Adam Ernst, Medicare Insurance Agent

Answer: No you cannot. You would be paying for 2 different types of insurance. Once you turn 65, your Marketplace insurance should not even work, plus Medicare coverage is better than Marketplace coverage.

Answer: All agents are contracted differently. Make sure they’re with a reputable company that’s going over your options, costs, how Medicare works and what plans work the best for you. I work for Bankers Life and that’s how we are trained. If they are looking at your financial picture in retirement rather than just getting Medicare and leaving, that’s who you want to go with.

Answer: Medigap/Medicare supplement would allow you to travel and get care anywhere. Since there are no networks in Original Medicare A/B, the supplement would help with that care anywhere them of Medicare. If you go with a Medicare Advantage plan, you run the risk of paying more out of pocket if it is a PPO plan or just not being covered at all. The N Plan is your best best, in my professional opinion.

Answer: Original Medicare only covers what is medically necessary. Lenses are not included with that. Part C/Private Medicare might have some coverage for vision, depending on the plan or you would have to get a specific vision plan.

Answer: This year for 2026 it is actually $1736 for the 60 day deductible that can be paid up to 5 times per calendar year. Each carrier in Part C breaks their plans down differently. When you are on Part C, all costs that Original Medicare (A and B) charges gets move to the private insurance companies (Part C) and they determine how much those costs are.

Answer: That is a very complicated question. As an agent who is authorized to sell 5 different companies' plans, they pay me as the agent for bringing in the business. There are percentages worked out between the doctor and insurance company to help pay the doctor and insurance company for their services. The problem with that is the insurance companies. Humana for example, do not pay the doctors under certain plans for up to 6 months and that can cause the hospital/doctor to no longer accept this carrier.

Answer: Usually it is because either the hospital system in the area is no longer taking that plan or the provider just up and leaves due to no profit. This is the issue with MA plans. If you can afford a supplement, even the high deductible G, they are worth the premium. If you are over 65, you will have to qualify with health questions. If you are less than 3 months past 65, you can still qualify without any health questions and get a preferred rating. Contact a local agent to get the best information about that.

Answer: Medicare covers most vaccines. Some are covered by Part B, and some are covered by Part D.

Vaccines covered by Medicare Part B

Medicare Part B covers four important vaccines as part of its preventive care benefits.

Covered vaccines include the following:

Flu vaccine: Annual vaccine given in one shot before or during flu season, usually November through April

COVID-19 vaccine1 : Exact frequency and timing under review, but recommended to get one dose of updated vaccine

Pneumonia vaccine: One-time vaccine given in two shots at least one year apart

Hepatitis B vaccine: One-time vaccine given in two to four shots over one to six months for people who are medium to high risk, including people with diabetes

Part B also covers vaccines you may need if you’re exposed to a harmful virus or bacteria by accident. You might need a tetanus shot, for example, if you step on a rusty nail. Or you may need rabies shots if you’re bitten by a stray dog.

Vaccines covered by Medicare Part D

Medicare Part D covers all commercially available vaccines needed to prevent illness. You can get Part D coverage through a stand-alone Medicare prescription drug plan (Part D) or a Medicare Advantage plan (Part C) that includes drug coverage.

Vaccines covered by Part D include the following:

RSV vaccine (Respiratory syncytial virus): One-time vaccine given in one shot

Shingles vaccine: One-time vaccine given in two shots over two to six months

Tdap vaccine (tetanus, diphtheria and pertussis/whooping cough): One shot if you’ve never been vaccinated, and a booster every ten years

Other vaccines covered: Vaccines that are "reasonable and necessary" to prevent illness and are not covered by Part B

Part D may also cover vaccines you may need if you are traveling internationally. Talk with your doctor about your travel plans and ask what vaccines are recommended.

Do I have to pay for vaccines with Medicare?

You pay nothing for vaccines covered by Part B – flu, pneumonia and Hepatitis B – as long a

Answer: Yes you can. You will have 2 months to be guaranteed insurable from the end of your employee coverage.

Answer: What are you switching from? Medicare Supplement? If you are, you would have to let your agent/company you have the supplement with know to end your policy so you do not continue to pay premiums and then you can make that switch during AEP.

