Russel Coley, Medicare Insurance Broker

Answer: It can be frustrating if an important trusted doctor is not in network and an HMO with network restrictions is their best option and they want to stick with their existing doctor.

Answer: I would say most big companies that have had an Advantage plan option for several years have most doctors in network but not all. You should have a trusted agent check that out for you before you enroll in any plan. Worth noting that a PPO as opposed to an HMO offers more flexibility to see most doctors with a bit higher cost if they are out of the PPO network.

Answer: That’s a matter of opinion based on the particular needs of an individual. If you are going to several specialists a month and in and out of the hospital, a supplement may work out mathematically. However, if you are healthy and just see your primary a couple times a year with a hospital visit thrown in every now and then, an advantage plan may suit you better as the copays you will pay may not be as much as what you would pay in premiums for the supplement. Plus advantage plans often come with extra benefits.

Answer: The simple answer is…if the inhalers are hand held and prescribed then they are typically covered under part D. If they are in liquid form and require a nebulizer then Part B is utilized. Under Part B, the patient will pay the deductible, if there is one and then 20% of the cost unless they have a Medicare supplement or advantage plan. With an advantage plan with drug coverage or a stand alone drug plan, the max out of pocket is $2100. After that, the patient will receive the handheld inhalers for $0.

Answer: Medicare Part B fully covers routine annual Mammograms. If you or your Dr request an additional Mammogram, you will typically pay 20% of the negotiated discounted price for the bill

Answer: Good question. Medigap/Medicare Supplement plans have less network restrictions. Medicare Advantage in $0 premium plans is paid for by your Part B contribution already coming out of your Social Security check. These plans protect you with a max out of pocket amount and often include dental, vision, prescription and over the counter benefits and allowances.

Answer: You should apply for the Medicare Savings program to help with your Part B premium and LIS to help with prescription drug costs. Let me help you do that online so you don’t have to wait at a local Medicare establishment.

Answer: That is a personal preference. However, if you qualify for Medicare, looking into it could be well worth your time. Let me help you for a zero consultation fee.

Answer: LTC is not covered by Medicare. Home Health Care and Hospice are included within the plan. We have LTC options available to you.

Answer: Well.. original Medicare does not cover dental cleanings. So the answer is normally yes because most Medicare Advantage plans include dental at no additional cost.

Answer: Specialist are covered with a copay. To make sure your Dr will be covered, ask about the best local PPO plan.

Answer: Part A will be awarded to you and Part B is optional for a premium based on your income. If you have VA coverage and the closest facility is a ways away. Having Medicare A&B with a Medicare Advantage plan $0 premium could be beneficial for convenience. Also, many plans include other benefits like dental, vision and over the counter allowances within the plan for no additional cost.

Answer: The money you pay for Part B to the government is rerouted to the private insurance company we select.

Answer: Medicare Part A covers hospitalization or inpatient coverage. Most people who have worked for 10 plus years qualify for a zero premium.

Answer: Working with a good agent can help you make the best choice. It does not cost any more and you will have someone you can reach for support. Sometimes a call to the Insurance Company can be a headache. Let me answer your questions quickly or call the insurance company for you. You might make a friend/advocate to support you.