Steve Brauer, Medicare Insurance Broker
Steve Brauer
Variety Benefits
Medicare Broker Licensed in AZ and CA
22+ Years of Experience
Contact Details
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Location
Scottsdale, AZ
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About Me
Simply put...we Translate Medicare into English! We are the Husband and Wife Medicare Team
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Articles by Steve Brauer
Q&A with Steve Brauer
What are the reasons why I should work with a Medicare agent?
Answer: Well...I would only recommend working with an INDEPENDENT Medicare agent, and one that you think you can trust. Our services are free and I highly recommend you find an Independent broker that ONLY does Medicare....Medicare has a lot of nuances and I've learned over the years, you can't be an "expert" at everything!
What's the trade-off between a Medicare Advantage PPO and HMO when it comes to flexibility?
Answer: Well...with a Medicare Advantage PPO plan, you have a little bit of flexibility with going to a provider OUT of the HMO network, however, if you compare the PPO benefits to the HMO benefits on Medicare Advantage Plans, you'll see that for a little bit of out of network coverage, your in-network benefits suffer....and you'll get a lot less "extra benefits" like Dental, Vision, Over the Counter, etc...
I'm taking a brand-name medication that doesn't have a generic version. How can I find a Medicare Part D plan that will cover it at a reasonable cost?
Answer: Your Independent Medicare agent that solely does Medicare should be able to strategize plans for you that cover your particular medication with the best coverage. Every carrier has their own "Formulary", which can differ greatly. If you have an expensive medication, you may have to spend a little more money each month to have it covered under a specific Part D plan.
When my husband dies, do I get his Social Security and mine?
Answer: I like to stick to my own lane...I always send people, and even accompany my clients many times, to the Dept of Social Security here in Phoenix. The people I've worked with there are super knowledgeable and helpful. I would not want to inform you about something like that if I was not 100% comfortable with it.
I picked a Medicare Advantage plan based on the low premium, but now I'm facing high copays. Did I make a mistake?
Answer: There is never a "one size fits all" approach to picking a Medicare Advantage Plan. If you have high copays, you most likely have other benefits to that plan that maybe other plans do not have. The best part, is that you can switch your plan once, and sometimes twice, a year!
My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?
Answer: Yes it is. As they say...the devil is in the detail. When a Medicare Advantage Plan offers "dental" coverage, it can mean a lot of things. Is it "first dollar dental", meaning that you have a pot of money to draw from, usually without having to pay anything first. Is there a "network" associated with the dental coverage offered. Is it an HMO dental plan or PPO? If you have a good Independent Broker, they know things like this.
I want to get a shingles vaccine. Will Medicare cover this preventive service?
Answer: There is never an "always" answer...but in most cases vaccines are covered at 100% now with most plans. Again, if you have an agent, they should be able to answer that question for you
My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?
Answer: In easy-to-understand terms, you are only responsible for up to $2000 in Prescription Drug costs on formulary medications. In previous years, you were responsible for part of the Prescription Drug costs up to $5030, and then the Donut Hole, or Coverage Gap, began. Then a formula ensued where between what you paid and the Prescription costs reached $8000, you would enter the Catastrophic phase and you portion was finished for the calendar year.
My Medicare Advantage plan denied coverage for a specialist I need to see. What are my options now?
Answer: You have the right to an appeal and to request the reasoning behind the denial. I would have my agent discuss with the carrier the reason for the denial and possible alternatives.
Is Guaranteed Issue available after the Medicare Open Enrollment period ends?
Answer: Yes, if you fall into one of the SEP's, the Special Enrollment Periods. If you change your residence to outside of the service area, you move from another state, you lose coverage through no fault of your own, you leave your Employer Group Health insurance plan are a few examples.
I keep hearing about free preventive services with Medicare. What exactly is free and what will I still pay for?
Answer: There should be no copay for preventative services with Medicare, or with any health plan for that matter. That was addressed with the beginning of the Affordable Care Act, or in slang terms ObamaCare.
How does the Part D "catastrophic coverage" phase work once I hit the out-of-pocket max?