Answer: You should definitely apply for Part A as it has no cost to you. You can defer Part B while you are still using your work coverage. I would do a comparison with Medicare to see if you could possibly save money on your Medicare coverage. If you do stop your work coverage, you have 2 months to make a Medicare decision. Ask your benefits person if they can help you with deferring Part B as they should have some kind of form. Make sure your coverage remains the same when you turn 65, as there are some employers that will push you to take Medicare by increasing your premiums.

Answer: I feel a Medicare Supplement/Medigap policy is better. You will know exactly what you are paying each month, the deductible is only $283 this year then your care would be taken care of. If you want to have all of your care under one roof, Medicare Advantage can work too as it includes dental, vision, hearing and a drug plan. There will be more costs outside of preventative care. If you can afford a premium, Medigap with a separate dental/vision plan with Part D is my favorite. This is what many of my clients and people I just know truly are happy to have.

Answer: If you are happy with your plan, you do not have to do anything. Make sure your plan is going to continue into the next year starting 1/1. Contact your agent you worked with or the company you have a plan with to ensure you are covered the same way or find out if there are different benefits added to the plan.

Answer: It completely depends on your situation and your local area. I like Original Medicare with a supplement and Part D over Medicare Advantage. It all depends on where you live and what the benefits of the plan entail. It also would depend on your health situation. If you are very healthy, MA might be a good option. If you are sick and will be going to the doctor quite a bit or needing more care, A/B and D with a supplement would be the better option so you know exactly what you are spending each month on your care.

Answer: As we age, our bodies do not get stronger and healthier, usually. Falls become more frequent, harder to fight sicknesses and any kind of hospital stay could be a death blow to your finances. Knowing what you pay each month for your premium helps you to know exactly what you will pay each month for your healthcare helps you position your finances. MA there can be a lot of money out of pocket and the plan/carrier can leave the network whenever they want, leaving you high and dry.

Answer: Contact your agent you started the plan with as that is their job or the company you have the MA plan with. The benefits are outlined in the Summary of Benefits that you should have been given when you set up your healthcare plan.

Answer: Cataract surgery should be covered from what current clients have told me. I have heard it was not in the past, but you should be good. Contact your agent or ask the doctor if Medicare/supplement or whatever your plan is will cover it.

Answer: Your friend probably has a $0 premium Medicare Advantage plan that has a VERY high deductible and large amounts of money out of pocket outside of doing preventative exams. If you are paying $200/month, do you have a supplement? If something were to happen, your medical expenses would be next to nothing after the $283 deductible. If you want to switch, you would want to contact your agent you used or a local agent to find the plans in the area you are in. You are able to make that change in the fall.

Answer: Yes it sure does. Since there are no networks, you should be covered 100% after your $283 deductible is satisfied. No copays with Plan G. If you receive a bill afterwards, contact your agent or the company you have the Plan G with to make sure they take care of it.

Answer: So many aspects of Medicare. Here are some basics, but it is best to contact a local agent with a trusted company:

Part A: hospital coverage, $0 premium (paid by taxes) with different deductibles

Part B: doctor/specialist coverage: $202.90/month premium taken out of SS, $283 deductible, then becomes an 80/20 plan

Part C: private Medicare/Medicare Advantage, $0 premium for many plans, combined with dental/vision/hearing and a prescription plan, offered by all private carriers (Humana, BCBS, Wellcare, Aetna, etc. )

Part D: prescription drug coverage if you are on Parts A/B that you set up once you have a Medicare #, premium comes out of your SS

The rest of the parts are different types of supplements/Medigap that is offered in each state.

The rest of the information will be best to contact a local agent about.

Answer: It would depend on what your coverage was before. Is it from a work plan moving to Original Medicare? Are you changing from MA to MS or the other way around? Contact your local agent or Social Security to find out your specific situation. If you are coming off of work coverage, I would contact your benefits person/office to get the best information.

Answer: MA plans are all different and have networks. You could have a PPO where you can go out of network for a little cost, but HMOs have a serious network you have to stay in.

Original Medicare, with or without a supplement, do not have any networks. You can get care anywhere in the US.

