Tristan Gibbs, Medicare Insurance Broker

Answer: You can enroll into Medicare up to 3 months prior to your birth month, and 3 months after. I recommend starting the process as early as possible in the event you have special circumstances that may need to be addressed.

Answer: There is an ad out right now claiming that seniors are entitled to a $150 food card and they have to act right now to “qualify”. This is misleading because 1)you have to have a qualifying Special Election Period to actually change your plan right now. 2)that food card is not guaranteed to everyone, as those type of benefits are typically only found in special needs programs. The best thing to do if you are interested in finding out if you can get that plan, is to call a trusted, licensed, LOCAL agent who is familiar with the plans in your area.

Answer: Medicare Supplement plans come with a monthly premium and sometimes that premium just does not fit the budget. Other people may feel like they’re healthy enough to not need all the coverage provided from a Medicare Supplement plan. The caveat with this line of thinking is that those people will likely miss their guaranteed issue period to get on a supplement with Hoyt going through underwriting.

Answer: If your doctor is not in network with your current insurance carrier, or your plan does not cover an annual physical, you may incur a bill from doing so. You should review your current coverage and network to make sure your physicals will be completely covered.

Answer: You can go onto Medicare.gov to order another card. You can also go down to the social security office to start the process of replacing your card in person.

Answer: Your friend may be on a different Medicare plan than you. SilverSneakers is not a universal benefit that is required to be in every plan, but rather it is a benefit offered by certain carriers.

Answer: If you have qualified employer coverage you do not NEED to sign up for Medicare right now. Although it may provide better coverage at a lower cost, you will not incur a penalty for a late enrollment if your group coverage is adequate.

Answer: Working with Medicare clients often comes with an emotionally rewarding feeling for me. Saving families money every month while ensuring they have coverage to keep them healthy and happy is tremendously rewarding for me, as I have witnessed first hand just how important having the right coverage is with my own mother.

Answer: If you have qualified and enrolled in Medicare, then NO, they cannot disenroll you for health reasons.

Answer: Make sure to thoroughly understand what your plan does and does not cover for lab testing. If your doctor recommends a test that you are unsure about, you can call your insurance company and ask if it will be covered and what the copayment is.

Answer: You can look into switching into a plan that is in network with your preferred hospital. Alternativly, you can look into hospital indemnity insurance as well as other hospital options in your area.

Answer: Yes this is covered under Medicare as it is considered preventative care. Medicare covers one screening every 24 months, unless your doctor determines it is medically necessary to do them more frequently, in which case an exception can be made.

Answer: A premium is essentially what you pay to be enrolled in a plan. A deductible is the portion you must pay before your insurance plan starts to pay their portion. A copayment is an agreed upon amount that you pay in tandem with your insurance provider for a given procedure or medication.

Answer: Medicare Advantage plans typically have a $0 monthly premium, meaning you do not get a bill every month for being enrolled in the plan. However, "free" is a loose term because there are deductibles and copayments and coinsurance costs associated with these plans.

Answer: Yes! Medicare does help cover durable medical equipment. Part B will pay 80% towards the cost of such devices. You can get additional coverage from a Medicare Advantage or Medicare Supplement plan.

Answer: In most cases Medicare Part A is not enough coverage for a hospital stay. While it does help pay for room and board, it does not cover the cost of medical procedures and care.

Answer: You may have coverage for Emergency Care when traveling outside of the United States. That is dependent on which plan you chose.

Answer: The best way to save money on your Medicare Supplement plan is to compare premium rates every year. Not all carriers charge the same amount for similar coverage. You can also save a small amount if you qualify for a household discount, requiring two or more members of your household to be enrolled in the same Medicare Supplement plan.

Answer: Your part B coverage will pay 80% of the cost of the surgery as well as the durable medical equipment. You may have additional coverage if you are enrolled in a Medicare Advantage or Medicare Supplement plan.

Answer: That largely depends on your area and situation. During the Annual Enrollment Period, you may switch plans as frequently as you like, though they do not take effect until the first of January. During Open Enrollment, you may change your Medicare Advantage plans one more time for the year. If you are on medicaid and enrolled in a Dual Special Needs plan, you can change your plan every month. There are also Special Enrollment Periods, such as from a natural disaster, that will open up a block of time you can enroll in the event that you missed the Annual Enrollment.

Answer: There is no age limit on receiving CT scans. Your doctor may be hesitant to order one if you are at risk of contrast-induced kidney damage, sensitivity to radiation, or mobility issues.

Answer: An agent near you will be well versed in the plans available in your area. They will have thorough information on the networks associated with those plans, as well as what is and is not covered. They often know medication pricing and which pharmacies offer the most help on certain prescriptions. They will be able to help you find doctors, specialists, and more, as they know the area well.

Answer: There are many options available. Do not jump on the first plan you hear about. Compare and contrast all of your options before making a determination.

Answer: Possibly. If you are still in your Guaranteed Issue period (3 months before and 3 months after your 65th birthday) or it is your first time enrolling with Medicare, then yes, you can qualify for a Medicare Supplement plan with Guaranteed Issue.

Answer: Not necessarily. Health insurance is a very personal matter, and in many cases, Medicare Advantage plans are the best fit for the client. It is not the ONLY option, just a popular one.

Answer: Yes! In order to avoid late enrollment penalties, you should start your enrollment with Parts A and B, as well as determine which pathway is best for you (Medicare Advantage vs. Medicare Supplement.) If you have qualifying group coverage that you will NOT lose after retirement, you may not need or want to enroll in Medicare. A thorough analysis of current coverage vs. your Medicare options is needed to determine what is best for you.

Answer: If you are using an agent, the agent can input your list of prescriptions into a database and compare the costs, including prescriptions costs and premiums, to determine the most cost effective plan to choose. Alternatively, you can do so yourself right through the Medicare website, albeit it could be confusing.

Answer: Yes, your part Medicare Part B will help pay for treatments for asthma and other breathing conditions.

Answer: You must be admitted into the hospital for 3 consecutive nights as an inpatient stay before Medicare will begin to pay for a stay in a Skilled-Nursing Facility.

Answer: It could increase your Medicare Part B premium if the household income greatly increases when you get married. Medicare checks your household income from two years prior to determine how much you pay for your Part B coverage. If you exceed the threshold, you will see a premium increase for Part B as defined by the Income Related Monthly Adjustment Amount.

Answer: Medicare does not pay for Long Term Care, and therefore typically will not cover home health aides or caregivers for dementia patients.

Answer: No. Medicare does not fully cover nursing home care and Medicare does NOT pay for Long Term Care at all.

Answer: The most important reason to work with a Medicare agent is because plan information can be very confusing and it is important to get the right coverage for you. There is no cost to you for working with an agent, they are well-versed in the plans in their area and they often know insider tips and tricks you might not think of.

Answer: The short answer is "possibly". If your copayments for medications are high, this plan will break them down into installments rather than paying the whole thing up front. Alternatively, there may be other plans that will cover your high-cost prescriptions and little better, or you may qualify for a tier exemption from your current carrier.