Answer: Every Part D Prescription Drug Plan, whether its a stand alone plan, or attached to a Medicare Advantage Plan has a list of Formulary Drugs....the prescription drugs they're willing to cover on your plan. You enter the Catastrophic Coverage phase once you've reached the $2000 limit, a formula between what YOU'VE paid on prescriptions and the cost of those prescriptions from the drug company. All your FORMULARY drugs are covered at no charge for the rest of the calendar year.
Can I enroll in Medicare if I've never paid into Social Security due to working overseas?
Answer: Anyone legally in the United States can enroll into Medicare if they are at least 65 years old or if they have been deemed disabled for the last 24 months by a physician. Someone that has worked overseas and not paid into the system may have to pay a premium for Part A (Hospital coverage) of Medicare, that people who have paid into the system get it premium free.
I'm planning to delay Social Security until age 70, but I'm turning 65 soon. How does this affect my Medicare enrollment?
Answer: They are two separate things entirely. You can enroll into Medicare at age 65 or delay it if you are still working and insured by an employer plan, IF your company has more than 20 full time employees. It will not affect your Social Security draw later in life.
I went to a free Medicare seminar and it felt like a timeshare pitch. Are any of those events actually helpful?
Answer: It really depends on who's running the show! The Medicare seminars, if they are "Educational", should be done without using any sales tactics. Agents can pass out their business cards and ask if they can call attendees, but other than that, they should be ONLY educational. This can be a shady industry....you have to choose your Independent Agent wisely!
Can you explain how Medicare works with other types of insurance like Veterans Affairs benefits or employer plans?
Answer: With employer plans, if you are still working and want to stay on the Employer Health Insurance plan, and you have more than 20 employees at the job, you can delay your Part B enrollment until you leave the employer. With VA-type benefits, it's a little trickier. The VA covers some people, and others have Tri-Care for life. With both you have to enroll into Part A and B of Medicare, but its a longer conversation with the coverage beyond that.
I have Medicare Advantage with a PPO, and I'm curious if my annual wellness visit is free or if I'll owe something for it.
Answer: Annual Wellness Vists or AWV should be free to anyone with Part B of Medicare. It doesn't matter if you have a PPO or an HMO Medicare Advantage Plan.
Would expanding Medicare to younger Americans improve or hurt the program?
Answer: Expanding the Medicare program to younger Americans COULD be a good thing, but like most things, the devil is in the details. That's really a political hot potato issue...there are a few scenarios introduced where it may make some sense.
I'm a green card holder who's been in the US for 4 years and turning 65 soon. Am I eligible for Medicare?
Answer: Green card holders have to have lived in the US for at least 5 continuous years and either qualify for a disability or reach the age of 65. They also may have to pay a premium for their Part A hospitalization coverage if they have not worked enough quarters and paid into the Social Security system
I worked for the federal government for 30 years and took early retirement. How does my federal retirement affect my Medicare options?
Answer: Your 30 years of work with the Federal Government should not affect your Medicare when you reach the age of 65. Every situation is different, but you may have different options after you've enrolled into your Part A and B since you've been with the Federal Government.
I changed my plan during Open Enrollment and now I can't see my regular specialist. Isn't this what the whole review period is supposed to prevent?
Answer: Nice question....OK, if you're talking about a Medicare Advantage Plan and the "Open Enrollment" you're speaking of is the Annual Enrollment Period between October 15th and December 7th, then yes, you have what is actually called the "Open Enrollment Period" at the first of the year, between January 1st and the end of March. Between that time, if you want to change your Medicare Advantage Plan you can do that, but only once, during that time.
Does Medicare Part A cover outpatient surgery, or is that strictly under Part B?
Answer: Typically, the "outpatient surgeries" are covered under Part B of Medicare. There may be some situations where you are actually in the hospital and go home that same day, which may be covered under Part A of Medicare
How do you stay up to date with changes in Medicare policies and plan options each year?
Answer: Well, hopefully you have an Independent Medicare Broker that does that for you...at no charge by the way. It's not easy to stay up with all of the nuances of Medicare and all of the plan options...that's why I HIGHLY recommend finding a broker that ONLY does Medicare.
How do Medicare Advantage star ratings affect the quality of care I can expect?
Answer: Medicare Advantage Plans are incentivized to not only give good service to their enrollees but also to proactively strategize people's healthcare. When one of their enrollees ends up in the hospital or has a chronic illness that is not treated properly, the Advantage plan is penalized, meaning it affects their star rating on that plan. The better the star ratings for a plan are, the more money they get from the federal government.
