Tim Measures, Medicare Insurance Agent

Answer: Yes, if you have Original Medicare, you can generally use it anywhere in the United States as long as the provider accepts Medicare.

Answer: The best way is to ask your doctor and the facility performing the procedure if it's covered by Medicare and whether any prior authorization is required. If you're on a Medicare Advantage plan, it's also a good idea to contact your plan directly before having the procedure done. A quick phone call can help you avoid unexpected costs and confirm exactly what your plan will cover.

Answer: Many Medicare Advantage plans do include dental coverage, but the benefits can vary quite a bit from one plan to another. Some plans cover preventive services like cleanings and exams, while others may also help pay for fillings, crowns, dentures, or even implants. That's why it's important to look beyond just having dental coverage and understand exactly what's included.

Answer: In most cases, your Medicare Advantage plan can't simply drop you because of your health. However, if the plan leaves your area, stops offering coverage, or you move outside the service area, you may need to choose a new plan. The good news is that Medicare gives you a Special Enrollment Period, so you'll have an opportunity to enroll in another Medicare Advantage plan or return to Original Medicare. If this happens, don't panic—just make sure you review your options before the deadline.

Answer: Great question, and you're not alone—many people confuse the two.

Medicare is health insurance that you generally become eligible for when you turn 65, regardless of your income. It's a federal program and includes things like hospital coverage (Part A), medical coverage (Part B), and optional prescription drug coverage (Part D).

Medicaid (called Medi-Cal here in California) is based on income and financial need. It can help pay Medicare costs like premiums, deductibles, copays, and coinsurance. It may also provide additional benefits that Medicare doesn't cover.

If you qualify for both Medicare and Medicaid, you may be eligible for a special type of Medicare Advantage plan called a Dual Eligible Special Needs Plan (D-SNP). These plans often include extra benefits such as dental, vision, hearing, transportation, over-the-counter allowances, and more.

The easiest way to remember it is:

Medicare = Age or disability-based health insurance

Medicaid (Medi-Cal) = Income-based assistance program

If you're not sure which programs you qualify for, I'd be happy to help review your situation and explain your options.

Answer: No, not as long as you have made your premiums. They are guaranteed renewable.

The only factors that will change this are for Non Payment, material misrepresentation & insolvency by insurer.

Answer: Lots of benefits.. Would it be ok to call you tomorrow to discuss? Would love to help your Mom navigate through the sometimes confusing Medicare world.

Answer: No. Guaranteed Issue only applies in special situations like losing coverage or moving; once Open Enrollment ends, most people have to answer health questions to get a Medigap plan.

Answer: You can always switch from a Medicare Advantage plan back to Original Medicare during the Annual Enrollment Period, but the tricky part is picking up a Medigap (Supplement) plan. In most cases, unless you qualify for a special situation or you’re in your initial enrollment window, the insurance company can ask health questions and decide whether to accept you. The Annual Enrollment Period doesn’t guarantee you can get Medigap without going through underwriting.

Answer: Some people regret choosing Medicare Advantage because they run into limits with doctors or hospitals, or they’re surprised by the copays and authorizations required for care. It often looks cheaper upfront, but the restrictions and out-of-pocket costs can make Original Medicare with a supplement a better fit for some.

Answer: For me, it’s knowing that I’m helping someone protect what’s important to them. Whether it’s health coverage or life insurance, it feels good to know they can breathe a little easier.