The Latest Medicare Questions and Answers
Accessing Medicare Online
Are Aetna’s claim details available through the computer? If so, how do I gain access to this? -Rose
Where can I locate my claims on the Medicare website? Thanks. -Diane
I have a Medicare ID, but I cannot recall, nor did I bookmark, the Medicare login page. I lost my card and need to order a new card. What is the URL? -Connie
Canceled Coverage
If my Medicare Advantage Plan (MA Plan) coverage was canceled by an insurer in 2021 due to no fault of my own and unknown to me until after the fact, can I enroll in another plan with the same insurer in 2022? This insurer only offers HMO MA Plans in my area. -Barbara
Contacting an Insurance Agent
Is it a good idea to use an insurance agent when applying for Medigap and Plan D? -Elka
Contacting Medicare
How do I call Medicare? -Sarah
Counseling
When do you/do you anticipate that Medicare will cover mental health counseling from Licensed Professional Counselors of Mental Health (LPCMHs)? Thank you. -Amy
Coverage Appeals
How can my patient’s family appeal a Medicare coverage decision? -Krissy
Dental Coverage
I am seeking info on dental coverage with AARP Medicare Advantage (MA)/UnitedHealthcare (UHC) Preferred Provider Organization (PPO). Is there any coverage at all? And if so, what is the coverage? -Janice
I need to find a plan that my dentist participates in. -Suzanne
What will Medicare pay if you need dental implants? -Rebeca
My wife is going to have Mandibulectomy and Fibula Free Flap Reconstruction for left side jaw cancer. We have Medicare and AARP Plan G supplemental insurance. Is there any coverage after this initial surgery to reconstruct the jaw with bone grafts that can support a denture (i.e. bridge or tooth implants) after the main surgery? -Joseph
Hi Ron, my wife, 68, has traditional Medicare with a supplemental insurance plan. She has a very limited income and is in need of serious dental work (crowns, etc.) Since there is no low-cost, comprehensive dental coverage that I am aware of, I am hoping that you might know of an affordable way for her to get her teeth repaired. Thanks for your assistance here. -Blessings, Tony
Dual Enrollment
Can you have both Medicare and Medicaid? -James
I’m getting Medicare and Medicaid starting July 1 and need a Medicare Advantage Plan (MA Plan). -Timothy
I used to have UnitedHealthcare (UHC) when I lived in Chicago and when I moved to Lake Havasu City, Arizona. I loved it. Now that I’m in California, I’m wondering if I can still get over-the-counter benefits here if I sign up for UHC. Although I had Extra Help before I don’t know if I qualify now. Not sure, but I’ll find out soon. That’s my main question. Thanks. -Marti
Fitness Club Memberships
Does my Aetna cover YMCA memberships? -Roger
Hearing Benefits
Does my plan cover hearing aids? -Robert
Living Outside of the U.S.
I have enrolled in Part A and Part B but have not made payment arrangements yet. My enrollment location is Massachusetts, but I currently split time between Europe and the U.S. I will likely purchase a home in New York in the coming months and live there more than 183 days per year. Since part of the year I live outside the U.S., can I deactivate and activate my plan as required? -Charles
What medical services are covered under Medicare Plan G and Transamerica Plan G outside of the U.S.? Also can you comment on coverage for dialysis outside the U.S.? -Athos
Hospice and Palliative Care
Can a person get hospice without a firm diagnosis from a doctor? -Valori
My husband is in need of palliative care due to dementia and severe neuropathy. He is homebound and does not qualify for a Special Needs (SNP)-type Medicare Advantage (MA) Plan. His right leg to his foot is causing him to be unable to walk and be bedbound; he still needs ongoing therapy twice a week to help slow his dementia with a once a month advanced practice registered nurse (APRN) visit to check on his ongoing medication Rx-needs and catheter change. Do you have a plan that will cover palliative care under the MA program with $0 premium monthly payments? We understand that if you do, the plan will not go into effect until Jan. 1, 2023. Can you help us, please? -Florence
Mandatory Medicare
Is it mandatory to go on Medicare when you turn 65? -Mary
Medicare Advantage Plans
I am trying to get my mother out of Kaiser. She is currently on the Medicare Advantage Plan (MA Plan). My husband and I use Mercy Medical doctors for care and have been happy. It’s not part of Carefirst but Medicare Advantage Preferred Provider Option (PPO). How do I find out about this plan? How do I go about researching plans and doctors? I want to find a geriatric doctor, a nephrologist, and maybe a vascular doctor. -Judy
What are the Medicare Advantage Plans (MA Plans) in my area with $0 premiums? -Dennis
How much does my Medicare Advantage Plan (MA Plan) pay for Evenity? -Laurel
I have questions regarding Medicare Advantage Plans (MA Plans) in North Carolina. Hopefully, you may offer help. Thank you. -Santina
Hello, I am trying to find a Medicare Advantage Plan (MA Plan) that will fit my needs. I am a New Hampshire resident, but my doctors are primarily in Massachusetts, and I would like to keep them. How do I find a provider that will cover my doctors since I live in New Hampshire? Thank you. -Cindy
Does Medicare Advantage (MA Plans) cover nursing home service? Or is it 100 % out-of-pocket? -Chandra
I have Medicare and Medicaid both part A and B. I have had Anthem insurance for three months but the customer service is not good so I want to switch to UnitedHealthcare (UHC). I applied but they wrote me that I don’t have Medicaid proof. I sent everything but it was not approved. Where do I request this? -Shaheen