What should I look for in a Medicare plan if I travel frequently both domestically and internationally?
Answer: If someone travels extensively throughout the year, it usually makes the most sense for them to be in a MediGap plan, or sometimes called a Medicare Supplement plan. With a MediGap plan, the person can see any doctor in the United States, as long as they accept Medicare patients. With International travel I ALWAYS recommend a "travel medical" policy.
Can I get a Medigap plan with Guaranteed Issue if I'm losing my employer coverage?
Answer: When you leave your Employer coverage, you usually have a "Guarantee Issue" scenario called a Special Enrollment period where your health issues are not a factor. But...you have only 60 days to obtain that MediGap coverage when you lose your employer health insurance. By the way, you have up to 8 months to enroll into Part B when you lose your employer coverage if you have not already enrolled.
I'm considering concierge medicine but already have Medicare. How would these work together?
Answer: Concierge medicine is usually not affiliated with or accepts any type of insurance coverage. I've heard that Concierge doctors' offices often bill Medicare for some of the services performed by their doctors, but I would not count on that to be the case 100% of the time.
I've been dreading hitting the donut hole each year. How will its elimination in 2025 change what I pay throughout the year?
Answer: Its a great thing....you're out of pocket limit has been reduced greatly. Its a complicated formula, but generally, you will not have to pay more than $2000 for "covered" or formulary prescription drugs in a calendar year. The formula takes into account, what YOU'VE paid for your prescription and what the drug manufactures drug costs are. The trick is making sure that you have a Prescription Drug Plan that covers your prescriptions....with all of the changes, many plan have revamped their formulary offerings or moved drugs into different "tiers" to save money.
I applied for a Medigap plan and got denied because of my health history-how is that even legal when I've paid into Medicare for years?
Answer: You can get denied for a MediGap plan if you did not enroll in that plan when you were first eligible, at that time, it would have been given to you without underwriting. After a certain time, if you want to change plans, or try to enroll into one for the first time, they can deny you coverage.
I'm a low-income senior who can't afford my prescription drugs even with Medicare Part D. What specific assistance programs should I apply for?
Answer: There are various levels of "Extra Help" that you can explore with Social Security. Its based on your Modified Adjusted Gross Income (MAGI) and they determine what level of extra help you qualify for.
I want to be proactive about my health. What preventive services should I be taking advantage of with Medicare?
Answer: I would absolutely do the yearly wellness exam to start with. Medicare Advantage plans offer "incentives" for people who are willing to be proactive with preventative services, join gyms, etc.
Don't you think Medicare's focus on treatment rather than prevention is backwards?
Answer: Yes...but that is the cornerstone of the Medicare Advantage programs. They take a proactive approach to healthcare and are incentivized by the Federal Government to do so.
When is the best time of the year to start looking at Medicare options?
Answer: The absolute earliest you can discuss Medicare options with your Independent Medicare Broker would be October 1st. The newest plans and options are released to brokers in September and the earliest they can discuss them is in October.
If I have been on disabilty due to an accident, do I qualify for Medicare Insurance?
Answer: If you are under 65, and your disability has been ongoing for at least 24 months, you should qualify for Medicare under those circumstances. Workers Comp plays a part in that, but your Medicare may be available to you if you are deemed "permanently disabled".
Aren't those Medicare seminars just sales pitches in disguise?
Answer: If they're done right, they can be both informative and also gives the broker a chance to show the audience that they would be the right choice for people to work with. "Its all in the delivery" as they say, so choose your broker wisely.
Are home modifications (like stairlifts) ever covered by Medicare for safety reasons?
Answer: That's an interesting question. I just had this come up recently. With typical DME, Durable Medicare Equipment, like wheelchairs, hospital beds, etc., is usually covered under Medicare Part B. Stair lifts, in particular, would fall under Part A coverage and are generally not covered under Medicare. There is an actual exclusion for that type of Home Modification need.
How do Medicare Savings Programs help with Medicare costs?
Answer: The Medicare Savings Program or MSP, is a program that helps lower-income seniors with help paying for things like Part A and Part B premiums, copays, co-insurance and other out of pocket costs. There are many "levels" of help that people can get, all based on your income level.
