David Wolfe Insurance

04/01/2026

Stopped in at one of those all you can eat seafood buffets with 5000 items. Asked the chef behind the aisle if the salad was really crab meat. He said it was imitation krab. I said: then it should be spelled Krabmeat. He reached under the counter - handed me a sharpie and said “do me a favor - update it”.

06/15/2025

A chauffeur took the dads to a brewery - not sure where but the draft beer and tacos are cookin! The days just getting started !!

04/20/2025

Happy Easter to all of our Canadian and American Friends

04/14/2025

Looking forward to a fun agenda with some of the great Medicare marketing minds in Orlando. “A” must be for All Access

03/23/2025

03/21/2025

Medicare pays for lots of things but not EVERY thing! That’s why people turning 65 call me to find the right plan that includes benefits. 858-722-8505 941-404-5842 More info at https://www.SeniorTopia.com. .

11/02/2024

Original Medicare usually doesn’t cover health care while you’re traveling outside the U.S. and its territories. There are some exceptions, including some cases where Medicare Part B (Medical Insurance) may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S.

Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in only a few rare cases, including the following:

- You're in the U.S. when a medical emergency occurs that requires immediate medical attention to prevent a disability or death, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
- You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
- You live in the U.S., and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.

10/30/2024

Under Original Medicare Part A & Part B, the following are NOT covered:

- Hearing aids or exams for fitting hearing aids.
- 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 you get when you're in a hospital.
- Medicare doesn’t cover eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B (Medical Insurance) covers eye exams for diabetic retinopathy once each year if you have diabetes. You may be responsible for a copay or deductible.

Some Medicare Advantage plans offer dental, vision, and hearing supplemental benefits. Talk to your agent to find a plan that provides these if it is important to you.

10/28/2024

The most crucial difference is that home health care can be covered by Medicare, whereas long-term care services in nursing homes are not. For a long-term nursing home, care is typically defined as non-medical custodial, which is not covered by Medicare.

Original Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:

- Part-time or "intermittent" skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services

Original Medicare doesn't pay for:

- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need.

The exact benefits and copays, coinsurance, and deductibles you are responsible for vary depending on whether you are enrolled in Original Medicare, Medicare Advantage, or a Medicare Supplement.

10/25/2024

Most people qualify for premium-free Part A: This covers inpatient hospital care, skilled nursing facility care, hospice care, and some home healthcare. If you or your spouse have paid Medicare payroll taxes for at least 10 years while working, you generally won't pay a premium for Part A. If you haven't met the work requirement, you can still purchase Part A, but it will have a significant monthly premium.

There are Medicare Advantage plans available that have premiums that are $0. However, it is important to know that it does not mean that all of your care is free. You may not have a plan premium to pay, but you will still have to pay your Medicare Part B premium. Additionally, $0 premium plans typically have higher out-of-pocket costs than other Medicare Advantage plans with higher premiums. You will also have fewer if any supplemental benefits like dental, vision, hearing, transportation, and the variety of other supplemental benefits you see on higher-priced plans. Talk to your independent Medicare agent, and they can help you make the right choice given your unique situation.

10/24/2024

How do I submit a bill to Medicare?

In almost all cases, if you are enrolled in a Medicare Advantage plan, you will not have to worry about submitting bills to Medicare. However, if you are enrolled in Original Medicare or Medicare and a Medicare Supplement, there can be times you need to file a claim for Medicare reimbursement. If you do, these are the steps you will need to take:

1. Complete a Medicare form 1490s, “Patient’s Request for Medical Payment.”
2. Include an itemized bill from the provider with the following information: the date and place of service, a description and charge for each service, your diagnosis, and the name and address of the doctor who provided the service.
3. Send the form and the itemized bill to your local Medicare contractor. You can find the appropriate local contractor here on the Centers for Medicare and Medicaid Services website.

You will need to submit your information within one calendar year of receiving care for it to be considered for payment. For any questions about the form or who is the correct local Medicare contractor, you can call 800-MEDICARE for assistance.

10/21/2024

Do Medicare Advantage payments count towards my “out of pocket” maximum?

Do Medicare Advantage payments count towards my "out-of-pocket" maximum?

Your out-of-pocket costs will be limited by your plan's Maximum Out-Of-Pocket (MOOP) limit for Medicare Advantage plans. If you are enrolled in a PPO, your plan will set two MOOPSs, one for in-network costs and another for a combination of in-network and out-of-network costs.

In 2023, the maximum allowable MOOP for Medicare Advantage Plans is $8,850, but plans can set lower limits if they choose.

So what things contribute to reaching your MOOP?

Your out-of-pocket costs in the form of copays, coinsurance, and deductibles contribute to meeting your MOOP. Once your MOOP is met, you will no longer have to pay any more out of pocket. It is essential to understand that only out-of-pocket costs for the medical side of your Medicare Advantage plan contribute to your MOOP. Part-D prescription drug costs are excluded, as are your plan premiums.