Hello, my grandmother will need to sign up for a Medicare Advantage Plan (MA Plan) before the end of open enrollment on March 31. I am hoping to get some guidance as to which plan would best fit my grandmother’s needs based on her current age and health conditions. To provide some quick info, she is 84 years old, and had a head injury in a car accident about two years ago that was never officially diagnosed. She has also for a time been suffering from memory issues and general forgetfulness. She will need to go in for tests and an MRI soon, but first needs an insurance plan that covers 100% and will allow her to get any necessary tests. Our family would greatly appreciate any bit of feedback as to what plans may be a good fit for her. Thank you for your time. -Amyr
I will be turning 65 in July, but my wife is only 63. I am a retired federal employee and my current medical insurance is with the Government Employees Health Association, Standard Option. I understand that any Medicare insurance I select will only cover me, so I need to continue something for my wife for the next couple of years. Is there a Medicare Advantage Plan (MA Plan) that can cover both of us at this time? Or do I need to have to pay for two plans at the same time? I ask this because everything I see online does not talk about what to do for married couples where the spouse is not eligible. Thanks. -Kenneth
I have UnitedHealthcare (UHC) through AARP. I was sent a new card and informed that my PCP is no longer a part of AARP Medicare Advantage (HMO-POS). Does this qualify as an event that would allow me to change to another Medicare Advantage Plan? My wife is with Kaiser here in Northern Virginia. I would like to change to Kaiser. -Carey
Hi, my mother is on Medicare Advantage (MA) in Oregon, and I am trying to find out to whom at Medicare I should address a concern about a provider and the negligent care my mother received. Thank you. -Jana
I already have Medicare Parts A and B and have Medicaid that pays for my Medicare premium. I was trying to sign up for the flex card for $2,888. Can I still get it? -Linda
Ron, I would like to know who you might recommend to me to assist me in reviewing the many Medicare Advantage (MA) Plans to determine which plan would best serve my needs. My head is swimming and the knowledge of someone familiar with this system would be of great help to me. Thank you so much for your time and advice. -Pam
Which Medicare Advantage (MA) plans will cover an actual physical exam along with the Medicare Annual Wellness? I am not sure which plans will cover my physical and it is expensive. Thank you. -Carol
My name is Nancy. Judy is my sister, and she has suffered from untreated Lyme disease for many years and has always said she cannot afford treatment as she lives on only a few hundred dollars a month from a Social Security Administration (SSA) check. She has many health problems due to Lyme disease, including pretty significant memory loss and cognitive decline. She has double vision and has special glasses with prisms to see. Her eyesight has deteriorated so badly in the last couple of years I am concerned she is going to lose her vision completely. Is there any Medicare Advantage (MA) Plan that will cover treatment for Lyme disease available in Hernando County, Florida? Her zip code is 34601. -Nancy
Is it true that diabetics can change their Medicare Advantage (MA) Plans any time? -Able
Medicare Denial
Can you be denied Medicare? -John
Medicare Enrollment
I have become unhappy with Kaiser, but given its rating, I wonder if all providers have experienced a degradation in services lately. -Ken
I am 77 years old and will be 78 in two weeks. I would like to enroll in the Medicare Advantage Plan (MA Plan). I have Parts A and B. Is there any Special Enrollment Period (SEP) prior to the open period of Oct. 15 to Dec. 7? -Susan
How do I know if I am choosing the right policy for me? -Steve
My wife and I have our 65th birthdays in November and December so we need to enroll in August and September. I’m doing the research on plans but can’t find any information on how I begin the process of self-enrollment. I’ve opened an account on my Social Security Administration (SSA) account. What’s my next step? Thank you! -Mark
I currently have traditional Medicare Part A, B, and C. When could I switch to a Medicare Advantage Plan (MA Plan)? -Patricia
An insurance agent supposedly hooked me up with Medicare plan G and advised me I would get a call about getting Plan D coverage, but I have not received any paperwork or phone calls for either program. I have called several times but no one has called me back. -Jolene
I need a prescription plan. -April
My wife and I are 65 and enrolled in Part A and B. We both are currently covered by my insurance through my employer, and it is renewed every November for the following year. I am looking at switching to either a Medigap or Medicare Advantage Plan (MA Plan) along with part D coverage. My wife is undergoing chemotherapy with stage 4 breast cancer at Duke Oncology. Are there any pitfalls that you know of in trying to get a policy for both of us? Also, any advice on how to proceed would be appreciated. -Glen
Is there anywhere near me I can go in person and discuss what I need and should get for Medicare? I can sign up at the end of August and am lost. I don’t want to do it over the phone. -Terry
I am new to Medicare. I am a single woman, I will be 65 in August and I am still employed part-time. I have no major health problems. Looking for suggestions on choosing the best health plan for myself. I currently have a health plan through the marketplace with Priority Health. Not sure I understand the difference between having Medicare with a Supplemental Plan vs. having a Medicare Advantage Plan (MA Plan). I have been inundated with calls and mailings and it’s become very confusing. Thank you for your assistance. -Mary Ellen
I am confused about what to sign up for. There are so many plans. -Vicky
When I enroll in Medicare 90 days before my 65th birthday, do I have to choose a Supplement Plan at that time or may I wait until it is closer to my Medicare effective date? -Thomas