What role might private insurers play if Medicare expands to cover more preventive care?
Answer: Private insurers will play a major role if Medicare expands its preventative care coverage, like offering many more "extra services" and benefits all centered around prevention. Currently almost all Medicare Advantage Plans and private insurers have some type of dental coverage, whether that be preventative checkups and maintenance to a more robust offering of basic and major services like fillings, crowns, deep cleanings, etc.
My friend said she got a free annual physical with Medicare, but my doctor billed me. What's going on?
Answer: Medicare does not have free annual physical exams but DOES have a yearly wellness visit. It's possible that your friend has a Medicare Advantage Plan and most of those have a $0 copay for visits to your primary care physician.
How does moving to a new state affect my Medicare enrollment timeline?
Answer: Moving to a new state only affects your enrollment in your "secondary insurance" as it pertains to Medicare. The Part A and Part B of Medicare is done on a Federal level, so the enrollment periods are the same no matter what state you live in. If you were enrolling in a Medicare Supplement Plan or Medicare Advantage Plan, moving to a new state opens a window of enrollment for you, called an SEP, Special Enrollment Period.
I'm on Original Medicare with no supplement, and I'm wondering how much I'd pay if I need an ambulance ride to the hospital tomorrow.
Answer: If someone has Original Medicare without any secondary insurance, they will be responsible for 20% of any covered services under Medicare. Also important to note is that there is NO limit to the amount of money you're responsible for, if you don't have secondary insurance. A "guess" of how much it would cost you for an ambulance ride with just Original Medicare, would be in the range of about $400-$600, roughly speaking
I've heard that once you're on Medicare, you might not need life insurance as much. Is that true?
Answer: Medicare and Life Insurance are two completely different types of insurance. Depending on the type, life insurance is usually a fixed-benefit type of product, meaning if you die, you will receive the amount of insurance you set up with your policy. Medicare is more like traditional Health Insurance and covers people for illnesses and injuries. A certain type of Life Insurance can cover people that are looking for Long Term Care, where when a person meets certain requirements, it triggers a daily or monthly payout of a certain amount.
Can Medicare pay for my groceries?
Answer: Medicare will not pay for your groceries, but certain kinds of coverage under many Medicare Advantage Plans have monthly or quarterly benefit amounts for things like groceries, gasoline, yard work, pest control, even rent.
Can you explain Special Needs Plans in Medicare?
Answer: Special Needs Plans for Medicare usually serve people with Heart, Liver, or Kidney issues and, in some areas of the country, lung issues. Certain Medicare Advantage Plans are designed to specifically address those medical issues with a more focused problem-solving approach.
How do I appeal a decision by Medicare or my plan if they deny coverage for a procedure or medication I need?
Answer: There are different ways to appeal a decision based on what type of Medicare coverage you have, whether that's Original Medicare, or a Medicare Advantage Plan. If you have a good Independent Broker, they should help you appeal any decision that you don't agree with.
What are the red flags I should look for when interviewing agents? I want to make sure I'm not just getting sold to but genuinely advised.
Answer: The biggest red flag when you're interviewing agents is to ask them what other types of insurance do they provide. If they tell you that they can do multiple types of insurance, you're not dealing with a specialist. Secondly, you have to make sure that they are an INDEPENDENT agent...meaning they are contracted with many insurance companies and not tied to one or two. You want a SPECIALIST not a GENERALIST
I tried calling Medicare and got transferred five times. Is there any way to get straight answers from them?
Answer: The best number we've found to reach Medicare is simply, 1-800 MEDICARE. I've helped many of our clients get through to Medicare and have been surprisingly impressed with the people that answer the phone. Once in a while you'll get someone that obviously needs to change jobs, but overall, they've been pretty good.
What should I do if I miss the Medicare Open Enrollment period, and I want to change my plan?
Answer: That really depends on what type of "plan" you have. If you have a Medicare Supplement Plan or MediGap plan, you can change it any time of the year, but you must go through an underwriting process most times. If you have a Medicare Advantage Plan, you have two separate Open Enrollment times, October 15th thru December 7th is the Annual Enrollment Period, and then you have the actual Open Enrollment Period from January 1st thru March 31st. Both of these times you can change your Advantage Plan.
