Wendy Lollar, Medicare Insurance Broker

Answer: I don’t think it’s a problem, unless its in reference to the telemarketers. I have spoken to so many stressed seniors about the hundreds of phone calls that they receive daily during certain enrollment periods.

Answer: Yes, Repatha is covered. Formularies and Tiers are sometimes different between carriers. Also, in my experience with Repatha, there’s usually a prior authorization needed.

Answer: It depends on your coverage. A Medicare Supplement goes wherever you go but Medicare Advantage Plans are state and county specific. That would definitely have to change with the move.

Answer: There are several ways. If you have a Supplement Plan, there are stand alone dental and vision plans that can be purchased separately.

Or if you have a Medicare Advantage Plan, dental, vision and hearing are almost always included in them for no extra cost.

Answer: I’m going to say yes. Medicare isn’t just one decision

It’s a stack of permanent and time-sensitive choices:

• Original Medicare vs Medicare Advantage

• Medigap Plan G vs Plan N (and when you’re allowed to enroll without underwriting)

• Part D drug plans that change every year

• Provider networks, prior authorizations, and out-of-pocket exposure

• Penalties that last for life if you miss something.

As an agent, I/we have to go thru annual training and certifications to assist you correctly. It’s not to say that you can’t search out the information for yourself and even get things right but I don’t know why one would if they found a good agent to work with them, and the help comes at no cost to them.

Answer: Hopefully it will have a positive effect. I’ve always been told by clients that nursing homes take them from their MA Plans and put them on Original Medicare only for the benefit of the nursing home. They are told that original Medicare doesn’t “question” their billing department but MA’s ask questions. This isn’t an area that I’m very knowledgeable in firsthand, but I do talk to my clients about their experiences.

Answer: Yes. Both are covered. We’d need to know exactly what health coverage that the person has to proceed with the percentages of coverage included.

Answer: I’ve often found new clients that didn’t realize they had dental, vision and hearing benefits included in their Medicare Advantage plans. OTC allowance is another perk that isn’t explained correctly and/or how to get those items.

Answer: No. But there are specific times throughout the year that you could change. Speaking to an agent would help confirm that eligibility.

Answer: It does but how much will depend on one’s coverage. Whether is original Medicare with or without a supplement or under a Medicare Advatage plan.

Answer: Yes — moving to a rural area can and usually always does affect your Medicare Advantage plan options because these plans are built around local provider networks, insurer availability, and healthcare infrastructure in your ZIP code/county.

I’ve often found that some carriers won’t offer any plan options in rural areas. That could leave the only option to be Original Medicare with a supplement plan, which doesn’t always fit budgets.

Answer: This isn’t something that I’m very familiar with but what I’ve found is if this is truly Medex (Medigap) and you’re opted out, you generally cannot bill Medex for therapy in a way that results in payment for Medicare-covered Part B therapy services.

I would recommend you reaching out to the carrier to verify rules and compliance.

Answer: A Medicare agent looks at your specific situation, including:

• Doctors and hospitals you use

• Prescription medications

• Budget and fixed income concerns

• Travel habits

• Eligibility for Extra Help, Medicaid, or other assistance

Instead of guessing online, you get guidance tailored to you.

Answer: Yes — many private hospitals in the U.S. do accept Medicare plans, but exactly which plans they accept can vary depending on the type of Medicare coverage you have. Supplements are excepted anywhere that takes Medicare but when it comes to a Part C Plan (Medicare Advantage) the options may be limited to specific carriers.