Velvet Ohlen, Medicare Insurance Broker

Answer: You should look for PPO plans that offer the travel flexibility. Make sure to read and understand the Evidence of Coverage for the rules, and coverage to the depth of what will be covered and when.

Answer: You can use Medicare Part B to cover medically necessary outpatient occupational therapy for arthritis or mobility issues. Medicare Advantage plans will have this included in their plans. A referral, may be necessary.

Answer: Medicare is a scam. It is not a scam. Medicare is for people 65 or older. You may be able to get Medicare earlier if you have a disability, End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease).

Answer: Yes, Medicare may cover Breztri, as it is often covered by Medicare Part D and Medicare Advantage plans for COPD.

However, coverage and your out-of-pocket cost depend on your specific plan's formulary (drug list).

Some plans might require prior authorization or have other restrictions, and your final cost will vary based on the plan and whether you meet your deductible.

Answer: The best course of action is to call your healthcare plan to find out what it would cost to see an out-of-network cardiologist. Often, the expense isn’t significant; sometimes just a few extra dollars.

Answer: Original Medicare do not include dental coverage. You will need a Medicare Advantage plan or a standalone dental plan, for the dental coverage you need.

Answer: Yes, you can continue seeing your doctors. The best approach is to have a proper plan review to ensure you can keep your preferred providers, have your prescription drugs covered, and receive the quality healthcare you need.

If a change is necessary, you will make that decision. I can help navigate that help.

Answer: Great question. Seniors who do not enroll in Medicare Part B or have creditable coverage will have a penalty.

Seniors who do not enroll in a stand alone or Medicare Advantage plan that offers Part D coverage will have a 1% penalty.

Please see below:

The penalty for late enrollment in Medicare Part B is generally an extra 10% of the monthly premium for each full 12-month period you could have signed up but didn't. For Part D, the penalty is 1% of the national base beneficiary premium for each month you didn't have coverage, and this is added to your monthly Part D premium. Both penalties are often permanent once incurred.

Answer: Yes. Medicare covers preventative screens. List is below.

Cancer screenings (colorectal, lung, breast, prostate, and cervical)

Diabetes screenings and supplies

Cardiovascular disease screenings

Bone density measurements

Glaucoma screenings

Abdominal aortic aneurysm (AAA) screening

Hepatitis B and C screenings

HIV screenings

Sexually transmitted infection (STI) screening

Vaccinations

Flu shots, Hepatitis B shots, and Pneumococcal shots.

Counseling and other services

Annual Wellness Visit (yearly "Wellness" visit)

Smoking cessation counseling

Alcohol misuse screening and counseling

Obesity screening and counseling

Depression screening

Medical nutrition therapy

Cognitive assessment

Answer: No, Medicare Part A you are entitled if you meet the qualifications. Part B you can enroll if you 64 1/2, disable or ESRD. Medicare out of pocket Part B has an expense depending on your income level you will pay the minimum rate.

If your income is over the following:

| Filing Status Modified Adjusted Gross Income (MAGI) Premium Adjustment

Individual ≤ $106,000 Standard premium $185/month

Married, Filing Jointly ≤ $212,000 Standard premium $185/month

Individual $106,001 – $133,000 Increased premium $259/month

Married, Filing Jointly $212,001 – $266,000 Increased premium $259/month

Individual $133,001 – $167,000 Further increased premium $370/month

Married, Filing Jointly $266,001 – $334,000 Further increased premium $370/month

Answer: Great question. Keep in mind rural, means distance. Healthcare plans are driven on zip codes. If you live far away from resources it will impact your care.

Answer: Medicare Advantage plans recognize the importance of mental health coverage. Most plans give beneficiaries the opportunity to see a therapist for a low out-of-pocket cost. If you don’t already have a therapist, your plan can provide access to in-network providers. Many plans also include inpatient mental health coverage.

If you take prescriptions, you can review the plan’s formulary to see whether your medications are covered under the plan you choose. I can assist with you search.

Answer: No, technology changes quickly, and I believe the tools are evolving in the right direction for the people they serve. There are more safeguards in place now to protect privacy, and information can be delivered securely by email.

People can receive everything from the comfort of their homes without needing to travel to a location or have anyone come inside their home.

Answer: Great question. One Medicare decision that too many people regret later, is having proper supplemental coverage to help offset the out of pockets expenses. As well as, not taking the Annual Enrollment Period seriously. You should review your plan with an agent to make sure you are in the right plan.

Answer: First, Medicare doesn't cover prescription drugs. Part D is not part of Original Medicare.

To have prescription coverage, you must enroll in a Part D plan. You can either choose a standalone Part D plan to pair with Original Medicare, or enroll in a Medicare Advantage plan that includes Part D coverage.

Lastly, whether your specific medications are covered depends on several factors, such as the tier your drug falls under and which healthcare plan includes it on their formulary.

I can help you compare plans and assist with applying for the Extra Help Part D program if you qualify.

Answer: Great question. Every hospital negotiates with the healthcare companies to be under contract or in network. If a hospital is in network that can help the Medicare Advantage beneficiaries with in network savings.

If the hospital and health insurance plan cannot agree on cost, fees and pay, the hospital will opt out of the relationship with the health insurance plan. This results to hospital not taking the Medicare Advantage healthcare plans.

Answer: No, Medicare does not cover everything; Medicare Part A generally pays 80%. If you have a Medicare Advantage plan, Days 1–20 in a skilled nursing facility typically have no cost to you. From Days 21–90, you will have a daily cost share. After Day 90, the cost may fall entirely on you or your family.

There are programs you may qualify for to help, but many require you to spend down your savings: and in some cases, even forfeit your home, before assistance becomes available.

The best approach is to put a safeguard in place now, in case you ever need nursing home care in the future.

Answer: Yes, you do, and here’s why. No health insurance plan covers 100% of your medical costs unless you have both Medicare and Medicaid. If you only have Medicare, you will have cost-sharing.

For example, many plans require a daily copay for a hospital stay. If the copay is $490 per day for Days 1–5, your total out-of-pocket cost for that inpatient stay would be $2,450.

A Hospital Indemnity Plan can help cover these expenses. Depending on the plan you choose, it can pay you a cash benefit to offset your out-of-pocket costs. Many Hospital Indemnity Plans are as low as $30–$40 per month.

I can help you find the right plan that fits both your needs and your budget.

Answer: Most seniors wait too long to get long-term care (LTC) coverage. Many believe LTC is only needed when moving into a nursing home, which isn’t true.

LTC benefits can be used when someone is unable to perform two or more Activities of Daily Living: such as eating, bathing, dressing, toileting, transferring, or managing continence. These services can be provided in the comfort of their own home, or they can help cover the cost of a nursing home if that becomes necessary.

I am able to find LTC coverage that's right for you.

Answer: Having an expert Medicare agent can make a big difference. I can drill down into the health plans to identify potential cost savings, and I’ll review the Summary of Benefits and Evidence of Coverage with you so there are no surprises.

I also help identify programs or supplemental coverage that may reduce your out-of-pocket costs.

Answer: First, I would confirm whether you qualify for the Medicare Extra Help program, which reduces your costs for Part D prescriptions.

Next, I use a comparison system that reviews all available plans to see which healthcare companies cover your medications.

From there, I determine which carrier provides the most assistance so you can understand your potential savings and cost-sharing.

Answer: You should work with a Medicare agent because understanding how the health plans work can be confusing. As a licensed and certified agent, I have the expertise to help you navigate your options and make confident decisions.