New to Medicare? What you Need to Know! Educational Seminar

HEALTH INSURANCE CLAIM FORM , Application Concept health care

FREE informational event!

Join our community to find out about all your Medicare Insurance Presented by Paula Q. Wallace, Medicare Subject Matter Expert. This educational seminar will inform you about Medicare and all the parts that go with it. Opportunity to ask questions.

Open to the public. Not a Sales presentation.

Light refreshments. There is no cost or obligation to attend. RSVP not required but appreciated.

June 25th, 2019 at 6:30 pm
Collaboration Space of Hampton Roads
4112 George Washington Memorial Hwy
Yorktown, VA 23692

For more info, call Paula at 757-232-4678

New to Medicare?

Have you seen the television commercial about a couple confronting a huge maze?  An insurance agent driving a bulldozer rescues them and gets them through the Medicare maze.  It is an apt analogy for those who be new to Medicare insurance.  It is complicated and confusing if you do not have a guide.

You are invited to attend an educational seminar about all the Medicare insurance options.  There is no cost nor obligation to attend.  It will be presented by Paula Q. Wallace of PQ Wallace insurance Consultants.   Paula is an independent insurance broker/agent with years of training and experience in guiding consumers through the Medicare system.

Tuesday, June 25, 2019   4112 George Washington Memorial Highway, Suite 1, Yorktown, VA 23692.

6: 30 PM.  The public is invited and light refreshments will be served.

For more information, contact Paula at 757-232-4678 or check out her website, .

Due to Social Security Glitch, You May have to Pay!

If you elected to have Social Security withhold funds from your Social Security to
cover your Prescription Drug Plan (PDP), you may have to pay to catch up. Due to
a system error, the Social Security Administration (SSA) and the Railroad
Retirement Board (RRB), did not withhold funds needed to pay for the cost of
your prescription plan. Be on the lookout for a bill from your insurance company
to cover February, March and April premiums. Evidently, this issue affected all
PDP insurance carriers.
To add even more confusion, because members now have past-due amounts, the
premium payment option has been changed to direct billing effective February 1, 2019. This means you have to pay any past-due amounts directly to the insurance
company that sends you a bill.
I recommend that you call your insurance company when you receive the notice
and bill. Ask them to restart your SSA premium deduction. This may take up to
90 days so be prepared to make payments monthly until the deductions start
This is not the fault of your insurance carrier. You are NOT at risk of having your
plan terminated, IF you start making payments. If you are confused or if this is a
financial hardship, please contact the customer service number on the back of
your prescription card.

Caution: Genetic Testing and Medicare

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There have been reports of educational sessions and Facebook ads stating that Medicare would pay for genetic testing for cancer screening or pharmacogenomic testing.  All the senior needs to do is supply their Medicare number and have a swab taken.

In most cases, this is Medicare fraud.  Genetic testing is only covered by Medicare when you have signs or symptoms of a disease or condition and your physician says that the test is medically necessary. Genetic tests used to screen for disease risk or to see how medicines may affect you are not covered by Medicare.

Please do not give your Medicare number to anyone outside of your healthcare networks like your physician’s office, hospital or pharmacy.

This includes outside screenings that you pay for yourself.  These outfits who set up screenings at churches, etc., will use your Medicare number to bill Medicare for a “Wellness” visit, so when your doctor tries to bill for this annual benefit, it has already been used.

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More questions? We would love to hear from you!

Medicare will not pay for a routine medical physical

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Medicare will not pay for a routine medical physical. However, they do pay for you to see your doctor once per year. During the first 12 months that you have Medicare Part B, you can get a “Welcome to Medicare” preventative visit. The doctor will review your health via an interview. They can also do some preventative covered services like your flu and pneumonia shots. You pay nothing for this visit if your provider accepts Medicare assignment.

If you have had Part B Medicare longer than 12 months, you can get a yearly “Wellness” visit. Make sure that when you are scheduling the appointment, that you specify that you want a wellness visit.

If your doctor or other healthcare provider performs any additional tests or services during either of your Welcome to Medicare or Wellness visits, during the same visit and they are not preventative, you may have to pay coinsurance and the Part B deductible may apply.

My personal doctor actually does the physical and writes off what Medicare does not cover. However, doctors are not obligated to do that by law. So be careful what you ask for. If you schedule an appointment with your healthcare provider and you have a “diagnosis” (something not normal), then the visit and corresponding tests should be approved to be paid. Medicare is starting to deny some routine screening tests such as a vitamin D blood test. If your provider knows that it is not routinely covered by Medicare, then they are obligated to tell you up front. Generally, you will have to sign paperwork stating you are aware that you may be responsible for the bill.

Remember, if Medicare does not approve the charges, then your Medicare supplement will not pay either.

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More questions? We would love to hear from you!