Tetonya Lewis Charles, Medicare Insurance Broker

Answer: At one time Medicare plans would exclude persons with kidney disease, but no more. Now All persons with kidney disease can enroll in any Medicare advantage plan. There are chronic plans available with all carriers. You just have to choose which one is right for you, as their features may differ, and they're not the same all the way around.

Answer: When you choose a plan during the annual election period Oct 15th to December 7th for the new year, when the new year comes you have the opportunity to either switch to a Medicare Advantage Plan or go back to original Medicare with a prescription plan from January 1st to March 31st.

Outside of this time you will have this plan the rest of the year unless you have a special election period. A medication change does not constitute a special election through the year.

Answer: Agents do not and cannot charge to help clients to enroll. Agents are compensated by the company in which they are enrolling the client, so the clients never have to worry about coming out of their pockets upon enrollment. Clients just pay their monthly premium.

Answer: If you have a great Agent you won't choose the wrong plan, checking your doctors & prescriptions are covered, and depending on your circumstances and whether there's an Special Enrollment Period throughout the year.

Also, January 1st through March 31st is Open Enrollment Period where you can examine your plan & change it if need be, so you won't be "stuck", so to speak. Just call your agent, & they will help you and let you know your options.

Answer: Medicare's support for seniors who need assisted living falls short in general, as it does not cover main costs that come along with assisted living care!

Medicare is designed for medically necessary, short-term care (acute care), not long-term custodial care,i.e. assisted living.

Answer: How much you will have to pay out-of-pocket for therapy will vary by carriers. Whether HUMANA, CIGNA, United, AETNA, or other, in each plan the cost will vary. It's important to check with the carrier you're choosing for your out-of-pocket cost for therapy.

Answer: Since the Coverage in plans change every year, it is advisable to review your plan each year during the annual enrolment period mid October to December 7th for each upcoming new year to begin January 1. This also gives you the opportunity to check on other benefits you can take advantage of.

In Addition to checking your therapy coverage, check your prescription formulary for your Rx coverage and that your doctors still accept the plan or still in network when on a Medicare Advantage plan. This way you won't be surprised come next year when things change, and you let your plan roll over without checking

Answer: At this time, if the Ozempic and similar drugs are only prescribed for weight loss alone, no they are not necessarily covered. If they are prescribed for a specific health condition however, like diabetes type 2, AND the medication is on their formulary list of covered drugs, then there is the likelihood it will be covered. For most, the weight loss will be a bonus after effect, but it cannot be the main reason for the prescription. This may change later on, but right now it's how it is.

It's important to check with the Medicare Advantage carrier of your choice to ensure coverage of these types of meds.

Answer: What you've been experiencing are the holes or gaps in Medicare, & there are a couple of ways to get peace of mind with Medicare.

* One way is a hospital indemnity plan, which many more Medicare beneficiaries should take advantage of. It helps pay for those hospital copays & such.

* The other is what some refer to as a Medigap plan (or Medicare Supplement)... a somewhat self explanatory name, fills in the gaps of Medicare and takes care of those surprises you otherwise receive.

Keep in mind, you will pay a much higher monthly premium, and have to obtain a separate prescription drug plan with a Medigap/ Medicare Supplement plan, but you will do away from the surprises.

Answer: No skepticism necessary.

Most seniors are on a fixed/limited income, & medicare advantage is much more economical up front to obtain, for their pockets. Some have $0 premiums, small specialist copays. While medicare supplements can have anywhere from high as $150 to 300 and more a month.

Knowing this, agents tend to lean towards M.A. plans for our seniors, but we do help with supplements also, when asked.

Answer: You should know you definitely need original Medicare A and B before you can obtain a Medicare Advantage plan. Then the additional benefits come with the Advantage plan.

Answer: Save yourself time, energy, and brain work, quite simply.

Searching the plans can be overwhelming, even for a licensed agent, but this is what we do, and you don't have to pay us to do it for you. By the time you finish going through all of these plans, you could have a headache! :D Many companies, many plans, who covers what, your doctors, the features and benefits of the plans! I'll go back to my first two words..... Save yourself!

Yes, you could very well do it yourself, but there are so many more reasons that you should. An agent will help you go deeper into the plan & find you some benefits you didn't know you could obtain.

Agent, Ms.T.

Answer: Which one is better depends on a few things, i.e., what type of plan you want AND what one you can afford, etc.

Medicare Advantage plans are low-cost up front, with many plans having $0 premiums and $0 primary copays. Your agent has to ensure your doctors accept the plan you're choosing, and your prescriptions are covered, or very close to it. While you need Parts A&B to enroll in a Medicare Advantage Plan, your new plan is what you will utilize fully once your plan goes into effect.

A Medigap plan (or Medicare supplement) will fill in the "gaps" of your original Medicare and work in conjunction with original Medicare, or pick up what Medicare does not. This is why it's called Medi"gap". You will pay a much higher premium per month, similar to the cost of group/employee coverage. You will need a separate prescription drug plan, while many Medicare Advantage plans have prescription plans already built in.

You determine which is better for you. It will depend on your preferences and how you'd like your plan to work for you.

Hope this helps.

Ms.T, Licensed Agent