Vachik Chakhbazian, Medicare Insurance Agent

Answer: How will my current and anticipated healthcare needs align with the coverage and flexibility of different Medicare plans.

Answer: While some Medicare Advantage plans advertise zero monthly premiums, they aren't truly "free." You'll still need to pay your Medicare Part B premium and may incur costs like deductibles, coinsurance, and copayments for medical services.

Answer: Treasury is good at printing money out of thin air, you will be OK. With the number of Baby Boomers entering retirement every day, the demand for Medicare guidance is escalating.

Answer: Medicare does not cover drugs solely for weight loss, but it may cover drugs like Ozempic and Wegovy when prescribed for other conditions like type 2 diabetes or cardiovascular disease

Answer: Yes. You can withdraw money from your HSA to reimburse yourself for Medicare premiums that are automatically deducted from your Social Security benefits check.

Answer: You need to call me as your agent to review your Medicare SOB and let you know your options. coverage is based on medical necessity, not a set number of visits, and there is no longer a therapy cap for Original Medicare.

Answer: Medicare covers knee replacement surgery, including robotic-assisted procedures, if your doctor determines it's medically necessary.

Answer: you'll need a prescription from your doctor stating the medical necessity and then find a Medicare-approved supplier.

Answer: Yes, Medicare covers mental health services, including treatment for bipolar disorder, through both Original Medicare (Parts A and B) and Medicare Advantage plans, covering both inpatient and outpatient services, as well as prescription medications.

Answer: which is allowed because these plans are contracted by commercial insurance companies, not the government.

Answer: Yes, stricter regulations on Medicare Advantage marketing and sales practices are needed. More oversight is needed

Answer: Medicare will typically pay for the full cost of these services if a Medicare-certified home health agency provides them.

Answer: Medicare provides support for quitting smoking through Part B, Part D, and Medicare Advantage plans. Part B covers counseling, while Part D and some Advantage plans may cover prescription smoking cessation medications.

Answer: With Original Medicare (Parts A & B) and Medicare Advantage plans, many preventive services are covered at no cost to you. These include screenings, vaccines, and counseling services aimed at preventing or detecting health problems early.

Answer: could significantly strain Medicare funding within the next 20 years due to reduced payroll tax revenue, the primary source of Medicare funding.

Answer: If you need medical care while traveling abroad, it's crucial to know that the U.S. government does not provide insurance coverage or pay for medical bills overseas. You are responsible for all costs. Before your trip, it's essential to purchase travel insurance and to know how to access healthcare abroad.

Answer: To ensure your procedure is covered by Medicare before incurring unexpected costs, you should first ask your doctor or the facility if they accept Medicare and if they will accept assignment. You can also verify coverage on the Medicare.gov website . If coverage is uncertain, inquire about potential out-of-pocket costs and ask if the provider will file a claim with Medicare, even if they anticipate a denial.

Answer: Medicare will reimburse for remote patient monitoring. home heart monitor is deemed medically necessary by your doctor then it will be covered by Medicare

Answer: Medicare Part B covers outpatient mental health services from various providers, including psychiatrists and therapists. However, it doesn't cover all mental health services. Medicare Part D covers mental health medications. To get medication, you'll likely need a prescription from a psychiatrist, and the medication itself is covered under Part D.

Answer: Traditional Medicare and even Medicare Advantage may not fully meet the diverse and evolving needs of all seniors, particularly those with chronic conditions or significant health needs.

The current system can be confusing and difficult to navigate, leading to errors and potential financial losses for beneficiaries.

Reforms to Medicare are likely to face political opposition and may require significant compromise.

Answer: focus on strategies to lower your Modified Adjusted Gross Income (MAGI), which is used to calculate IRMAA. This can include shifting from traditional to Roth IRAs, maximizing tax-deductible retirement account contributions, and utilizing tax-efficient withdrawal strategies. You can also consider appealing the surcharge if you have a life-changing event that significantly impacts your income

Answer: No, you likely do not need to change your Medicare coverage when moving from New York to Florida, as long as you have Original Medicare and a Medigap plan. Original Medicare coverage remains the same regardless of your location, and most Medigap plans are transferable if you remain within the US. However, you should notify your Medigap insurance company of your new address.

