Sherry Stone, Medicare Insurance Agent

Answer: You can go to your insurance's website and look for their "find a provider" on the page. Each site is a little different, but you'll put in your zip code, then choose your plan. Usually you can search a specific doctors name or you can search the area of practice (like Nephrology) and it'll give you a list of providers in your plan. You can also (usually) limit your distance of search so you're not finding doctors fifty miles away!

Answer: A special needs plan, or SNP, will have a defining term in front of the SNP in its title. A Dual SNP is a plan for people who have both Medicare and Medicaid. A Chronic SNP if for people with certain chronic health conditions, like diabetes, CHF, or cardiovascular disorders.

Answer: Short answer, yes. But, what is their situation? Are they turning 65 soon? Will they have health insurance benefits they get to keep as retirees? If so, sign them up for Part A - this is the $0 premium part if you paid Medicare taxes for 40+ quarters. If they'll have continuing health insurance from a former employer, you can decline Part B enrollment. If they won't/don't have any other form of health insurance, yes - help them sign up!

Answer: Oh my gosh, I don't want to get anyone into trouble - please ask your accountant!!! (but in some situations, yes)

Answer: If you're already collecting social security, you'll automatically be signed up for your Medicare benefits. If you have not yet started social security, you need to apply for your Medicare benefits - this is done through the Social Security Administration and/or you can sign up on ssa.gov. That's step one! Then you can start looking into the insurance that goes along with your Medicare A and B, however you'll need your Medicare ID to enroll into a plan.

Answer: It all depends on the county - each one has a different offering of Medicare Advantage plans. It can happen, though, where counties with larger populations will have 30 MAPDs offered, to a much less populated county's offering of ten. Always check with your local agent.

Answer: I don't necessarily think this is a "better or worse" scenario, it's simply what is best for your situation. If you have original Medicare Parts A and B and a traditional supplement, then you must enroll into a stand alone Part D plan. You cannot have both a supplement and an advantage plan at the same time. If you are not going to have a traditional supplement, enrolling into a Medicare advantage plan (with prescription coverage) would be a great way to go. There are several MAPDs in this area with a $0 monthly premium, besides what you pay for your Part B.

Answer: It depends what your prescription drug plan you're enrolled in. I help my clients understand their specific medications with the various drug plans or advantage plans offered in their county. Every plan has its own formulary (list of covered drugs) and may not cover the same brand of inhalers as the next plan, for example. If I have a client call me and say they've been prescribed XYZ inhaler and it's going to cost them a zillion dollars, I tell them not to panic, it's just probably not in the formulary. I then pull up that specific plan's formulary and send the list of covered inhalers to the client to share with their doctor so the doc can prescribe one that is in network. (Docs/providers don't know their patient's insurance and formularies, they just prescribe what they know will work, and sometimes it's not in their patients plan.)

Answer: Wow, this could be tricky! I suppose it would depend where this cruise is taking place. In general, Medicare does not pay for services rendered outside the U.S. or its territories. However, some traditional Medicare supplements (Plan F, G, N for example) offer some foreign travel coverage up to $50,000 lifetime max. Certain Medicare advantage plans may offer foreign travel coverage, it just depends on the plan. If you are going on a cruise and concerned, ask your local Medicare agent if you have any coverage.

Answer: If you do not have any state assistance from Medicaid, Original Medicare A and B and adding a traditional Medicare supplement would be what I recommend. You'll pay a monthly premium for the supplement, and almost all of the other 20% Medicare does not cover will be taken care of by the supplement (it depends which exact supplement in which you enroll). This makes it easier to budget, and most times it will save the person money if you need chronic care.

Answer: Yes, however if you are not in a "guaranteed issue" period - like when you're first turning 65 or coming off your employer's insurance - it will be fully underwritten (with various health questions).

Answer: The easiest way to start is to apply for "Extra Help" with Medicare Part D costs. When you start with the application for this (it's literally called "Extra Help"), it will send your information to the state/DHS to see if you might qualify for further assistance - unless you specifically click the box to say not to. Go to this link. Scroll down to the bottom of the page and click on "Apply now". Follow your way through the application. This is actually done through the ssa.gov (Social Security Administration) website, so it's totally legit and secure. Worst they'll say is no, so I always tell my clients there is no harm in applying.

https://secure.ssa.gov/i1020/Ee001View.action

Answer: I actually cannot answer that 100% accurately without more information. What I can tell you, though, is that Medicare bills the Part B premium on a "sliding scale", if you will, which is based off your income from two years prior. For 2025, if you are single with a yearly income of $106,000 or less, or married with a yearly income of $212,000 or less, you pay the "standard" Part B premium - which is $185 monthly (for 2025). The rest:

Single $106,000 - $133,000 or Married $212,000 - $266,000 yearly income - your Part B is $259 monthly.

Single $133,000-$167,000 or Married $266,000 - $334,000 yearly income - your Part B is $370 monthly.

Single $167,000-$200,000 or Married $334,000-$400,000 yearly income - your Part B is $480.90 monthly.

Single $200,000-$500,000 or Married $400,000 -$750,000 yearly income - your Part B is $591.90 monthly.

Single with over $500,000 or Married with over $750,000 yearly income - your Part B is $628.90 monthly.

This is called IRMAA - Income Related Monthly Adjustment Amount. It will change a little each year. This also pertains to Part D!

Answer: Sadly, no. Medicare Parts A and B definitely (as of the year 2025!) does not cover routine/comprehensive dental benefits, such as dental implants. Some Medicare advantage plans ("Part C") offer a dental benefit, however each plan's monetary and coverage offering will vary and should be reviewed with a local agent.

Answer: Meeting with an experienced, local Medicare agent is really the best way to compare plans. Not only do plans vary from state to state, they can vary county to county!

Answer: Unfortunately, the answer to that question is not so cut and dry. Most EMS/ambulance companies will charge what's called a "base rate" - the amount they'll charge to leave their premises and do a job. Generally, they'll also add costs onto each mile traveled, as well as costs onto the level of care given to the patient/rider. If you don't have a supplement or advantage plan to help pay those costs, it can be into the thousands.

Answer: In general, all insurance plans will require prior authorization for surgical procedures, and there can be several reasons for this. Cost is always high on the list. The insurer will want to make sure the procedure is medically necessary, if the surgery is the most appropriate course of action, and if less expensive options have been explored first.