I missed my Medigap window by a few months and now no one will cover me without underwriting. Why isn't this rule more well known?
Answer: This is another example of having a competent broker that ONLY does Medicare and is INDEPENDENT. Your broker should have explained the rules and deadlines to you so you would not miss your opportunity. The reason Medicare recipients should have a broker that only does Medicare is simple....you can't be an expert at everything, there just isn't enough hours in the day.
How do you explain to clients that "zero-premium" doesn't mean "zero-cost" with Medicare Advantage?
Answer: Most Medicare Advantage plans do not have a monthly premium, but DO have copays for Medicare services. I tell people that Original Medicare is more of a "pre-pay" system, where Advantage plans are a "pay as you go" model.
Can I change my Supplemental/Medigap plan at any time?
Answer: You can change your MediGap plan at any time, but you will most likely have to go through underwriting. That means that depending on how you answer health questions, the carrier can deny you coverage.
I just started on Medicare Part D, and I'm confused about whether my new cholesterol medication counts toward my coverage gap. Can you explain?
Answer: It depends on if your cholesterol medication is part of your Part D Prescription Drug plan formulary list. The formulary list is the list of drugs that the insurance company has agreed to make, part of their offering to the members that enroll on their plan. If the cholesterol medication is not part of the formulary, you will not have coverage and it will not count towards your yearly total spending of the $2000 limit.
I'm confused about all these different Medicare costs - premiums, deductibles, copays. How do they all work together?
Answer: The "premiums" are what people pay each month, no matter if you use the Medicare plan or not. That is the cost of having the plan. Some plans have a "deductible" which means that when you receive covered services, you will pay towards the deductible first, before you realize any "benefit" on the plan. The copays are pre determined costs that you'll pay for certain services, based on your plan.
My neighbor says I'm crazy for paying for a Medigap plan when Medicare Advantage is "free." What should I tell him?
Answer: You can first tell him that nothing is free. Your Medicare Advantage plan may not have a monthly premium, but instead you'll have copays for services that you need, its kind of a pay as you go model. The MediGap plans are designed so that you pay a monthly premium up front, whether you use services or not, and then when you DO use services they are very low cost or free.
Does Medicare cover Ozempic and other drugs prescribed for weight loss?
Answer: Most times, Ozempic and other medications are only covered if the member's Medicare plan has them in its formulary list or if they are deemed medically necessary. If someone just wants to lose weight, Ozempic is probably not going to be a covered service.
Are there any tax benefits tied to paying Medicare premiums as a retiree?
Answer: That is more of a question for a tax expert...but I do know that IF you have an HSA that you've been building up for a long time, you can use those funds for any Medicare premiums, as well as Medicare services, on a tax free basis.
Why are people leaving Medicare Advantage plans?
Answer: If you live in a rural area,. or an area that does not have a good Medicare Advantage plan "network", people can be disappointed in the amount of providers available to them. Sometimes people have been denied services from Advantage plans because the plan deemed the service not to be medically necessary.
Does Medicare cover emergency care if I'm traveling in a U.S. territory like Puerto Rico?
Answer: Medicare covers people in Puerto Rico just like it would in the other 50 states, there is no difference, which makes some Americans relocate to places like Puerto Rico when they retire for a lower cost of living.
Is Medicare's coverage for cataract surgery enough, or do seniors still face high out-of-pocket costs?
Answer: Medicare covers cataract surgery like most other types of medically necessary procedures. It does not matter if you're on Original Medicare with a Supplement or a Medicare Advantage plans...they cover it the same, in terms of the procedure. IF you wanted to do the Lasik surgery while they are fixing the cataracts, it would be an additional charge, since Lasik is not considered medically necessary
I've heard Medicare covers home health care, but what exactly does that include?
Answer: If someone is considered home bound and requires skilled care, AND is certified by a physician, Medicare will pay for some of the costs of Home Health Care. Medicare Advantage plans also have coverage for Home Health Care and differs from carrier to carrier.
I'm interested in a robotic knee replacement surgery that my surgeon recommends for my specific anatomy. How does Medicare coverage work for this advanced procedure?