Answer: It depends on if you are in a PPO or HMO. You would want to see what the coverage will be. If it is medically necessary, then yes you will need authorization and will more than likely be fine. The costs will definitely be an important question for the carrier/agent. They should be able to tell you the exact costs or you can look in your Summary of Benefits from your MA plan.

Answer: If you are a citizen and are taking Social Security, the answer is yes. If you creditable coverage deemed approved by Medicare, then no. You can choose not to pay for it until you are required to take SS, but then you risk serious Part B/D penalties when you are ready to start Medicare. Medicare will coverage some international costs, especially with a Medicare Supplement.

Answer: It depends on their plan. I do not believe Original Medicare does not cover eye exams. It has to be "medically necessary". It is possible to have it covered. If you have MA, then your plan should have some vision coverage. If you have a supplement, you will need to purchase a personal vision plan. Some of the carriers have great private plans that cover vision, dental and hearing. You can much more coverage than on an MA plan, in my opinion.

Answer: The best thing to do is to call the agent in charge of this client. They will be able to answer their questions the best, as they can connect the client with BCBS. The location of the client and what is covered plays a big part in what is covered. Is it in network or out of network? If not agent is on the account, ask to speak to a local agent in the area. We, as agents, love helping people and creating better and more trustworthy business. We are here to help. Please use us as it is no cost to speak to somebody locally.

Answer: There are out of pocket costs that are not discussed with Medicare Advantage as they advertise $0 premium, but that only includes the very basics. As you get older, your body does not get healthier. If you require hospital care and you have a G or N Plan, you would pay either the small yearly deductible and then from there everything is taken care of by Medicare and the Supplemental carrier.

Answer: It really depends on your situation. This is why you should contact a local agent so they can give you the best information for your situation. It would depend on your finances, health conditions, etc. I like the Original Medicare with a Supplement so you know exactly how much you would be spending each month.

Answer: That is a better question for Social Security. There are certain disabilities that qualify and there are certain work requirements that you must meet. Every situation is unique. Schedule an appt with SS and they will be able to help you.

Answer: They are advertising well, but do not have a good name. They are designed for people that have special situations or cannot afford a premium. Hospitals/doctors are not a big fan due to not getting paid for their service by the carriers. There are a few great companies, like Devoted, that truly want to help people.

Answer: Yes you sure are. You will have 63 days to set up your Medicare Part B that you have deferred. You can enroll into Medicare without any underwriting since you are on this enrollment period.

Answer: Your kids are not on Medicare Advantage so listening to them might not be your best choice. If you are on original Medicare, are you on a supplement, as well? If you are not, a Medicare Advantage plan would be a good choice. If you can afford a premium for a supplement, that is the better route and then you can purchase your own dental/vision plan to get more coverage there. It all depends on your situation. Contacting a licensed agent is the best way to get this information or go to your local SHIP office as they can give you the information, but cannot sign you up for anything.

Answer: Go on SSA.gov to get registered with SS and Medicare. You can do it online, schedule a phone or in-person appointment. They will give you the information you need to get Part A and B set up. If you are already taking your SS each month, you will automatically get registered once you turn 65. If you already have your Medicare card, you do not need to take any of these steps.

Next contact a local agent who you can speak to or meet with to discuss the basics and true costs of Medicare so you can make the best choice for your Medicare coverage. Once you make that choice, either Medicare Supplement or a Medicare Advantage plan, that will determine your next steps.

Answer: Contact your doctor, and they will be able to tell you if they take the plan/MA carrier you are enrolling in. You can also contact the carrier or check on My Health Policy to see if your doctor accepts that specific plan. It’s best to contact your local agent or reach out to one, like me, to help you in this process. We do this for no cost when you’re seeking help.

Answer: This is a common issue. I have heard from clients and just getting to know people in the Medicare community. It all depends on the carrier. This is why it is better to be on a Medicare supplement that way you do not have to worry about networks. Original Medicare does not have networks and all costs are straightforward. Contact a local agent during Open Enrollment coming up to see if you can switch out of MA. You may not get dental/vision, but your healthcare will be much less and you’ll know your exact costs each month with only 1 yearly deductible with your supplement.

