these perplexing questions!

Answer: No Advantage plans are definitely not free, even though some with Seniors do not have to pay a monthly premium. Most of the services require either copayments or co-insurance % payments, or both. Some preventive services are low or no cost, but most have some cost to them. Still, they are a great value, especially if seniors are in pretty good health!

Answer: Depending upon your income and assets you might qualify for Extra Help to reduce your out of pocket expenses considerably. If you don't qualify for that, you might ask your Dr. about Manufacturer discounts that could be available for expensive medications. Now that we are in 2025, the donut hole cost share has been phased out!

Answer: Getting on good Advantage Plans or Medsup plans can help you control future costs, and since you can choose among those plans each year, as your health changes, you can counsel with knowledgeable agents to help you seek the best coverage for your situation.

Answer: They really don’t. Popular discount cards like “Good Rx “ can be used to give you a better price on some medications.

However, they do not count towards your Rx deductibles or true out-of-pocket costs. They are not insurance plans, so they are just standalone discounts!

Answer: Part B of Medicare covers common vaccines like the flu, Covid 19, pneumonia, & Hepatitus B shots.

Part D drug coverage, generally covers adult immunizations to prevent things like shingles, tetanus shots if you have a puncture wound, respiratory viruses, and things like those at no cost to you.

Answer: Yes, but not directly. You would have to use personal funds to pay the premiums like using a bank account or credit card. Then you can reimburse yourself by making withdrawals of your HSA, as long as you keep careful records and receipts of your withdrawals so you can prove those are Medicare qualified expenses!

Advantage plans do qualify as well as copays & coinsurance, however Medicare Supplement premiums do not qualify!

Answer: Sure, the Extra help would be ideal to help pay copayments, coinsurance & premiums for low income people on fixed incomes. Simply type in Extra Help in the Medicare.gov search box & it will show you exactly how the program works & how you qualify!

Answer: No I don’t think so. About 35% of 20 million Medicare beneficiaries are on private Medicare advantage plans. The idea of those plans was to provide better care at lower cost than traditional Medicare. The center For Medicare advocacy feels that promise has not been met.

A couple of reasons have been suggested for that, such as the Medicare modernization act of 2003 led to increased program costs, and also risk adjustment practices that resulted in annual overpayments in billions of dollars to MA plans have been blamed.

Answer: It is the cost. Advantage plans are often 0 premium plans or low premiums like$35/mo for each person. They are very attractive if you are quite healthy. Medsupp plans typically would cost $150/ mo for each person so only more affluent seniors can afford the Medsupp plans Plus they would also have the Rx plan monthly cost on top of that!

Answer: That might be an overnight procedure & with most advantage plans surgery in a hospital would mean a co-pay per night of about $350 to maybe $500, depending upon your plan. So if you have to stay a couple of days in the hospital, it’s still probably gonna be less than about $1000!

If it is just same day surgery, it will be about that much co-pay for the single procedure itself. So still the cost is pretty reasonable for surgery. $350- $500.

Answer: Medicare seems complex, but you only have to decide between two types of plans, Medicare Advantage Plans or Medicare supplements.

A knowledgeable Agent can explain it easily in a no pressure setting, and you will know what feels right for you & your family. It can be quite simple & you will feel good about your choices!

Answer: That does not happen often! Simply call Customer Service on the back of your advantage plan Wallet card, and the carrier will help you find providers… Once in a while I’ve run into a similar problem, but the Insurance companies have additional resources and provider lists that they can point you to!

Answer: Failing to sign up for part D of Medicare, prescription drug coverage when eligible to do so! Some seniors feel that if they are not taking any prescription drugs, they do not want to pay for nor need part D, but then they find out a couple of years later about the penalty of one percent per month that will be charged retroactively if you are not on a qualified Rx plan.

When they finally do need prescription drug coverage, they find the penalty is never removed unless you appeal with a very good reason for not enrolling!

Answer: With advantage plans, it would be rare to pay too much for them, most are fairly low cost at $35-$75 per person & many are zero premium plans, which means it costs nothing to enroll in them, though that does not mean they are without cost! But they’re very reasonably priced and most are very similarl

The more difficult ones to analyze are the Medicare supplement plans, Most start at about $150/mo per person upon retirement, if you’re on them for many years and they go up even moderately every year, in 10 years or more, they can become somewhat expensive!

Answer: It covers a Woman age 40 plus once a year without cost if your Dr accepts Medicare Assignment, just ask them, they will tell you!

Diagnostic screenings are covered more often if medically necessary, which means your Dr must order them, then you’ll pay 20% of the medicare approved amount! With these, The Part B deductible applies first, which is $240 annually in 2025!

Answer: That’s a tricky, one first determine where most of your medical bills are coming from, is that from RX cost, or is it from doctors and hospital visits? If you look back over the past year and determine that you’ll know how to approach a solution with a knowledgeable Medicare agent. It sounds like you are picking among Advantage plans each year. They have a lot of co-pay dollar costs and coinsurance percentage costs if you use them frequently. But they also have very low monthly premiums and often times even zero premiums. So those are desirable if you have lower medical costs and infrequent specialist and doctor visits.

Medicare supplement plans, however, cover most all medical expenses, if you can afford the much higher monthly premiums, typically starting around $150 a month per person at age 65 and going up moderately each year from there. People like those that need predictable costs and can afford the higher premiums monthly, plus an Rx plan each. You need guidance on picking the right kind of plan, and one that is affordable to you!

Answer: There is always a Benefit Summary that shows you exactly what you will pay, depending upon what Tier the drug has been assigned! You can look those up online at the Carrier’s website under Formulary lists, or you can call the Customer support # on the back of your card & they will help you know the right Tier.

Then just look up the Tier # on your Benefit Summary, & it will tell you the copay $ amount, or the Co-insurance % amount that you will pay for that Prescription!

Answer: Good question, original Medicare, which is part A coverage and part B coverage do not cover hearing aids nor the exams for fitting them. However, most advantage plans do provide some hearing aid benefits. But you have to shop carefully because the copayments can range widely, depending upon the expense and complexity of the hearing aids.

Also, Medicare does cover diagnostic exams if your doctor orders them to see if you need medical treatment for hearing. Many advantage plans will provide additional benefits for hearing aids, but you usually must pay 20% of the Medicare approved amount and your part B deductible does appy. There also can be copayments for outpatient treatments in the hospital.

Answer: Part B of Medicare will cover some Acupunture if you have Chronic Lower back pain as diagnosed by a Doctor.

There are other limitations too, so check with An Agent or your Provider so you know your treatments will be covered! Most plans limit even those visits to 12 times a year or monthly treatments! Also expect to pay some coinsurance percentage and also some dollar copayments as well!

Answer: Yes, under Original Medicare, part B covers smoking cessation programs because it’s considered a preventative service and is usually fully covered!

However, there are some limits to those programs. Usually two cessation programs a year are covered, with four visits per session, a total of eight per year!

Answer: You want to apply as early as possible to try to qualify for long-term care policies. They are carefully underwritten so you have to be in reasonably good health in order to buy long-term care policies!

They are quite easy to calculate the cost for because you really only need about three pieces of information to fill out an application and get a quote on what those will cost. About all you need to know is the amount of money needed per month, and the period of time that you want the Benefits to run, and finally What waiting period to use before your benefits begin after you qualify to start receiving benefits. Typically.those would be 60 or 90 days and it acts like a deductible!