Victoria R. Trevino, Medicare Insurance Broker

Answer: Medicare does not cover dental, vision or hearing care. However, many MAPD plans offer these extra benefits as part of their standard coverage. I can help explore MAPD plans in your area to find which benefits are available for each insurance carrier.

Answer: The 5-Star Special Enrollment Period (SEP) allows Medicare clients to switch to a 5-star rated Medicare Advantage or Part D plan once per year, outside of the standard enrollment periods of AEP and OEP. The 5-star SEP is available between December 8 and November 30.

Answer: Medicare covers the shingles vaccine (Shingrix) as a preventative service at no cost to the Medicare client.

Answer: I work with clients through each step of the Medicare process, including access to the health services and procedures needed. I can help direct them through the appeals process and walk them through the steps needed to file an appeal. The decision is ultimately up to the health insurance carrier but I can help explain and locate the documents needed.

Answer: Let's take a look at your individual needs including travel, budget and utilization of services. I can help find a solution that works meets your current health insurance needs.

Answer: There are now 3 stages of Part D coverage.

Deductible stage, Initial stage and Catastrophic stage. The donut hole (coverage gap) no longer exists. When one hits the threshold of $2100 in Rx expenses, the Medicare client pays $0 for covered Rx the remainer of the year.

Answer: It is important to review your Part D (Rx) plan benefits every year. Take a close look at the premium, deductible and copays/co-insurance to understand your costs. Refer to the plan's formulary to understand which tier each medication falls under in order to determine costs.

Answer: MAPD plans work in rural and urban areas. It is the responsibility of the licensed agent to review the provider network with the Medicare client before enrolling.

Answer: Administrative staff may assist in distributing and collecting the Scope of Appointment (SOA) form. However, it is the responsibility of the licensed agent to ensure the SOA is completed correctly and signed by the agent.

Answer: In this scenario, I recommend a no-cost consultation with me to review the Medicare clients particular situation. There are several factors to consider when adivising a client whether or not to enroll in Medicare at age 65 (example: size of the employer, credible coverage,etc).

Answer: With Original Medicare only, one will generally pay 20% of the Medicare-approved amount for an ambulance ride. In addition, one must first pay the annual Part B deductible of $283 in 2026.

Because there is no financial cap (stop loss) on the amount one might spend on medical expenses with Medicare only, I highly recommend looking at additional coverage to fill in the gaps.

Answer: Educating clients on the 'Medicare Basics' is the best way to explain premiums, deductibles and copays. I work directly with clients to understand out-of-pocket expenses and how to plan for healthcare costs.

Answer: I encourage Medicare clients to review the benefits of their insurance plan, includiing chiropractic services. The 'Evidence of Coverage' book provided by the insurance carrier is the best way to understand each of the health benefits included in the plan. This document is also available electronically.

Answer: Medicare is a federally-funded government program and is subject to changes with each different administration. Every year, I encourage clients to review their insurance plan with me to verify the plan continues to meet their individual needs and budget.

Answer: I work with Medicare clients to understand the full benefits of each different Medicare Supplement (also known as Medigap). Regarding the specific medical costs associated with bloodwork on a Medigap Plan C, one does not need to budget extra for this service because it is covered by the plan.

Answer: I enjoy educating Medicare clients and their families in order to make informed health insurance decisions. It's rewarding to know I can make a difference in the health and well-being of a Medicare client.

Answer: Medicare is a complex subject. Licensed agents are certified annually with the insurance carriers to understand the health plan benefits and to know the network of doctors/hospitals in the service area. Working with a Medicare agent can save time, energy and help you avoid enrollment mistakes.