Answer: Make sure the agency is reputable and has been in business for a longer period of time. Find out who does their supplements. For example, I worked for Bankers Life that has been around since 1879. We do our Medicare Supplements through Washington National, another long-standing company. We also cover all areas of retirement planning with financial advising in there. We sit down and do a holistic approach to their financial situation so we are not just making a sale then leaving.

Answer: If your Part D plan does not cover any of your medications, you may want to seek a better plan or look at the local pharmacy to see if they have their own discount plan. You can also ask your doctor if there are generics that work just as well for a lower price. You can also look into mail order pharmacies as they help you save money, as well.

Answer: Yes you can, but you cannot put money into your HSA once you are on Medicare. The government does not allow you to.

Answer: Contact a local agent. They are there to sit down with you and discuss the basics and true costs of Medicare so you can make the best decision for their plans. Local agents with have the most updated info and make sure they are licensed.

Answer: This question is a little too vague. It would depend on in you have Original Medicare or Medicare Advantage. Each plan is a bitt different. You would have to contact Medicare to see what they would cover or if you are on Med Adv, you would have to contact the carrier or your doctor to see what your plan covers.

Answer: There is a lot of information in there to know before making any decision. A personal agent would go over with you the costs of A/B with premiums and deductibles, show you the difference of care between Medicare and then Med Adv. Original Medicare has no networks, along with Medicare Supplements, while Medicare Advantage has networks (PPO, HMO) that you will have to stay in to get the in network coverage. If you choose Original Medicare, you would then need to know about Part D Prescription Drug coverage as this is a required plan you need to have that has a small premium deducted from your Social Security. Medicare Advantage plans have their own prescription drug cover within your plan, along with dental, vision, hearing. With Original Medicare/Medigap, you would need to get your own private dental coverage, as Medicare will only cover what is medically necessary. There are a few others, but that is why it is important to contact a personal agent so they can help simplify this for you.

Answer: That is where Medicare draws the line. There is no long term care supported by Medicare. That is a separate type of insurance you can purchase, but not all companies offer it. Bankers Life, the company I work for, offers it in every state except Alaska.

Answer: People always talk to their friends about what they did or read customer complaints online. They do not realize that the agent is their customer service and if they trust the agent and the company, there is no need to meet with a multitude of people. People dig in and look for every question to talk Medicare to death. They do not realize that if they are already used to paying a much higher premium with higher deductible, this should be a no brainer. People also fall in love with a specific carrier, rather than getting the best plan for themselves.

Answer: Reach out to a local agent in your area to get help. If you just have Medicare claims questions, you have to call the number, but if you are with an agency, they can do the leg work for you. If you looking to get signed up for Medicare, reach out to a local agent who is licensed and you would have a local number to call for one of us to come out to you and tell you what you need.

Answer: Good question. If you have retirement saved up and are planning to leave that to loved ones, investing in a life insurance policy will help your loved ones to not have to use that legacy you are passing down to pay for your final expenses/bills/funeral, etc. It would allow them to have some financial freedom while celebrating your life. Life insurance can also help to start the next generation with some wealth. You can also use the cash value in life insurance to loan to yourself and then pay yourself back without any actual taxes. Some people use life insurance policies to create a long term care so that your wealth does not have to get spent down to Medicaid, that way your hard earned wealth you have built does not get spent into that assisted/full time care.

Answer: It will all depend on the carrier you are with if you are on an MA plan. If you have a supplement, the doctor/practice would know exactly how much you would have to pay out of pocket. There are details that would need to be known in order to figure that out. Contact your agent or carrier of your plan to see what the cost would be. If you just have A, B and Part D drug plan, it would be a $257 deductible for the rest of this year, but increases to $283 next year, then your doctor visits would become an 80/20 plan where you pay 20% of what Medicare would pay for.

Answer: If you have an agent, give them a call and they will go over it with you. If you are on a MA plan, you would have to contact the carrier to find out about that. You can always call the doctor/practice that is administering your therapy to see what Medicare is covering.