I am 63 and currently unemployed. Can I qualify for Medicare? -Colleen
Hello Ron. I am a 66-year-old retiree enrolled in both Part A and Part B. I was also covered under my husband’s employee insurance plan through Aetna until he retired a month ago. He has decided to return to the workforce as he has a few years before he is Medicare-eligible. My concern now is how do I determine whether to have my husband include me under his new insurance? Or should I be looking into a Medicare Supplement Plan and prescription coverage, if that’s even possible at this point since my Initial Enrollment Period (IEP) is past? His previous plan through Aetna provided me with a letter stating that the plan was comparable to any Medicare plan, but it was quite the ordeal to obtain. Thanks for your time. -Connie
I will be turning 65 in September and will need to switch my plan. I now have a plan for those under 65 with disabilities and low income, Commonwealth Care Alliance. I need help finding the same type of plan that I don’t pay monthly fees or for doctor visits. I signed up for something different and was put on this plan. I don’t want the same mistake being made as this is the fourth plan I was wrongly put on. Thank you in advance for any help you can offer me. -Debra
How can I enroll in Medicare Part B only, as part of my Initial Enrollment Period (IEP)? Details: My application for Medicare Part A is in process. At the time of that application (early July), I elected to wait on applying for Part B, because I wanted to talk to private insurers, first, about C and D. I thought, incorrectly, that if I got a Medicare Advantage (MA) Plan, I would discontinue paying Medicare and all costs would go through a private insurer. Now, I understand that the private insurers only administer A and B, but I must still pay for those through Medicare. So, I need to enroll in B only, as my Part A is in process. -Ingrid
This has been my first year on Medicare. After months of researching and talking to people, I opted for traditional Medicare A and B with Supplement Plan N and a separate Prescription Drug Plan (PDP). Do you consider Medicare A and B and a Supplement and PDP better than a Medicare Advantage (MA) Plan? I am very frustrated that I am already about to enter the coverage gap phase of my PDP. This has been one of the most frustrating years of my life trying to figure out the Medicare world. I mainly just want to know if it is truly better to stay with Medicare A and B and a Supplement Plan and PDP or whether a MA Plan is really better. Thanks so much in advance. -Karen
Hi, thank you for your time. I am turning 65 until March but just trying to get a head start on understanding. I never smoked and am not overweight at 5 feet 11 inches tall and 175 pounds. I walk fast doing 3 miles a day, and am not on any medications. Both parents are still alive and very well. I have Blue Cross Blue Shield Preferred Provider Option (PPO) now and am happy with the coverage but unhappy with the price. Basically, I am living off Social Security Administration (SSA) and some rental income. My doctor said to check out BayCare Medicare Advantage (MA). I rarely ever go to a doctor, except for my yearly checkups and teeth cleaning. Are the MA Plans best for me? I plan to live to over 100 on a budget. Thanks for your advice -Alex
Who can buy Medicare? Where do I apply for Medicare? -Eva
I am eligible for Medicare in October when I turn 65. I do not want to sign up for Part B at this time. I signed a paper back in July and sent it in declining Part B. Now I received a letter stating they will start taking out over $170 per month for Part B. I cannot afford this. What do I do just to sign up for Part A? I know this is just hospital coverage, which is all I want. I only see a doctor two times a year. -Allie
Medicare and VA Coverage
Ron, I am a 70% disabled Vietnam veteran. The only prescription I need help with is Trulicity(Tier 3). Thank you. -David
I have Medicare Part A. My medical is VA full coverage. Can I still get covered for dental through Medicare Advantage (MA)? I do not have Medicare Part B. -Robert
Is there more than one wraparound Medicare Plan for military retirees residing in Tennessee who have TRICARE For Life? -Sandra
Does a military retiree receive a reimbursement of his Medicare Part B premium? If yes, how does he apply for this reimbursement? If he is entitled to reimbursement, why is he not receiving it automatically on his monthly retirement check? -Roy
I am 70 years old and I pay for Medicare. I am retired from the Air Force. I am going to the Veterans Affairs (VA) and questioning the statement occurring on two of my bills that were sent from OPTUM VA CCN to me as a receipt I guess. One is a bill from my allergist, saying “Veteran Responsibility: 0 1 – MEDICARE ALLOWABLE FOR VA CCN.” I also pay a copay of $50 to VA per visit. Is Medicare paying anything? VA said it is not, so then why put this statement on the bill? Could you clarify this for me? VA doesn’t answer the phone lately for billing questions. I have asked several veterans about this but they don’t have insurance so they don’t know. If Medicare is paying then why do I have a copay? Can you please ensure me Medicare is not involved with the military VA billing program? -Darlene
Hello, I am in desperate need of guidance in helping my beloved grandpa get Medicare health insurance. He is a Vietnam veteran who has prostate cancer, high blood pressure, and other health issues but he does not have access to a doctor or his medications. We have gone in circles with the Social Security Administration (SSA) office in an attempt to sign up for coverage. We’ve gotten very few answers and don’t know where to turn to next. I found your website and am hoping you can help with this process. Thank you for your help! With gratitude, Clarissa
