Stephanie Calvillo, Medicare Insurance Broker

Answer: The new $2,100 out-of-pocket maximum is important because it helps protect people from having to spend too much on their prescription medications. Once they reach that amount, they won’t keep paying those high drug costs for the rest of the year. This can be a big help for people who take several medications or have expensive prescriptions.

Answer: No, you don't have to sign up for Medicare again. Since you're already on Medicare because of a disability, your coverage will continue. When you turn 65, you'll get a special enrollment period, which gives you the chance to review your options and switch plans if you find one that's a better fit for your needs.

Answer: Before you call any number from a Medicare commercial, talk to a trusted Medicare agent first. We can help you make sure the benefits they're advertising are actually available where you live and that you qualify for them. A lot of those commercials make things sound better than they really are, so it's always a good idea to double check before you sign up.

Answer: If you’re on your spouse’s active employer plan and it’s creditable coverage, you can usually delay Medicare without a penalty. Once that coverage ends, you’ll have an 8-month Special Enrollment Period to sign up for Medicare. You’ll just need proof from the employer when you enroll later.

Answer: It’s not exactly a preventive service. For diabetes, Medicare covers nutrition counseling under Medical Nutrition Therapy (Part B). It is covered, but it does require a doctor’s referral. Once you meet your Part B deductible, Medicare usually covers it at 100% as long as you use a Medicare-approved provider.

Answer: Yes, with Medicare Part B, physical therapy is covered, but you do have to meet your Part B deductible first. Once that is met, Medicare usually pays 80% of the approved amount, and you’re responsible for the other 20%. As long as your doctor says it’s medically necessary and the provider accepts Medicare, there’s no set limit on how many visits you can have.

Answer: The best part for me is hearing how happy my clients are after I’ve helped them. When they’re satisfied enough to refer me to their friends and family, that really means a lot. It tells me I’m doing my job the right way.

Answer: Most people look at Medicare options during the annual enrollment period, which runs October 15 through December 7 each year. That’s when you can review your plan and make changes for the following year.

If you’re turning 65, you’ll first enroll during your Initial Enrollment Period, a 7 month window that starts 3 months before your birthday month, includes your birthday month, and ends 3 months after.

There’s also a Medicare Advantage Open Enrollment Period from January 1 through March 31 if you already have a Medicare Advantage plan and want to switch or make changes.

Answer: Medicare may cover certain costs for approved clinical trials. However, Medicare generally does not cover the experimental treatment itself if it has not been approved. Coverage can vary depending on the type of study and treatment.

Answer: If you have Original Medicare and a Medigap plan, you can generally keep your coverage when you move to another state because Medigap plans work nationwide. However, it's still a good idea to review your coverage and update your address with Social Security and your insurance company.

Answer: Medicare Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. For most people, Part A is premium free because they or their spouse paid Medicare taxes while working (earned 40 quarters). Keep in mind, though, that there can still be deductibles and other out-of-pocket costs.

Answer: No. If you have VA health benefits, you are not required to enroll in Medicare at age 65. However, VA coverage does not protect you from Medicare Part B late enrollment penalties if you delay enrollment. It's important to consider whether you may need care outside the VA in the future and the potential penalties you could incur if you do not enroll in Medicare when first eligible.

Answer: Medicare is complicated, and a Medicare agent helps make it easier. We compare plans, explain benefits, make sure doctors and medications are covered, and help people choose a plan that fits their needs. All at no cost to them.