Medicare Questions – FAQ

Your Medicare questions answered. Review popular Medicare questions and answers. Where are the BEST Medigap rates? Does my doctor take Medicare? How do I find the RIGHT plan for my needs and budget? What are Medicare Advantage plans?

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Turning 65 – Medicare Questions

Most people turning 65 will be eligible for Medicare. What are my options? You should enroll in Medicare Part A and Part B if you are losing current health insurance. If you will continue receiving employer group health insurance coverage you may not need Part B.

Category: Turning 65
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Most people will enroll in Medicare Part A and Part B before turning 65. How do I choose the right plan? If you are currently receiving Social Security, you will be automatically enrolled effective the month you turn 65. If you need to apply direct you may do so no sooner than 3 months before your 65th birthday.  Use this link to apply online.

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Does original Medicare include dental coverage? Will Medicare pay for dentures? What kind of dental plans are available for folks over age 65? Are dentist discount plans good to have? How do they differ from dental insurance? Where do I find a good dental plan if I am on Medicare?

Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you’re in a hospital.

Some employer plans allow retirees to continue their dental insurance plan. If you like your plan and can keep it into retirement, consider that option.

Senior Dental Insurance

Do Dentures Cause Dementia?



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Medicare Open Enrollment

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Finding the RIGHT plan

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Medicare Part D

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Medicare Advantage Plans

Medicare Advantage plans seem to be popular. But why? What is the appeal? What is so attractive about these managed care plans? Are they really free?


Medicare Advantage – Why or Why Not?

Are you turning 65 and confused about the Medicare process? Why is it so difficult? Why do my friends, and many agents as well, want to push me in the direction of an Advantage plan? Low premiums are attractive. So is “free”. Is there really such a thing as a free lunch?Confused about Medicare Advantage plans?

Medicare Advantage plans are like the Hotel California. You can check in but you may never leave.

Some people turn to Advantage plans when they first go on Medicare at age 65. Low premiums, many are $0. Extra benefits like dental, vision and some have gym memberships. Drug plans are often included in the plan. “One stop shopping”.

What’s not to love?


Where are the traps?

Have you ever bought something and later realized you had no idea how it works? Maybe the sales person forgot to mention key details that might have changed your decision.

If something is too good to be true it probably is.

There is nothing inherently wrong with Advantage plans. You just need to understand what you have signed on for. Here are a few questions you need to ask.

Preferably BEFORE you enroll.

  • Is the plan a PPO or HMO?
  • Do I need a referral to see a specialist?
  • Will my doctor take my Medicare Advantage plan?
  • Are there any out of network penalties?
  • Can I change plans at any time?
  • Can I return to original Medicare and a supplement plan if I want?
  • Does the out of pocket limit include prescription medication?
  • What will my health care really cost if I use an out-of-network doctor?
  • Will my claims be paid if I use a non-par provider?

If you ask the right questions and are satisfied with the responses, the Medicare Advantage plan could be just what you need.

When you enroll in a managed care Advantage plan, the insurance carrier, not Medicare, provides your benefits then reviews, adjudicates and pays your claims.

“No premium” plans are not free. You still have to pay for health care and prescription drugs.

There is no free lunch.

Health care is not free. SOMEBODY pays the bill. Either you or the insurance carrier.

But you knew that all along, didn’t you?


This Doesn’t Look Like Kansas Anymore

Managed care plans often have small provider networks. Fewer doctors. Fewer hospitals. The question is, how much smaller?

A Kaiser Foundation survey found that on average “Medicare Advantage plan networks included 46% of all physicians in a county.” Some plans had fewer than 5 thoracic surgeons, fewer than 5 neurosurgeons and fewer than 5 radiation oncologists.

This isn’t JUST about dollars. It is also about access to health CARE.

Each calendar year brings a new list of approved providers. Will your doctors be included or will they disappear into a dark hole?

Are you willing to change doctors to save money or pay more to keep your doctor?

Are claims submitted by non-par providers covered by your plan?

A recent government report says seniors are more likely to LEAVE managed care plans when they get sicker.

Managed care is great when you enjoy good health. But how much will your plan cost when your health changes dramatically? Can you really afford to be sick?


Final Exam Time

Many who enroll in a managed care plan never really understood how the plans work . . . until they had large claims. Don’t be one of them!

Do you like your current doctor(s)? Would you like to keep him or her?

Can my doctor refuse to treat me if I have a Medicare Advantage plan?

Do you want to direct your own health care, pick your own doctors and hospitals, or would you rather let an insurance carrier do that for you?

Is it easier for you to budget $120 per month to cover almost all of your health care costs or are you OK paying for your health care only as needed?

Could you budget $6,000 per year or more for your health care (not including drugs) if you had to?

How long could you afford to pay that much? One year? Two years? Longer?

Would you trade places with Marsha’s husband?

You can change your Advantage plan every year. Same is true for your drug plan. You can also enroll in original Medicare any time you want without answering health questions.

But if you want to change to a Medicare supplement plan you may need to prove you are healthy. Your best shot at getting a Medicare supplement plan is when you first enroll in Medicare Part B. If you wait until you NEED a Medigap plan you may not be able to get one. That is Catch-22.

Many will only have one chance to enroll in a Medigap plan. Will you be one of them?


You have questions.

We have answers.


#MedicareAdvantagePlans #FreeMedicarePlans  #MedicareHMO  #MedicarePPO

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Medicare Myths

Does my doctor take Medicare? How much does Medicare pay doctors? What percent of doctors do not take Medicare? Do all doctors accept Medicare? How do I find Medicare providers? If you are about to turn 65 and enroll in Medicare, you need answers to these questions.

Medicare Doctor

Ask your doctor if they take Medicare assignment or use Physician Compare. Medicare providers will be paid by EFT. More than 90% of PCP’s accept Medicare. 

If you currently have a regular doctor there is a good chance you can continue to see your doctor as long as you opt for original Medicare and a supplement plan. However, many doctors do not participate in at least some Advantage plans. Ask your doctor before enrolling in Medicare.

Medicare participating doctors are paid a fee for services rendered. Congress sets payment guidelines for Medicare participating doctors.

Most primary care doctors participate in Medicare and accept assignment of benefits. On the other hand, many psychotherapists and gynecologists often choose to opt out of Medicare. In this case you are expected to pay cash at the time of service.


#MedicareDoctor #MedicareAssignment #MedicarePhysicianFinder

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  • Jessica Jones says:

    Bob, you are the best. Your information is so helpful. This is a new area to me and it is now the time for me to look at this and find the answers I need to help me decide which is the best way to go, the best plans to take. Thank you so much and we will be in touch.

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