Answer: virtual agents can provide convenience and potentially broader coverage options, allowing you to compare plans from multiple companies.

Answer: Medicare Part B covers certain outpatient mental health services, there are still out-of-pocket costs like copayments or coinsurance. Original Medicare, which includes Part A and Part B, provides coverage for both inpatient and outpatient mental health services, but it's important to understand that not all mental health treatments are covered without any conditions.

Answer: Medicare generally covers the routine costs of clinical trials and may cover certain experimental treatments or services, especially those that are part of a "Coverage with Evidence Development" (CED) study. Routine costs include services that would normally be covered by Medicare if not part of a clinical trial.

Answer: Yeah, you're definitely not alone in thinking that. A lot of people—especially those working within or alongside Medicare—have raised concerns about how outdated and clunky some of their systems are. These outdated systems can make data sharing between providers real headache.

Answer: ​Yes, Medicare has begun covering several AI-powered diagnostic tools that aid in early disease detection, particularly in areas like cardiovascular health and cancer surveillance.

Answer: Yes, Medicare provides comprehensive coverage for hospice care through Medicare Part A (Hospital Insurance). To qualify, you must meet the criterias.

Answer: If you’re at high risk for heart disease, Medicare actually offers a pretty solid range of preventive services designed to catch issues early and manage your risk.

Answer: There are legit plans with strong benefits, but verifying them is key so you’re not misled by marketing fluff. Go to Medicare.gov/plan-compare or call me and i will be more than happy to help you.

Answer: Medigap plans can be more expensive than Medicare Advantage plans, but Medigap policies cover all the areas where Medicare has limitations, which is beneficial for travelers. Medigap might not always be the best choice for everyone.

Answer: you can delay enrolling in Part B and may not need it until you retire. if your employer has fewer than 20 employees, you'll likely need Part B to avoid gaps in coverage.

Answer: Depending on your health condition. it's a complex decision that depends on individual circumstances. may have lower premiums or offer extra benefits, they often come with trade-offs like network restrictions and potential higher costs for out-of-network care.

Answer: they can work together. but Medicare doesn't cover the membership fees for concierge care. You'll need to pay the membership fee out-of-pocket, but your Medicare Part B may cover services provided by a concierge physician that would normally be covered under Part B.

Answer: Yes, Medicare covers emergency care in U.S. territories like Puerto Rico. This includes both Original Medicare and Medicare Advantage plans.

Answer: can help ensure they fully understand their coverage and make informed decisions, as well as provide ongoing support and address any questions or concerns that may arise.

Answer: faster approvals, reduced errors, and more efficient use of resources. AI can also enhance the accuracy of claims documentation and streamline the overall process.

Answer: spending on these plans significantly increasing as a percentage of total Medicare spending. ith Medicare Advantage enrollment growing rapidly and representing a larger portion of Medicare spending than traditional Medicare. Furthermore, Medicare Advantage plans are, on average, paid more per beneficiary than traditional Medicare.

Answer: You have up to four months to enroll in new Medicare coverage insurance following your move, if you let your Medicare provider know before you leave. In this situation, you can enroll a month prior to the move date, and up to two months after the moving month.

Answer: Yes, Medigap Plan G will help cover your knee replacement surgery costs after you meet your Part B deductible. Once you've met the deductible, Plan G will cover the remaining out-of-pocket costs, including copayments and coinsurance

Answer: Yes, it can be suspicious While legitimate Medicare Advantage plans may offer some extra benefits, such as flex cards for certain expenses, it's crucial to be aware of potential scams and misleading marketing tactics.

