Satoshi Aoki, Medicare Insurance Agent

Answer: Explain the Medicare system and what is options available then my client understands.

My client was very happy with the plan he signed up for.

Answer: Most people confuse the open enrollment period for the Medicare Advantage plan, Part D Plan, and Medicare Supplement plan.

Answer: I cannot say it is covered, and how much depends on what kind of medication you take and the Part D plan provided by the health insurance company. You should contact Medicare agents and make an appointment.

Answer: If you enroll in Medicare without a Medigap plan, you must pay a lot for medical care, especially Part A hospitalization.

For example, if you are hospitalized for 120 days, you will have to pay

Deductible: $1,676,

(61 days to 90 days): $419/day = $12,570

(91 days and after): $838/day = $25,140

TOTAL: $1,676+$12,570+$25,140= $39,386

, respectively, if you only have Medicare.

However, if you have a Medigap plan, you will be covered. A lot of Medigap plans will cover Part B depending on the type of Medicap plan.

For more information, it is a good idea to ask the agent from AGENTS HUB.

Answer: Yes, If your friend enrolled Medicare Advantage plan, each plan is different compared with other cities or counties most likely.

Answer: Yes, Puerto Rico is covered.

In most situations, Medicare won’t pay for health care or supplies you get outside the

U.S. The term “outside the U.S.” means anywhere other than the 50 states of the U.S.,

the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa,

and the Northern Mariana Islands. There are some limited exceptions that would allow

you to get coverage outside the U.S. under Medicare Part A (Hospital Insurance) and

or Part B (Medical Insurance).

Answer: If you only have Medicare Part A and Part B, most of the costs will be covered, but some are not. Medicare Supplement Plans are used to make up for those costs.

Example A(2025)

If you need to be hospitalized for 120 days

Part A does not cover(You have to pay)

Part A deductible: $1,676

61 day to 90 day: $419/ day = $12,570

91 day and after: $838/ day = $25,080

Total cost = $39,326

Most Medicare Supplement Plans will cover this cost.

Part B also covers 80% of the cost, but the remaining 20% ​​will not be covered, but most Medicare Supplement Plans will.

Please consult with your agent for more details.

Answer: If you already have Medicare benefits due to disability, you just continue to have your Medicare benefit. If you like to change your plan such as the Medicare supplement plan, you are eligible to an open enrollment period that begins three months before your 65th birthday and ends three months after your 65th birthday. Please ask your Medicare insurance agent.

If you don't have Medicare benefits now and have enough Medicare credit, you will automatically receive your medicare benefit.

I prefer to access to Social Security Administration on WEBSITE.

https://www.ssa.gov/medicare/sign-up

Answer: I will assume that you have power of attorney.

First, you will need to understand the details of your father's prescription drug insurance (Part D) and the types(tier) and numbers of medications he is taking.

Next, you will need to confirm where the bill came from and contact the insurance company to find out if the claim is valid.

(I also recommend making a bullet point list.)

Finally, many insurance companies allow you to check the medication status online.

We recommend that you speak to your agent for more information.

Answer: Each prescription drug has a tier, and the amount you have to pay out of pocket varies depending on the type of drug.

Example:

TIER 1: Preferred Generic

TIER 2: Other Generic

TEAR 3: Preferred brand

TEAR 4: Brand

Special: Special

If you already have a Part D plan, we recommend you check with your insurance company or agent to find out what tier the drug you are taking is.

Answer: Yes.

Medicare covers screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There’s no minimum age requirement.

If you initially have a non-invasive stool-based screening test (fecal occult blood tests or multi-target stool DNA test) and receive a positive result, Medicare also covers a follow-up colonoscopy as a screening test.

https://www.medicare.gov/coverage/colonoscopies

Answer: First, I examine the client's current health condition as well as any concerns they may have about the future, and then I tell them what options are available.

Ultimately, it is the client who makes the decision, so I believe it is the agent's job to help them find the answer.

Answer: First, I will speak under the assumption that there is no Medicare myth among most agents.

I think some agents think that it is better to enroll in a Medicare Supplement Plan with Part A and Part B rather than a Medicare Advantage Plan. This is an assumption considering the advantages of the scope of coverage and the greater number of doctor choices.

Conversely, there may be agents who think that the Advantage Plan is better.

However, this differs depending on each customer's situation, so it is not absolute.

I think that the agent's role is ultimately to suggest which plan is most suitable for the customer's situation.

Answer: Medicare Star Ratings measure the quality of Medicare Advantage and Part D plans.

If you have a Medicare Advantage plan, you should know about the star rating on your plan.

Star rating uses a 1 to 5-star scale.

A 5-star rating means excellent performance. The ratings are based on factors like member satisfaction, customer service, and health care quality. Plans with higher stars often offer better care and service. Ratings are updated yearly by Medicare to help beneficiaries compare plans and make informed choices. Choosing a higher-rated plan can improve your overall experience and access to care.

You may also switch to a 5-star plan during a special enrollment period, even outside of the usual enrollment times.

Answer: Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters) and

wheelchairs as durable medical equipment (DME) if:

• The doctor treating your condition submits a written order stating that you have a

medical need for a wheelchair or scooter for use in your home.

• You have limited mobility and meet all of these conditions:

– You have a health condition that causes significant difficulty moving around in

your home.

– You’re unable to do activities of daily living (like bathing, dressing, getting in

or out of a bed or chair, or using the bathroom) even with the help of a cane,

crutch, or walker.

– You’re able to safely operate and get on and off a wheelchair or scooter, or have

someone with you who is always available to help you.

– Both the doctor treating you for the condition that requires a wheelchair or

scooter, and the DME supplier of the wheelchair or scooter, accept Medicare.

– Your doctor or DME supplier has visited your home and verified that you can

use the equipment within your home (for example, it’s not too big to fit through

doorways in your home).

WEBSITE: https://www.medicare.gov/publications/11046-medicare-coverage-of-wheelchairs-scooters.pdf

Answer: It is important to choose a Part D plan even if you are healthy when you turn 65. If you delay your application, you will incur a penalty and have to pay additional premiums. Furthermore, the penalty will continue.

reference

https://www.medicare.gov/health-drug-plans/part-d/basics/costs

Answer: Original Medicare (Part A and Part B) does not cover hearing aids or exams for fitting hearing aids. If you only have Original Medicare, you’ll typically have to pay out of pocket for hearing aids and related services. However, some Medicare Advantage (Part C) plans may offer hearing benefits. You should check your plan if you have a Medicare Advantage plan with your agent or health insurance company.