Wade Lashley, Medicare Insurance Broker

Answer: Generally speaking you will have a copay for outpatient surgery. The amount varies depending on your plans coverage. I'd refer to your Evidence of Coverage booklet or call member services to find out how much you'll be expected to pay.

Answer: In early 2024 I had a Client who used a special enrollment period to start he's Medicare benefits at the time of his retirement. He had issues getting enrolled in part B but managed to get it taken care of in late January.

We submitted an enrollment for a Medicare Advantage plan to begin on February 1st. There was a mix up at Medicare and they instructed the insurance company to cancel his enrollment. Too many details to share here but I took the additional steps required to get his coverage reinstated. It took some time and a few phone calls but I was glad to do it.

Answer: It's a good idea to do a side by side comparison of your employer sponsored coverage and the options you have from Medicare. Consider the cost of your premiums, deductibles and maximum out of pocket, then you can make an informed decision on how to proceed. You can delay Medicare enrollment without penalty as long as you have insurance coverage through yours' or your spouses employment.

Answer: Once you reach the catastrophic phase you won't pay anything for your Medicare covered part D drugs.

Answer: A MOOP is generally associated with Medicare Advantage plans. Think of it as max out of your pocket. It’s your annual cap on copays and coinsurance like the amount you pay for a Specialist office visit, X-ray or a night in the hospital.

Answer: Yes it is and a good idea to do so. You’ll want an Agent who is knowledgeable and trustworthy in addition to someone that you have a good rapport with. Take a long term view when selecting an Agent.

Answer: The Medicare program can be complicated and confusing. A local Agent can be of great assistance to you in determining what option might be the best fit for your unique needs and monthly budget.

Your local Agent can become your first point of contact for questions regarding plan benefits, claims, Rx costs etc. Better to have a local contact than wait on hold to speak with someone in a call center.

A local Medicare Agent can also assist with annual coverage reviews during the Medicare Annual enrollment period to be certain you're on the right track with coverage for the coming year.

Answer: For Part A (Hospital insurance) there is a $1,676 deductible if you're admitted as an inpatient. You could be responsible for additional charges if you had a hospital stay of 61 straight days or more.

For part B (Medical services) you are responsible for the deductible of $257. Once the deductible is met Medicare covers 80% of the approved charge and you would be responsible for the remaining 20% whether the bill is $100 or $100,000,

Purchasing a Medigap plan or enrolling in a Medicare Advantage plan can help you reduce your out of pocket costs. Speak with a local Agent for more info on all of your options.

Answer: Obesity behavioral therapy

If you have a body mass index (BMI) of 30 or more, Medicare covers obesity

screenings and behavioral counseling to help you lose weight by focusing on

diet and exercise. Medicare covers this counseling if your primary care doctor

or other primary care provider gives the counseling in a primary care setting

(like a doctor’s office), where they can coordinate your personalized plan with

your other care.

From Medicare.gov: Medicare covers some bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery when you meet certain conditions related to morbid obesity. I'd consult your PCP for more info.

Answer: The death benefit is a great way to replace lost income due to the unexpected passing of a spouse or loved one. The cash value of permanent insurance that accumulates over time can be used to supplement retirement income.

Answer: Anyone calling claiming to be from Medicare or Social Security and asking for personal info. Medicare will only contact you by phone if you have requested a call back.

Answer: Ultimately it's a choice you have to make yourself. Other people's opinions can be helpful but how much do they really know about Medicare? There are pros and cons to both options. If your uncertain as to which is the right choice for your needs I'd recommend contacting a Local Agent to clarify the differences between the two so that you can make an informed decision.