Answer: With a PPO, you have the flexibility to visit providers outside of your network. However, visiting an out-of-network provider will include a higher fee and a separate deductible. HMOs don't offer coverage for care from out-of-network healthcare providers.

Answer: Yes, you may be wrong. some PPOs, may require referrals, even for specialists. rules can vary between different insurance companies and even between different plans offered by the same company. You might be required to use specialists within the plan's network, and some plans may require referrals to use in-network specialists.

Answer: as of 2025, the Medicare Part D coverage gap is eliminated. Beginning January 1, 2025, there are now three phases of part D coverage: deductible phase, initial coverage period, and catastrophic coverage.

Answer: can cover a range of home health care services, including skilled nursing care, therapy, and medical supplies. Skilled Nursing Care, Therapy, home health aides, social services, telehealth,.

Answer: one of them is the missing the initial enrollment period. 2nd is listening to some one other than their agent. each policy is tailored to specific needs.

Answer: your first step is to understand why the denial occurred and whether it's due to a network issue, lack of prior authorization, or other coverage limitations. Then, you can appeal the denial through the formal Medicare appeal process, you can consider switching to a different Medicare Advantage plan or exploring Original Medicare with a Medigap policy

Answer: you have the right to appeal. The first step is a redetermination, where you submit a written request within 120 days of the initial denial. If that's denied, you can move on to a reconsideration, a level two appeal with a Qualified Independent Contractor.

Answer: No, Medicare Supplement plans and "Medicare Secondary Insurance" are not exactly the same, though they are related. Medicare Supplement plans, also known as Medigap, are specific types of secondary insurance designed to cover the costs that Original Medicare doesn't cover.

Answer: include changes in your health status, changes in your medication list, concerns about plan costs, or changes in your plan's benefits.

Answer: No, you do not need to sign up for Medicare again when you turn 65 if you are already receiving it based on disability benefits. Your Medicare coverage will continue without interruption.

Answer: the top five companies for Medicare Supplement plans for 2025.

Best for Medigap plan options: AARP/UnitedHealthcare.

Best for premium discounts: Mutual of Omaha.

Best for member satisfaction: State Farm.

Best for low premiums: Cigna.

Best for extra benefits: Anthem.

Answer: Yes, it's possible to be denied a Medicare Supplement (Medigap) plan, but it depends on the circumstances and when you're applying. Generally, you can't be denied for pre-existing conditions if you are in your 6-month Medigap open enrollment period or during other guaranteed issue periods.

Answer: These cards allow you to purchase eligible health and wellness products at participating retailers.

Answer: Your SSI will continue as long as you meet the financial requirements (income and resource limits). It can continue for life unless your income, assets, or living situation change.

Answer: In 2025, once your out-of-pocket prescription drug costs reach $2,000, you enter the catastrophic coverage phase of Medicare Part D. At this point, you won't have to pay anything for covered Part D drugs for the rest of the year

Answer: Medicare generally covers palliative care through Part A and Part B, often as part of broader care during a serious illness, and may also cover palliative care during hospice. Hospice care, however, is a specialized type of palliative care specifically for those with a terminal illness and a life expectancy of six months or less, where curative treatments are no longer pursued.

Answer: No, not all types of blood tests are covered by Medicare. Medicare covers blood tests that are ordered by a doctor to help diagnose or treat a medical condition.

Answer: While it's possible to call your health insurance carrier directly for some inquiries, it's often more efficient and effective to use online resources or contact your doctor's office for health-related questions. Calling the insurance company might be best for issues like policy changes or claim status checks. However, for medical advice or questions about your health, it's generally recommended to consult with a healthcare professional or your doctor's office.

Answer: generally won't directly impact your Medicare coverage, but it can affect how you handle pre-existing medical debt and future medical expenses. Medicare benefits typically remain unchanged during and after bankruptcy, and you'll continue to receive the same coverage. However, you are still responsible for new medical bills incurred after filing for bankruptcy.

