How to find a Medicare expert?

Asked by: Dewayne Lemke DVM  |  Last update: May 27, 2025
Score: 4.8/5 (15 votes)

Each state has at least one Medicare State Health Insurance Assistance Program (SHIP). They provide trusted, unbiased advice on your Medicare options and your rights. They're funded by the federal government and free to you. Find your local SHIP by calling (877) 839-2675.

Who is the best person to talk to about Medicare?

Talk to someone
  • Call us at 1-800-MEDICARE (1-800-633-4227). Help from Medicare is available 24 hours a day, 7 days a week, except some federal holidays. ...
  • Contact your local State Health Insurance Assistance Program (SHIP) – Get free personalized health insurance counseling.

Do you need a referral to see a specialist on Medicare?

Original Medicare benefits through Part A, hospital insurance and Part B, medical insurance, do not need their primary care physician to provide a referral in order to see a specialist. Complications with coverage can occur if you see a specialist who is not Medicare-approved or opts out of accepting Medicare payments.

How much does a Medicare advisor cost?

Medicare brokers such as Boomer Benefits get paid by the insurance companies they represent. And you pay exactly the same rate for your insurance if you use a Medicare consultant (broker). There is no extra fee or cost for enrolling through a broker. You will never pay a fee for our help.

Is it hard to find a doctor who takes Medicare?

In fact, according to the Centers for Medicare and Medicaid Services (CMS), 98 percent of medical service providers accept Medicare. That means your area's medical services and doctors will likely work with your Original Medicare coverage.

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How do I find a doctor when I'm on Medicare?

To find a provider that accepts Medicare payments, use the Care Compare tool on Medicare.gov. This tool gives you a list of professionals or group practices in the specialty and geographic area you specify, along with detailed profiles, maps and driving directions. Find and compare doctors and other providers near you.

How long will Medicare pay for home health care?

You can continue to receive home health care for as long as you qualify. However, your plan of care must be recertified every 60 days by your doctor. Your doctor may make changes to the hours you are receiving or other services, depending on whether the level of care you are receiving is still reasonable and necessary.

What's the difference between a Medicare agent and a Medicare broker?

Medicare agents working for a single insurance company are typically employed with and paid by that specific insurance provider. Medicare brokers who work with a wide range of organizations are contracted by these companies for featuring their plans and are paid by commission after enrolling a client.

Are Medicare advisors legitimate?

Medicare advisors are licensed professionals who will help you select and enroll in the right plan.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

Why are people leaving Medicare Advantage plans?

Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.

What is the best Medicare plan that covers everything for seniors?

Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.

Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

What is the biggest problem with Medicare?

The biggest challenges reported by those in Traditional Medicare and Medicare Advantage: Out-of-pocket medical costs and health services they needed but weren't covered. “The gaps in Medicare coverage can really be notable,” says Jacobson.

What are the three requirements for Medicare?

Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) are available to the individuals below:
  • Age 65 or older.
  • Disabled.
  • End-Stage Renal Disease (ESRD)

Is there a Medicare Supplement that covers everything?

With Medicare Supplement Plan F, you get the most complete coverage available. And because Plan F also covers costs in excess of Medicare-approved amounts, you may have no out-of-pocket costs for hospital and doctor's office care.

Why is Social Security no longer paying Medicare Part B?

There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.

Is Medicare free at age 65 for seniors?

People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A. You're eligible for Part A at no cost at age 65 if 1 of the following applies: You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB).

Do Medicare advisors charge a fee?

Medicare Advisors are typically compensated by insurance companies, meaning they do not charge a fee to their clients. However, the commission paid to an advisor can vary depending on the insurance plan selected.

What are the disadvantages of using an insurance broker?

The advantages consist of cost-effectiveness, expertise and the capability to provide a broad range of policy alternatives saving consumers time and effort associated with finding coverage. Similarly, disadvantages include decreased professionalism and sometimes high broker fees.

Why do agents push Medicare Advantage plans?

Why do brokers push Advantage plans so hard? It's money. Sorry, that's the honest truth. The commission for an Advantage plan can be roughly double that of the most popular Medicare supplement plan and it's paid all at one time.

Does Medicare pay for house cleaning?

Original Medicare does not provide coverage for housekeeping services, known as “homemaker” services. These services encompass activities such as shopping, cleaning, and laundry. If an older adult requires assistance with home cleaning, they are usually responsible for covering these costs out of pocket.

Which type of care is not covered by Medicare?

We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.

What is the most common diagnosis for home health care?

A few common ones include:
  1. Heart disease or heart failure. In-home services can help clients establish a healthy lifestyle if they have heart disease or have had a heart attack. ...
  2. Stroke. ...
  3. Respiratory diseases like COPD, asthma and emphysema. ...
  4. Cancer. ...
  5. Alzheimer's, dementia or confusion.