Is there a Medicare carrier that has a plan in conjunction with Veterans Affairs (VA)? I have hearing, eyes, prescription, and doctor visits covered and I did use Medicare Plan D for dental. -Craig
Medicare MSA Plans
I am interested in Medicare MSA Plans for my Part C and the plans seem difficult to find. Why is that? -Charles
Medicare Part B
Is it mandatory to have Medicare Part B? -Michael
Medigap
Can a patient with Medicare part A and B get a Medigap plan that will cover coinsurance and deductible while they are currently admitted in a short-term acute care hospital? -Samantha
My husband and I are U.S. citizens living in Washington state. When we retire in a year we would like to move just across the border on the Canadian side 60 minutes from here. Our children live there and we would like to be closer to them. We know we can keep our Social Security Administration (SSA) and Medicare when we move as long as we use Medicare in the U.S. Our question is regarding Medigap. Enrollment is contingent on residence at the time of enrollment; after that it is portable. Can we be disenrolled upon moving and changing our address? When we call the insurers their knowledge of this kind of situation is very limited. Nobody has been able to give us the answer so they just say no. Also, as I am a dual citizen due to tax complications, I am contemplating renouncing my U.S. citizenship. How will that affect Medicare and Medigap considering a wife of an American citizen gets Medicare? Thank you. -Karin
Moving From a Work Plan
My husband and I are on his work plan. He will turn 65 in two years and plans on working for many years. I am only 59 (funny how 20 years ago I thought that was so old but now, not so much) and I am on his plan.
Does it make sense for us both to stay on his plan until I become eligible for Medicare? We pay a fortune for his plan for us both, but it is a premium plan. I think it’s about $1,400 a month: 900 for me and 500 for him. The employer pays a large majority of his and a small amount of mine.
Should he sign up for Part A and keep his plan as well? If he signs up for Part A Medicare, could we potentially get a reduction from the private plan? It’s Blue Cross Blue Shield. Thank you in advance for your assistance. -Denise
I have been on my husband’s insurance, but he is retiring in three months. I already have Medicare A but that is all, so what do I need to do to get my insurance brought up to date and be covered? I am 73 and diabetic but I do take medicine to control it. I will wait for your phone call or email. -Bobbie
My husband is 69 and he was covered under my insurance for many years, but as of October 2020 is on Medicare. I changed employment and so my insurance changed as well. I need to gain a better understanding of options and costs related to Medicare and supplements. I decided to reach out to you because the bios on your team are quite impressive. I look forward to learning from your expertise and guidance. Thank you. -Susie
I just retired on June 1 at age 67. I am looking for a Medigap Plan that will cover what Parts A and B will not cover and also for dental and vision. Basically, I do not want to have surprise out-of-pocket expenses. Ideas? Thanks. -John
I retired from the California state public school system [teacher] in 2018 at age 60. I have district-provided medical coverage until 2023. Do I still enroll in Medicare when eligible or do I wait for my coverage to expire? Will I be given notice as to when I should begin enrollment or do I find those things out on my own? All the information that I have is from word of mouth from other retirees, which is confusing, to say the least. I have been told that you can enroll after your 63rd birthday at 63.5 years. I’ve heard that you should wait until 64.5. That’s a discrepancy of a year. When exactly should one enroll in Medicare so as to not have a lapse in coverage? -Kenneth
Moving With Medicare
I am presently with UnitedHealthcare (UHC) as my Medicare Advantage Plan. My agent here has advised me to find an agent in Maine to advise me about changes. Thanks so much. -Debbie
We are moving my brother-in-law to Pennsylvania from Tennessee. He currently has UnitedHealthcare (UHC) in Tennessee. What steps does he need to do to have this plan automatically transferred to Pennsylvania? Will he lose any coverage? Please advise. -Teresa
I am starting our move from Nashville, Tennessee area next week. We hope to move into our new home in late July. What is the process of changing Medicare plans from one state to another? -Gilbert
I am thinking about moving back to Colorado and right now I’m assessing all anticipated expenses and comparing them to my current ones in Wyoming. I need a phone number for someone that can talk with me about possibly reinstating my previous Medicare Advantage Plan (MA Plan) I had in Denver in 2019. I’m pretty sure it was with UnitedHealthcare (UHC) but I’m not positive. -Karen
Hello, I am in Seattle, Washington, and possibly moving to Casper, Wyoming, in the next couple of months. I am a low-income senior and currently have Medicare and UnitedHealthcare (UHC) Dual Complete. Am I right in assuming I can maintain this coverage in Casper? I’m also assuming when I get there I have to apply for Medicaid then UHC would kick in? Thanks for any and all information. -Stephanie
I’m moving from Colorado Springs, Colorado, to Boise, Idaho, later this year. I’m starting Medicare on July 1. My current plan is with Kaiser Permanente. Could you briefly explain how I transfer my Colorado plan to the Idaho plan? Thanks!! – Eric
I need to know how to sign up in Georgia. We already have started the process in California, but we are moving. – Laura