Answer: Agents are often financially incentivized to enroll beneficiaries in Medicare Advantage due to higher commissions, potentially influencing their recommendations.

Answer: begin by contacting the healthcare provider or billing department first to inquire about the error and seek resolution. If the issue persists, you can then report the error to the Medicare Administrative Contractor (MAC) or the Senior Medicare Patrol (SMP) for further investigation. You can also submit a complaint through Medicare.gov.

Answer: I provided clear and concise explanations of the Medicare regulations and plan's coverage rules, helped the client gather necessary documentation, and filed an appeal on their behalf.

Answer: Original Medicare offers more flexibility in choosing doctors and hospitals, while Medicare Advantage plans often provide extra benefits and lower costs,

Answer: Empathize with their concerns, and be mindful of potential feelings of loss of independence or fear. Ensure you have their consent to discuss their medical information with Medicare. Use plain language, explain options in detail,

Answer: No, routine eye exams for glasses or contacts are generally not covered by Original Medicare. However, Medicare does cover certain eye exams related to the diagnosis and treatment of eye diseases, such as glaucoma and cataracts.

Answer: Individuals under 65 can qualify for Medicare coverage if they have a disability, End-Stage Renal Disease (ESRD), or ALS (Amyotrophic Lateral Sclerosis). If they are receiving Social Security Disability Insurance (SSDI) benefits, they are automatically enrolled in Medicare Parts A and B after receiving benefits for 24 months. If they have ESRD or ALS, they are also eligible for Medicare.

Answer: You will receive either his survivor benefit (which is based on his work history) or your own retirement benefit, whichever is higher. Social Security only pays one benefit at a time.

Answer: helps cover the cost of prescription drugs, a benefit not included in the original Medicare plan (Part A and Part B). This coverage is provided through private insurance companies approved by the federal government.

Answer: Original Medicare offers greater freedom in choosing providers, while Medicare Advantage often includes extra benefits like dental, vision, and fitness coverage, and may have lower out-of-pocket costs.

Answer: Medicare may cover specific services like physician care and hospitalization within a CCRC. Medicare doesn't typically cover the cost of living in a CCRC itself, but it can be used for related medical expenses.

Answer: Taking it early at 62 results in a reduced monthly payment, while waiting until 70 guarantees the highest possible monthly payout. The best approach depends on individual circumstances, including health, financial situation, and life expectancy

Answer: dialysis doesn't automatically change Medicare eligibility, but it triggers Medicare coverage for dialysis after a waiting period, typically the fourth month of treatment. If you're already eligible for Medicare, your coverage begins right away. If you're only eligible because of ESRD (End-Stage Renal Disease), the waiting period applies.

Answer: Medicare Advantage plans set their own cost-sharing terms and may or may not charge deductibles for hospital stays. After meeting the deductible, your Medicare Advantage plan may have a copay for the initial days of your stay.

Answer: help people with limited income and resources pay for some or all of their Medicare costs, including premiums, deductibles, and coinsurance. are designed to ease the financial burden of Medicare for low-income beneficiaries.

Answer: For your expensive diabetes medication, both standalone Part D and Medicare Advantage plans can offer drug coverage, but the best choice depends on your specific needs and situation.

Answer: I've heard about IRMAA affecting my Medicare premiums. How can I find out if it applies to me, and how does it work?

Answer: The best time to start researching Medicare options is three months before you turn 65, during your Initial Enrollment Period. This seven-month window includes the month you turn 65 and ends three months after.

Answer: The main difference is that Medigap (Medicare Supplement) plans allow you to see any doctor or specialist who accepts Medicare, regardless of whether they're in-network or out-of-network. Medicare Advantage plans generally require you to stay within a network of providers, and may charge more or not cover services if you go out-of-network.

