Sandy Hammond, Medicare Insurance Agent

Answer: So sorry for the delay in getting to this question! Outpatient surgery is only covered under Medicare Part B, even if the outpatient surgery is performed at the hospital. Hospital coverage Part A covers some of the costs associated with an in-patient hospital stay-key word being "in-patient" overnight hospital stay.

I hope I have answered your question.

Answer: Medicare is confusing at best! I feel that I am a good teacher and just love it when I can see that light bulb moment of understanding. The sense of gratitude the beneficiaries have for me when they know I have their best interest at heart is truly gratifying to me.

Answer: Enroll in Medicare Parts A & B if you have not done so already. Also, you must include the L564 form, your employer will fill this out, that indicates that you have had creditable employer coverage up to this point. You will want the Part B effective date to be the 1st of the month for which you will no longer have employer coverage. If you have not already enrolled in Part A, it will be back-dated for 6 months.

Please apply online through your SSA.gov account (Social Security Account). If you are also expecting to apply for your Social Security Retirement Income, please do not apply at the same time as Medicare. For some reason, this causes major delays in getting your Medicare card. Apply for your Medicare A & B first, get your Medicare card, and then apply for Social Security, if that is possible for you.

Once you have received your Medicare card, you can then speak with an agent about "additional" insurance coverage options. I hope this answer is helpful.

Answer: If you are currently on a Medicare Advantage plan or a PDP-Prescription Drug Plan, then yes you should received and ANOC each and every year. They are usually sent out in the month of September. The ANOC explains what the difference in your current plan is against that same plan for the upcoming year, in this case 2026. It is at this time that you can decide if you need further guidance from a licensed agent as to whether or not you should continue with such plan. Annual Enrollment Period (AEP) runs from October 15th - December 7th each and every year and it is at this time that you can make a change to either the MAPD (Medicare Advantage Plan), or the PDP (Prescription Drug Plan). This plan change would become effective 1/1/2026.

If you are one a Medicare Supplement plan, you will not receive an ANOC since these plans typically do not change from year to year.

I hope you find this answer helpful.

Answer: The Annual Notice of Change is typically sent out during the month of September each year. It will show you the changes being made to your current plan for the upcoming plan year.

Answer: If you are on a Medicare Supplement plan, then yes, most private hospitals will accept Medicare Supplement plans.

If you are on a Medicare Advantage Plan, then you would typically have to go to a hospital in that plan's network.

No matter what type of plan you are one, emergency room visits will always be covered.

Answer: There are a few ways that a Medigap insurer can terminate your policy:

1. Non-payment of premium.

2. You move out of the area and would need to enroll in a plan that is offered in your new state.

3. The insurer files for bankruptcy.

I hope you find this answer helpful.

Answer: The one thing I would like to change about Medicare is the late enrollment penalties. I do not believe that they are fair, since Medicare can be so confusing and Social Security is not allowed to give any type of direction as to what one needs to do when, when it comes to enrolling into Medicare. You don't know what you don't know.

Answer: There are several different types of Special Needs Plans:

1. DSNP stand for Dual Special Needs Plan. This is a plan specifically for those individuals who are on both Medicare and Medicaid.

2. CSNP stands for Chronic Special Needs Plan. This is a plan specifically for those individual who suffer from chronic conditions such as Diabetes, Chronic Heart Failure, Cardiovascular Disease, Dementia, etc.

3. ISNP stands for Institutional Special Needs Plan. This is a plan specifically for those individual who are in a Nursing Home situation.

I hope you find this answer helpful.

Answer: There are many preventive screenings that are at no cost for Medicare Beneficiaries:

Diabetes Screening

Cardiovascular Screening

Pulmonary Screening

Various Cancer Screenings for both male and female

Obesity Screening

Bone Mass Measurement Screening

Colorectal Screening

Gynecological Screening

Prostate Screening

This is not the full list of preventive screenings that are available. For a more comprehensive list, please see the Medicare & You Handbook that should be mailed to you each year.

Answer: If you have been on disability for more than 24 months, prior to age 65, then you should already be on Medicare at month 25 of disability. Otherwise, yes, you will automatically be put onto Medicare and you should receive your Medicare card and number up to 3 months prior to your 65th birth month. At this time, you can then decide on additional Medicare coverage options to help fill in the gaps that Medicare leaves behind. It is at this time that you would want to speak with a Licensed Agent who can guide you in this situation so you know exactly what your options are. You have until 3 months after your 65th birth month to decide on the additional coverage options.

Answer: It really depends on what type of Medicare plan that you have. Do you have a Medicare Supplement plan along with a stand alone Prescription Drug Plan, or do you have a Medicare Advantage Plan with a built in Prescription Drug plan?

We would really need to know this information first, before providing a list of possible lesser-know benefits or services your plan might cover.

The best thing to do is to call the Member Services number listed on your member ID card and they should be able to assist you.