My father is 87 and moved 8 miles east of Mesquite, Nevada, to Littlefield, Arizona. I was updating his address with Humana and was informed he would need to change his plan to one in Arizona. This little strip of land doesn’t have any medical care providers. He has a primary care doctor in St. George and does all his medical in Utah. I am confused if he must choose another Humana plan or if that even matters. I also do not understand the Medicare Advantage Plans (MA Plans) when it comes to the drugs. It often says N/A under the drug section while at the same time it says drugs are included in the said plan. I was also given until the end of the month to make the change or he would lose coverage. He is in the middle of a health crisis and having spinal surgery next week. If I do change his plan, does that go into effect now? -Cindy
I have Plan G through Premera in Washington. How do I choose a company in Colorado best for my needs? -Debra
My father recently passed and my mother is 81 years old with dementia. She is living in California and has a full-time caretaker. Her health plan is with Kaiser Permanente. I need to move her to Illinois to a facility near my home. What is the procedure for switching health insurance this late in the year? -Pam
I am moving from Michigan to Wisconsin in September. When do I need to sign up for a Medicare Advantage (MA) Plan? Are all available in Dane County? One site I looked at only gave me three choices. -Deborah
Hi Ron. My mother and I live in Tennessee but will be moving to the Buffalo, New York, area soon. My mother has yet to apply for health insurance until we settle in. She is 55 years old and is disabled with a bad knee from an injury she suffered six years ago. She also has a dislocated shoulder from a car accident that she suffered years prior. I read that even if she’s not 65, she can still qualify for Medicare due to disability. If so, would you recommend it for her now? She’s looking to enroll in UnitedHealthcare (UHC) D-SNP for $0 copays on medications and $0 premiums so it can give her the complete coverage she’s looking for. Can Medicare help her even more so at this point? If so, what can it do? What Medicare plan would best help with the insurance plan she plans to have? Thanks. -Ana
I am on SSDI and have Medicare. I moved to Alabama from Arizona, I am looking for a Medicare Advantage Plan (MA Plan). I get confused very easily and don’t understand the plans and process for applying. -William
Dear Ron: My wife turns 65 on June 26 and I turn 65 on Aug. 29. We have both enrolled in Medicare Parts A and B. Here in Washington we have been on Medicaid for a number of years and have had all our medical concerns covered. If we were to stay in Washington, I understand that Medicaid will cover everything that Medicare will not. We plan to move to Boise, Idaho, this summer. What sort of plan should we seek to cover all our prescription drugs, eye, ear, and dental? Is there a way to transfer Medicaid Washington to Medicaid Idaho, or what Medicare Advantage (MA) Plan should we seek? Thank you. -Joseph
My husband is retiring at the end of May, so we will no longer have medical benefits. We will be moving to Colorado in June. We both have Medicare Part A. Should we wait till we are in Colorado to find a Medicare Advantage Plan (MA Plan)? Thank you, Betsy
Following my dad’s recent death, we needed to relocate my mom from Florida to Maryland to be closer to family members. We’ve just learned that her Medicare insurance provider in Florida (Humana) does not offer coverage in Maryland. How do we go about finding similar coverage for her in Maryland? The plan she had in Florida seemed to work fine for her needs. Thank you. -Chuck
My wife and I are both on Medicare with Kaiser Permanente of Oregon. This summer we are going to be full-timers with our RV using South Dakota as our domicile. Which Medicare plans in South Dakota work in all states? Thanks for your time and your opinion. -Joe
Hi, I am looking to move my mother from Florida to an assisted living facility here in Maryland. As I understand, I will need to switch her Medicare to Maryland? Can you give me any information on that process, please? How long does it take, and is there overlap coverage for both states while the transition takes place? She is in a rehab facility in Florida now. I appreciate any information/links you could send me. -Linda
I have Kaiser coverage in California but we have a new home that is being built, so we will be moving in late April. Since Kaiser is not available in Arizona I will need a new carrier. I have recently undergone bladder cancer surgery on Jan. 28, 2022, and am still undergoing treatments and procedures as part of my recovery. I will need to continue all scheduled CAT scans, etc. when I move. How do I go about signing up with your company? Thank you for a prompt reply! -Stephen
My wife and I are on Medicare and have Kaiser Permanente as a Medicare Advantage Plan (MA Plan). We sold our home on May 31, 2022, and now are full time in an RV with Sioux Falls, South Dakota as our domicile. Because we no longer live in Oregon we need to find a plan that will cover us no matter where we are in the U.S. Any info would be greatly appreciated. -Joe
Hello, how can I find a local agent to help me with my mom’s and dad’s Medicare in Utah? They have already had Medicare and Medicaid but I need to get them switched over to Utah. -Ave
If I have a Massachusetts Supplement Plan and move to another state (Georgia) I would not be able to take that plan with me as MA has state-specific plans. Will I be able to choose another Supplement Plan in that state without medical underwriting? -Ken
We have just moved from Illinois to Wisconsin and need to change the Part D plan. How do I cancel the Illinois plan and start a Wisconsin plan? -Gail
Name Changes
How do I correct my name now that I’m married? -Kerry
Plan N Guaranteed Issue Rights
Can you tell me if Medicare Supplement Plan N is a guaranteed enrollment plan? -Jim
Preventive Surgery
I am 81 years old and was recently diagnosed with breast cancer. Because I was being treated for arthritis, I may have had this disease process for over 18 to 24 months. My left breast is involved and soon I will get a bone scan to see how far the cancer has spread.