Answer: Again, if a physician deems the procedure medically necessary, Medicare will cover robotic knee surgery. You may still be responsible for some out of pocket costs depending on your coverage.
What's the financial risk of sticking with Original Medicare without a Medigap plan?
Answer: There is a GREAT risk if you don't have what they call secondary coverage like a MediGap plan. Medicare covers 100% of the Part A (Hospital) coverage, but with Part B (physician services) it only covers about 80%, the other 20% is what you risk if you don't have a MediGap plan. Also...there is NO LIMIT to the amount of money you are responsible for with that 20%.
I just got a $300 bill for an ambulance ride I thought was covered. Am I the only one who didn't know Medicare doesn't pay for all emergency transport?
Answer: Ambulance rides and other types of services are covered under the Part B of Medicare. If you got a bill for an ambulance ride, that is most likely the copay for the plan that you've enrolled into. If you had a MediGap plan, you may not pay anything, but remember, there is a monthly premium (pretty high sometimes) with MediGap plans, based on your age and zip code.
What's the biggest mistake seniors make when choosing a Medicare Part D plan?
Answer: Usually the biggest mistake people make when choosing a Part D Drug plan is they go for the cheapest alternative. Many Part D plans are very inexpensive, but if you look closely, the Prescription Drug list, or formulary, that they cover may be lacking or thin in some areas.
Why am I paying more for Medicare Part B and D than my friends? What is IRMAA and how is it calculated?
Answer: IRMAA is an acronym for Income Related Monthly Adjustment Amount. It sounds like you were lucky enough to make more money than most people, two years ago. the Part B and Part D premiums are based on a "lookback" of your tax returns of 2 years ago...if you made over $212,000 as a couple of $106,000 as an individual, you will be hit with the IRMAA upcharge for that particular calendar year. The next year, its recalculated and adjusted to whatever 2 years ago tax returns show.
Isn't it suspicious that Medicare Advantage plans offer gift cards and incentives to enroll?
Answer: Enrolling in a Medicare Advantage plan offers incentives because Medicare is big business. Remember, all Advantage plans must provide the same coverage that Original Medicare covers and usually have many "extra" benefits. It's just a different model for administering Medicare.
I've had the same Part D plan for years, but this year my insulin shot up in price. Did the Inflation Reduction Act not fix this yet?
Answer: Something does not sound right...insulin costs are capped at $35 each month. I would check with your broker if you are being charged more than that.
I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn't anyone tell me this upfront?
Answer: If you had a broker that was good, they would have explained all of this to you. Once again, its important to not only find an Independent Agent, but one that ONLY does Medicare. You can't be an expert at everything and if the agent does multiple lines of insurance, they cannot be an expert at Medicare, there's just not enough hours in the day to stay current.
What are the most overhyped benefits of Medicare Advantage plans that seniors should be wary of?
Answer: The most overhyped benefit is the "money back" plans that many Medicare Advantage Plans offer. Don't get me wrong, they are a good product IF you are aware of the other benefits that are not nearly as robust as the non "money back" plans. There are some insurance products to pair with "money back on your Part B plans" that most brokers are not aware of.
Do Medicare Advantage plans save money?
Answer: Yes, Medicare Advantage saves you money, but you will still pay copays when you use services. The copays and out of pocket costs vary greatly depending on the plan. With a MediGap plan, you pay quite a bit up front for services you MAY use. The Medicare Advantage model is more of a "pay as you go"
Why does Medicare allow insurance companies to bombard seniors with confusing mail and TV ads?
Answer: Medicare is a highly regulated industry, but yes, they do allow the companies to advertise on TV and radio. Once again...if you have an Independent Broker, it doesn't matter what they advertise, your broker will advise you on what would be the best plan for you
How does getting married late in life affect my Medicare coverage or costs?
Answer: Whenever you get married should have no bearing on when or how you enroll into Medicare. Medicare is based on your individual situation and not typically about your spouse
My kids keep telling me to get a Medicare Advantage plan, but my friends say stick with Original Medicare. Who should I listen to?
Answer: Since Medicare is not a "one size fits all", you should listen to your Independent Medicare Broker. We are trained and hopefully knowledgable about the industry and products in your area. In my opinion, you MUST find someone that only does Medicare, since you can't be an expert at everything.