Answer: Yes, some Medicare Advantage plans may cover acupuncture and other alternative therapies, Original Medicare covers acupuncture for chronic low back pain, Medicare Advantage plans can offer broader coverage for acupuncture and other alternative therapies, including massage therapy, chiropractic care, and biofeedback,

Answer: Medicare generally doesn't cover 24/7 in-home care for dementia patients who wander or need constant supervision, but it can cover part-time, intermittent care for those who are "homebound" and need skilled nursing or therapy. Medicare may cover home health services, including skilled nursing, physical therapy, and speech therapy, if a doctor deems these services medically necessary and the person is "homebound". However, Medicare doesn't cover personal care like bathing or dressing, or homemaker services like laundry and shopping

Answer: Medicare Part B covers preventive services, including screening mammograms. Diagnostic mammograms are also covered when medically necessary, with the beneficiary paying 20% of the Medicare-approved amount after meeting their Part B deductible.

Answer: No, Medicare generally does not fully cover nursing home care, but it does cover short-term, medically necessary care in a skilled nursing facility. Alternatives to paying for nursing home care include Medicaid, long-term care insurance, and private pay. Medicare Part A covers up to 100 days. The first 20 days are fully covered, and then a daily coinsurance applies for days 21-100.

Answer: Yes, the changes to Medicare Part D for 2025 are designed to potentially lower your out-of-pocket prescription drug costs. The main change is the removal of the "donut hole" and a cap on annual out-of-pocket spending at $2,000. This cap means that once you reach $2,000 in out-of-pocket drug costs for the year, you won't have to pay anything for covered drugs for the rest of the calendar year.

Answer: start by building trust and understanding their individual needs. Explain the basics of Medicare, including the different parts (A, B, C, D) and their coverage, then tailor your explanation to their specific circumstances. Use plain language, avoid jargon, and be patient as they learn the system.

Answer: they offer personalized guidance, local knowledge, and can help you compare different plan options, ensuring you choose the right coverage for your specific needs. They can also provide ongoing support and connect you with relevant community resources.

Answer: focus on their knowledge, experience, and approach. Experienced brokers will have a deep understanding of Medicare, its various plans, and how they work together. They will also be able to explain the benefits, restrictions, and complexities of Medicare, including recent changes and updates. Inexperienced brokers may lack this detailed knowledge and may be less helpful in navigating the intricacies of Medicare.

Answer: Yes, you are generally eligible for a Special Enrollment Period (SEP) if you lose your employer-sponsored health insurance coverage.

Answer: The MOOP is the limit on annual out-of-pocket expenses that you'll pay for medical services that are covered by your Medicare plan. Once you reach this limit, your insurance pays 100% of the covered costs for the rest of the policy year. This limit helps protect you from excessive healthcare expenses.

Answer: Yes, Medicare covers the shingles vaccine through Medicare Part D or a Medicare Advantage plan with drug coverage.

Answer: ou can request a reconsideration of your Income-Related Monthly Adjustment Amount (IRMAA) by filing Form SSA-44 with the Social Security Administration (SSA). This form reports a life-changing event like retirement, which can significantly impact your income.

Answer: Part D plans can have various factors that lead to changes in drug costs, including plan-specific formulary, manufacturer price changes, and the coverage gap or donut hole.

Answer: Medicare now offers a range of preventive services, and the shift towards Medicare Advantage plans and value-based care emphasizes a more proactive approach.

Answer: Medicare Part B, which covers ambulance services, has a yearly deductible that you must meet before Medicare starts to pay.

For 2025, the Part B deductible is $257. You will be responsible for this amount if you haven't already met it.

After you meet your Part B deductible, you'll generally pay 20% of the Medicare-approved amount for the ambulance ride.

Medicare will pay the remaining 80%.

Answer: To check if your mom can keep her doctors with a Medicare Advantage plan, you need to verify if they are in the plan's network. You can do this by contacting the plan directly, checking their website, or using Medicare's online tool. If they are not in-network, you'll need to consider whether the plan allows out-of-network care and what the costs would be.