My question to you is, if the surgeon removes my afflicted left breast, will Medicare help pay for the right one to be removed at the same time? Since my three sisters and myself all have cancer, it is almost certain cancer will show up in the right breast. Is preventive surgery accepted under Medicare? -Nora
Qualify for Medicare
Who qualifies for Medicare? -Rebecca
My friend is on Social Security Disability (SSDI) and is becoming eligible for Medicare in August. She lives in Arizona and is 56 years old. We have been told she cannot purchase a Medigap Plan in Arizona due to state laws. Do you know more about this and is there any way around this problem? She is not eligible for financial assistance plans as her retirement and disability plans bring in too much. We are not as interested in Medicare Advantage Plans (MA Plans) for a number of reasons, but most importantly, she is a Mayo Clinic patient and would have to do the Preferred Provider Organization (PPO) and would only be covered out-of-network. -Sara
I am 32 years old and recently was approved for Social Security Administration (SSA) disability and was told I qualify for Medicare. My total income will be $830 per month, and if I sign up for Part A and B my cost would be $170 per month. Do you recommend I do Part B or what would you suggest? Thank you. -Deanna
Replacement Cards
I lost my card and need a replacement. I need my number for a recent doctor’s appointment. -Robert
Respite Care
Are there any Medicare Advantage programs (MA Plans, Part C) in Alabama that will pay for seniors to have home care services, such as personal care, homemaker services, or unskilled respite? -Tiffanie
Are there any Medicare Advantage programs (MA Plans) in Connecticut that will pay for seniors to have home care services, such as personal care, homemaker services or unskilled respite? -James
Hi Ron, my sister is the full-time caregiver for my parents who both have dementia. On top of that, she is working full time and has a son in kindergarten. She needs help with services such as adult care and in-home caregivers. We are in desperate need of a reliable and dependable agency or trained individual who can provide respite. Both of them are on Medicare. My dad needs the most help with Medicare A and B I believe. My mom has Social Security Disability Insurance (SSDI) Medicare. They live in Waimea and Kekaha, Kauai. I would love to talk to a Medicare counseling specialist. Thanks in advance. -Amanda
My mother is 91, a wheelchair user, has limited vision in one eye, and lives in an assisted living facility. She has fallen many times, with a broken pelvis, broken ankle and some other falls. She fell last week which caused some dementia. The facility is requiring a 24-hour sitter to aid her and ensure she does not fall again. This is in addition to the facility care. If I get a doctor’s order will Medicare cover this service as a personal care service? Thanks. -Pat
Retirement
Hello, I am 65 and plan to retire in May. I am enrolled in an employer health plan and I also have Medicare Part A. My health coverage runs out in August and my wife does not work. She has not been able to work for nine years due to a medical condition, but she does not have disability status. She is 57 years old. Since I will only have Social Security Administration (SSA) income for both of us (and my wife nothing for five years), as well as some savings, what Medicare Advantage Plan (MA Plan) is best and most affordable for me? I would like to avoid any premiums if possible. I have no major health problems. What plan is best for my wife? I am assuming it will have to be a federally-subsidized health plan. -John
First: My husband and I are now 69. At 65 we enrolled in Medicare Part A. We both are now 69 and are continuing to work. I provide health insurance through my employer for both of us. But, this year I am retiring and want to enroll us both in a Preferred Provider Organization (PPO) plan for Medicare B/C/D. Can you help me with this? I want a company that is at least 4 stars. I’m an RN and work in the health care industry. Thanks so much. -Cathy
My wife is retired and drawing Social Security Administration (SSA). I am still working but plan to exit my job and draw my SSA in January 2023. I have a 15 year old dependent. How can we cover her medical needs (she is not disabled)? -Kenneth
Special Needs Plans
How do I change my plan? I want a food card. -Leanna
What form needs to be filled out by the primary care provider (PCP) to verify eligibility for a chronic special needs plan (C-SNP)? And who sends this form to the PCP, the sales agent, or the health plan? -Maureen
In Florida moving to North Dakota. Have Special Needs (D-SNP)Plan Medicare and Medicaid. Need to transfer. – Diana
Supplement Plan Acceptance
Does the Cleveland Clinic (facilities and doctors) accept Mutual of Omaha (MOO) Medicare Plan G? MOO does not show on its online list of insurances accepted. -Tom
My wife and I have had Plan F (with Gerber) since 2012. I did a cost-benefit analysis for inception to date and we paid $55,000 and Gerber paid $7,300. My wife will turn 75 this month and I will be 80 in July. She identified as a smoker but since 2022 she is smoke-free. My question is how much premium can I save by going to plan G? -Steve
Supplement Plan Denial
I tried to sign up with a major insurance company for the supplemental Medicare Plan N. It refused coverage in Plan N and said I could only get Plan F. The reason is that I use a prescription that disqualifies me for Plan N.
