Terri McClinton, Medicare Insurance Agent

Answer: Your drug plans formulary is going to be a determinant factor as to cost of your prescription drugs. Generic inhalers are often less expensive than their brand named counterparts, but they will need to be on your plans formulary to be covered. Some drug plans choose to cover the brand named drugs and they are often at a higher, more costly tier in their placement in the formulary. Choosing the correct plan that covers your medications is a big part of your planning! Getting it right can't be a make or break situation. A trusted advisor will help!

Answer: A MSA (Medical Savings Account) plan, if available in your area, will often give you more latitude in providers and will give you greater flexibility in managing the expenses yourself. Some draw backs, though, are the lack of prescription drug coverage and often they have high deductibles associated with the plan that you are responsible for paying.

Answer: Your areas local health care costs and Medicare's benchmark payment rates can make a difference in the plans that are available in your area. Often areas that have typically higher health care costs will usually see an increase in competitive plans and often extra benefits.

Answer: Spiriva is covered by Medicare. It will be covered under your Part D benefit. You will need to make sure that it is on your plan's formulary.

Answer: Yes, you can begin collecting Social Security benefits prior the age or eligibility for Medicare. Unless you are deemed disabled by the Social Security Administration, you will not typically be eligible for Medicare until the age of 65. You can collect Social Security as early as 62 or even earlier at the age of 60 if your spouse passes away. This is called a Survivor Benefit.

Answer: In Medicare, the three types of Special Needs Plans are: ISNP's for folks that are institutionalized in long term care facilities, DSNP's for folks that are dually eligible for Medicare and Medicaid, and lastly, CSNP's for folks with specific chronic health care conditions that the plan available in their area covers.

Answer: If it is considered Medically Necessary, an AeroChamber or other spacer, may be covered by Medicare under Part B Durable Medical Equipment (DME) as long as the physician prescribes it for your Medically Necessary condition. You will typically be responsible for the Part B deductible and the 20% coinsurance.

Answer: If you are not already receiving your Social Security, you will need to enroll in Medicare no more than three (3) months prior to your effective date. Your Medicare A & B will be effective the first day of the month of the month you were born, unless you were born on the first of the month and then your coverage for A & B will be effective the month prior to that. For example: Birthdate of March 1, 1962--A & B effective date will be February 1, 2027. If you are already receiving your social security benefit, you will be automatically enrolled in Medicare and will receive your card approximately 3 to 3 1/2 months prior to the effective date. Watch your mail!

Answer: Sometimes when a prescription drug is not covered on your plan's formulary of covered drugs, your doctor may need to show that you cannot take alternatives like generics and that you have tried with no success. It is one of the ways that costs are contained in drug plans and is an allowed method. You or your doctor can ask for a formulary exception so that you may receive the meds that work for you.

Answer: Your plan will send you the Annual Notice of Change in September each year, just prior to Annual Enrollment Period. It will provide the changes that are happening in your current plan should you choose to stay in it for the following year. Reach out with questions and do not assume that the plan will stay the same year to year!

Answer: Even though a terminated plan for this reason will not be automatically reinstated by Medicare, an appeal can be filed with the request to reinstate. Don't be afraid to ask for help from a valued agent that knows the ropes of navigating this pitfall.

Answer: Correspondence received is often confusing to the recipient. Having a trusted advisor to call upon is key to being able to respond appropriately, take timely action, or make changes as needed.

Answer: A licensed and trained Medicare agent is going to be able to not only educate you on Medicare options, but also the Alphabet Soup of Medicare. It is complex and confusing and agent will guide you with your best interest in mind.