Answer: Yes, when switching from one Medigap (Supplemental) plan to another, you may have to answer health questions and go through a medical underwriting process in most states. However, there are exceptions, including your first Medigap open enrollment period and guaranteed issue rights.

Answer: A zero-premium Medicare Advantage plan means there's no monthly fee for the plan itself, but it's not necessarily "free" overall. You'll still have to pay your Medicare Part B premium, and you may also have out-of-pocket costs for services, medications, or other plan-specific expenses.

Answer: While Original Medicare covers medically necessary specialist visits, you'll generally be responsible for the Part B deductible and 20% coinsurance for the Medicare-approved amount of the service.

Answer: Yes, Medicare may cover acupuncture for chronic lower back pain, but with some limitations. Medicare Part B covers a maximum of 12 acupuncture sessions in a 90-day period, and potentially an additional 8 if the pain is improving, for a total of 20 treatments per year. However, the pain must be chronic (lasting 12 weeks or longer) and not due to other specific causes like surgery, pregnancy, or systemic diseases.

Answer: depends on whether Medicare itself considers the tests medically necessary. Medicare Part B typically covers blood tests and other diagnostic tests that are medically necessary to diagnose or treat a health condition, or if your doctor orders them for that purpose.

Answer: Each Medicare Part D plan has a formulary, which is a list of covered drugs. Utilize the Medicare Plan Finder tool to see if your medications are on a plan's formulary. After entering your medications, you can compare estimated costs for each plan. The covered drugs list and associated rules might change, so review your plan's latest information online.

Answer: Ensure traditional Medicare is comprehensive, simple to navigate, and affordable.

Add oral health, audiology, and vision coverage for all beneficiaries in traditional Medicare.

Increase low-income protections and reduce cost-sharing.

Add coverage for long-term care.

Answer: Carefully review the specifics of any Medicare plan you're considering, particularly its coverage for travel. A licensed insurance agent, specially me, can help you compare plans and choose the one that best suits your travel habits and healthcare needs.

Answer: Yes, there are penalties for delaying enrollment in Medicare Part B, The penalty is a 10% increase to your monthly premium for each 12-month period you delay enrolling, and you'll pay this penalty for as long as you have Part B.

Answer: you can still enroll, but you may face late enrollment penalties. You can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. You may also qualify for a Special Enrollment Period (SEP) if you had other coverage when you turned 65 and are now retiring.

Answer: can be used instead of your Medicare Part D plan for prescription costs if the discounted price is lower. However, you cannot combine these discounts with your Medicare coverage for a single prescription. If you choose to use a discount card, the cost doesn't count towards your Medicare deductible or out-of-pocket maximum.

Answer: consider exploring these options: switching to a different Part D plan, seeking manufacturer assistance programs, or investigating state-run programs. If you have limited income and resources, Extra Help or Medicaid may also be available to further reduce costs.

Answer: not reviewing their Medicare plans, particularly drug coverage, annually during the Annual Enrollment Period. Drug manufacturers can change their prices and how they are covered by plans, and this can significantly impact out-of-pocket costs.

Answer: gaps include prescription drugs, routine dental, vision, and hearing care, and long-term care. To address these, you can enroll in Medicare Advantage (Part C) or Medicare Supplement Insurance (Medigap).

Answer: Generally, U.S. health insurance plans do not cover medical care received outside the United States. This means you may need to pay out-of-pocket for medical services or file for reimbursement upon returning home

Answer: Adding dental, vision, and hearing coverage to traditional Medicare would likely increase costs for some beneficiaries, but it could also improve overall health outcomes and potentially reduce healthcare spending in the long run by addressing preventative issues early. Currently, Original Medicare doesn't cover routine dental, vision, or hearing care, leading to high out-of-pocket costs for many beneficiaries and potentially delaying or forgoing necessary care.

Answer: You can sign in to your MyMedicare account and print a copy of your card or request a replacement to be mailed to you. Alternatively, you can call 1-800-MEDICARE to order a replacement.