Is taking this one drug reason enough for the company to say I can’t get Plan N?
Any help you could provide would be greatly appreciated. -Jim
Transportation
Does Medicare pay for transportation to your doctor’s appointment in St. Petersburg, Florida? -Brenda
I have South Carolina BlueCross Total. My question is: I have an upcoming day surgery for a toe correction on March 8. Can I get transportation to and from the hospital that’s less than 10 miles from my home? -Felix
Vision Benefits
My mother-in-law had cataract surgery on both eyes. She just got a new pair of prescription eyeglasses. I thought there was a program for her to get partial payment on her new prescription glasses. Does she need to fill out a form to do that? Where can I get a form for her? Thank you! -Charlene
My aunt is nearly blind with macular degeneration and we are wondering if Iris Vision glasses for the visually impaired would be covered by Medicare? My aunt lives alone at home, and is pretty self-sufficient, except for her eyesight. -Sandy
Does Medicare cover cataract surgery? -Dale
I am in Fort Worth, Texas, and am about to schedule cataract surgery. The doctor’s office is telling me that Medicare and my supplemental insurance will only pay for the surgery if no laser is used. Is this correct? -Cynthia
I collect $1,184 monthly in Social Security Disability Insurance (SSDI). I have Specified Low Income Medicare Beneficiary (SLMB) benefits through the Department of Health and Human Services (DHHS) in the state of New Hampshire, which I am told is them paying my premium for Medicare Part A and Part B. When I call Medicare, the staff tells me I have Medicaid benefits as well. DHHS says I don’t. I can’t find a number for Medicaid except for DHHS. I need to see an eye doctor for glasses and an exam. They told me to get gap insurance but it looks like it will cost me $200 monthly. I can’t afford that. Is there any way you can advise me on what to do? Thanks. -Michael
Getting ready for cataract surgery and eyeglasses after surgery. I want to know if I get glasses at Thomas Eye Center in Roswell, Georgia, who will be doing cataract surgery? Are they a supplier enrolled in Medicare so my one pair of glasses is covered, or do I need to get a glasses prescription somewhere else? -Joanne
I just had surgery to repair a detached retina which was covered by Medicare and my Supplement Plan. Will Medicare help pay for the new lens that I will need for my eyeglasses when my eye heals? I already had cataract surgery in both eyes. -Fred
If I have Medicare in California, can I get cataract surgery covered in Colorado? I have two sons that live out of state and work full time. I have no one to help take care of me here in California after the surgery. Could I have it out of state so I can have my sons take care of me in their hometown? -Alyssa
What Medicare Covers
If Medicare pays for ostomy supplies, should I pay a copay if I have Part B and Supplemental Aetna Plan G? -Tamara
Will Medicare cover my diabetic supplies such as strips and a monitor? -Helen
I currently have a UnitedHealthcare (UHC) HMO plan. I am a state retiree and will be 65 in August. I am on a specialty medicine. Will my specialty medicine be covered if I choose the UHC Medicare Advantage Standard Plan (MA Plan) instead of the UHC Medicare Advantage Premium Plan? -Janet
I had a total right knee replacement. My surgeon has given me a prescription for rehabilitation sessions (outpatient). The rehabilitation facility is charging me a $20 copay for each session. I had rehabilitation five years ago for the left knee replacement and there was no copay. Has this changed and I am now required to pay $20 for each session? -Kenneth
Is a cystoscopy covered by Medicare in South Carolina? -CA Kaplan
I take Ozempic and Jardiance and they are wiping out my finances. Is there any plan or coverage where I could get a discounted price on these prescriptions? Because the prescription for Ozempic costs about $2,000, I move right into gap coverage after the first round. -William
I am 80 and have several health challenges including arthritis and a bad knee. I’ve read that Medicare B will help pay for a recliner chair. I do have part B and would like some info about that. Thank you. -Philip
My husband has Medicare Part A insurance. He did not sign up for Part B because he liked his insurance. He had Blue Cross Blue Shield but when the company found out he was eligible for Medicare it terminated his coverage. Unfortunately on May 29, 2022, he suffered a stroke in Portland, Maine, and is currently in the hospital. He needs to go to rehab after he is discharged and I do not know what to do. We live in New Hampshire and I am trying to get him into a facility in southern New Hampshire. Is he covered for anything under Medicare Part A for the rehab? Would he be covered for home health visiting nurses? Can I sign up for any other plans and pay a premium to help with the rehab costs? Any help you can provide is greatly appreciated. -Laura