I need a hearing aid but I've heard Medicare doesn't cover them. Is there any way around this?
Answer: That is one of the benefits of having a Medicare Advantage Plan. Most Advantage plans have hearing aid coverage or provide substantial discounts on them at their network providers. With the new Medicare laws, people can purchase hearing aids "over the counter" and don't need a doctor's approval. Honestly....Costco has some pretty good deals with them too!
Isn't Medicare headed for a crisis with so many baby boomers aging into the system?
Answer: There is definitely more utilization with all of the people turning 65. They say that each day, 10,000 people turn 65 in the United States. Hopefully focusing on addressing all of the fraud will also help revitalize the system
Will my Medicare plan work when traveling to Europe?
Answer: Your Medicare plan will only work NEAR the US border, and only in some circumstances. I always advise people that are traveling outside of the US to purchase a Travel Medical plan. They are fairly inexpensive and very robust in their coverage. They don't cover travel to some countries where there is unrest.
I'm confused about which vaccines Medicare covers. Can you explain which ones are free?
Answer: All of the vaccinations that the CDC recommends are no cost to Medicare beneficiaries. That includes vaccinations for Shingles, Whooping cough, Tetanus, etc.
I'm worried about affording my medications even with the 2025 changes. Are there additional assistance programs I should know about?
Answer: If you fall into certain income brackets, you would be eligible for what they call Extra Help. It would either pay part, or all of your medications, copays and other charges. You would check with Social Security to see if you qualify.
I don't understand how my friend pays nothing for their plan and I pay over $200-are these plans just totally random by ZIP code?
Answer: Plans, depending on exactly what plan you're talking about, are priced based on your zip code, your age, your sex, and then discounted based on your income level.
My doctor prescribed physical therapy, but I'm not sure how many visits Medicare will cover. How do I find out?
Answer: Medicare, or Medicare Advantage plans will cover "medically necessary" physical therapy. With Orginal Medicare, its covered under the Part B, and then you either have the remaining 20% covered with a MediGap plan or you'd pay a copay with your Medicare Advantage plan
I'm caring for my elderly parent with dementia. How can I get legal authority to manage their Medicare?
Answer: You would have to get a POA, Power of Attorney either with the parent giving consent, or by going through the court system and obtaining a Conservatorship or Guardianship. Its probably best to consult an Elder Law attorney
What's the most cost-effective way for a healthy 65-year-old to structure their Medicare coverage?
Answer: If you are healthy, enrolling into a Medicare Advantage plan would be the most cost effective, since most plans are premium free. They would pay copays when they use services
What's an underrated benefit of Original Medicare that many people overlook?
Answer: Probably the most underrated benefit of Medicare is the Annual Wellness Visit which can also include "end-of-life" care planning and assistance in completing the Advanced Directive
Won't Medicare run out of money before I can benefit from it?
Answer: With 68 million people using Medicare, I highly doubt that it will run out of money. They've been saying that about Medicare and Social Security since I was a kid in the 1960's
Does Medicare Advantage cover home health care?
Answer: Yes, typically most Advantage plans cover Home Health care. Some are more comprehensive than others, but the benefit exists with most of the Medicare carriers
I switched to a new Part D plan and now half my meds require prior authorization. Why didn't anyone warn me this could happen?
Answer: When your Independent Broker strategized your new Part D plan, that should have been part of the discussion. Oh...you didn't use an Independent Broker...that may be part of the problem
What is the biggest disadvantage of the Medicare Advantage plans?
Answer: Probably the biggest perceived disadvantage to Medicare Advantage Plans is that you have to stay within the network of the insurance company that you have. In reality, if you live in the Phoenix area, or Florida, the networks are VERY robust and easy to navigate.
Why would you not choose a medicare Advantage plan?
Answer: About the only reason I would not choose a Medicare Advantage Plan is if I traveled constantly and wanted to see Medicare providers out of my resident state. Other than that, I would absolutely choose an Advantage plan
I'm turning 65 next month and the amount of Medicare mail I'm getting is overwhelming. How do I sort through all this?
Answer: My advice to people is to put all of it aside. If you try and read all of it your head will explode. Find an Independent Medicare Broker and use them as your Adviser, their services are free and if you choose one that only does Medicare, you'll be getting an expert