Hi there. I’m trying to be proactive about finding a Part D plan that will give me an affordable copayment for Shingrix vaccinations. With my current plan, the shots are going to cost me over $200 each. I have a $480 deductible and am lucky enough not to have expensive prescriptions at this point in time. But I just can’t afford to pay nearly $500 total. My pharmacist suggested I search for a plan that will give me a better price. I’m not getting anywhere so I am hoping you’ll be able to provide some suggestions. Thank you. -Cheryl
Looking for one down the road with low out-of-pocket costs for possible knee or hip surgery. I would need not too much more of a premium. I currently have A and B and turn 68 next month. Please text as I can’t hear the phone. -Robert
My mother-in-law recently moved into assisted living from independent living. She used to give herself a daily insulin shot but now has dementia. She has Medicare Part C. We are currently paying $95 for a daily service of insulin injection. The assisted living facility receives her insulin but won’t inject it. Is there a better plan we should have that will help offset the costs? Thanks. -Patricia
I have Aetna Medicare Preferred Provider Option (PPO). The orthopedic group I would like to make an appointment with stated they accept traditional Medicare. I would like to make an appointment online, but I don’t know if my Aetna Medicare PPO plan will be accepted. Is there a difference? The name of the group is Princeton Orthopaedic. -Carol
I just received a Medicare Summary Notice (MSN) for my husband’s Part B (Medical Insurance). He has several charges on it that say the procedures were approved and that the amount the hospital charged was approved but that the payment is included in another service received on the same day. There are also a couple of procedures that were for a few thousand dollars that have been approved and the amount was approved but less than $50 was paid on them. Who is responsible for paying for these procedures? -Patricia
Hi, my psychiatrist/therapist is out-of-network, and we just moved to San Francisco. Can I submit an out-of-network claim and pay 80%? Will Medigap Plan G Blue Shield of California cover the 20%? So far my one claim for COVID-19 tests has taken four months and is still not processed. -PK Jain
I am trying to learn more about Medicare Part D coverage. Is there a plan that is just for catastrophic coverage, or are all the deductibles the same, such as $480 and $4,430? I can find the drugs I am taking much cheaper than using the local pharmacy and the plan I am currently on. Also, it seems they can change tiers on you from year to year. They moved one of my tier 1 drugs to tier 3 and I had to consult my physician to change. – Robert
Does Medicare approve dermatology cancer screening services e.g., a full body exam? If so, how many per year? Melanoma runs in my family and my dermatologist has suggested that I come in for a screen every four months. Will that be approved? -Katherine
My wife has Parkinson’s disease and diagnosed major cognitive issues. She has been having physical therapy (PT) at home and the provider wants to end treatment because “PT is not forever.” The provider does not seem to understand the changes that have taken place in Medicare coverage of PT for Parkinson’s since 2013. If my wife’s doctor deems it “medically necessary” to help maintain her mobility and general health, and should be administered by a physical therapist because my wife’s condition requires oversight by a skilled and knowledgeable professional, shouldn’t my wife’s treatment be continued? -Glen
Does Medicare cover medical alert devices for seniors? -Julie
Is there a Medicare plan that covers two of my glaucoma meds: Alphagan and Azopt? Thank you. -Patty
I currently have prescription medicine that I take. I will also need coverage for hearing, dental, and vision. These items are covered on my insurance I presently have from my employer. I don’t want to give up anything. I need to know which plan to select to maintain my coverage. -Frank
Do you have a plan that covers hearing aids, dental, and drug coverage? -Karin
Need advice regarding the best Part D Prescription coverage for me. -Daniel
My dad and I are both on Medicare through Social Security Disability Insurance (SSDI). My dad will be turning 65 next March and we are getting bombarded with unrequested calls telling us that Medicare for disabled is different from Medicare for those 65 or older. Is this true? If so, what is the difference? -Ms. Eckstein
I recently had eyelid surgery in which they removed tissue from the roof of my mouth to implant in my eyelids. This left two large and deep wounds in the roof of my mouth that were exposed without sutures. My surgeon had me order a stint plate for the roof of my mouth to protect the unsutured wounds while they healed. UnitedHealthcare Medical Advantage (MA) Plan denied my claim for the plate. They are calling this an oral procedure and not classifying it as part of my eyelid surgery. I’m not sure how to prepare an appeal. Any help would be appreciated. -Tom
If I have a private medical insurance policy and Medicare Parts A/B, can I get free COVID-19 home testing kits through Medicare? -Randy
Working With Medicare
Can I work full-time while on Medicare? -Robert