Answer: There are different rules that apply when taking Medicare past turning 65 as that is your initial enrollment period to take Medicare. Since you are still working, have you had creditable coverage until now? If not, have you started taking your SS checks? If you have and never deferred Part B, you might already be paying for it. If you have not, you would have to start that process of applying for your SS benefits then they would figure out. This is why you get a personal agent that is licensed and does this education for you for no cost to make sure you understand all of these rights. They send you lots of information, but most people do not have the time nor the patience to interpret it all. Leave it to us and let us know how we can help.

Answer: That is the question of the day every time I speak with people turning 65 or leaving work coverage to go into Medicare. The simplified way of thinking about it (if there is such a thing)

1. Medicare is Part A, B and D with a possible Medicare Supplement added to it. This care is all run by the federal government. You get the standardized care, which means no networks and pay the same costs as anybody in the country would. The Supplement helps to pay for portions or all of the costs that Traditional Medicare does not pay for.

2. Medicare Advantage or Part C is Private Medicare. The costs/care/services are all determined by the insurance carrier: Humana, Aetna, Wellcare, Blue Cross Blue Shield, etc. Each of their plans are by network/area you live. These plans offer a little bit of dental, vision and hearing with a Part D drug plan that is usually part of the coverage.

There are a lot more details that could be shared. This is why it is good to have a personal agent that does no cost consultations to help you make the best choice for your coverage. We are all happy to help, but make sure not to just listen to friends about these as you will get opinions, rather than the facts. We try to give facts and then professional opinions, according to who YOU are and are looking for in your care.

Answer: I feel this would overload the system. The expenses would be higher and our understaffed hospitals/doctors' office would be overwhelmed.

Answer: I have never heard of this type of test being covered by Medicare, but it depends on your current situation. It must be related to a specific medical condition. Assessing risk for possible cancer due to family does not seem that it would be covered. You can always ask your doctor to see if they can get that covered by Medicare.

Answer: Networks are part of MA plans. Using a supplement, to me, is the better option if you can afford an extra monthly premium. MA carriers will leave the area and leave people without any coverage. $0 premiums do not mean that it is free. There is always a max out of pocket that you pay if something happens. In more remote areas, this can cause you to have to get care far away from your home.

Answer: "Medicare is free because I paid for it with taxes". People do not always realize that there are big hospital deductibles that can be paid up to 5 times per year and that Medicare does not help with any kind of long term/extended care.

Answer: Dental coverage is not easy to find in network even if you have a separate dental plan from the marketplace. My private coverage is not in most dentists' networks. You might be better off looking at supplement and then finding dental coverage separately. Call the carrier to find out what the out of network costs are with their plan. You may want to ask your dentist to see which carrier is in network for them so you can make the better decision during Annual Enrollment to change that plan for the next year.

Answer: Look at the firm they work for, like myself I work for Bankers Life that has been in business since 1879. Find out what carriers they are certified with. Make sure they are licensed in the state you live in.

Answer: Since there is a government shutdown and benefits are being pulled from 2025 to 2026, I am not sure what it will look like in 5 years. I know that there are more telehealth options being offered on certain Medicare Advantage plans, but it would be specific to the plan.

Answer: Traditional Medicare and supplements will not cover this type of wearable technology as it is not considered durable medical equipment or medically necessary. Some Part C Medicare Advantage plans may cover some of the cost for this equipment, but it would be up to the carrier.

Answer: From my experience no Medicare does not cover those types of treatments/medicines. I wish they did, but do not think this will ever be covered by Medicare.

Answer: I know that this is a current type of care that is being focused on with Medicare, but I am not sure. I know that some Medicare Advantage carrier have this type of care in their coverage. That would be something you would be able to look at with a Medicare agent to see the summary of benefits for each plan.

Answer: That would be up to Medicare or the Part C carrier you are using. You can check on Medicare.gov by looking at the Part D prescription drug coverage to see if the specific drugs would be covered.

Answer: It is free to speak with somebody who is licensed and keeps up with the industry. We share information so people can make the best decision for peoples' healthcare coverage going into retirement. They also can help you compare coverage with current work coverage to see if it is beneficial for you to even take Medicare. In my firm with Bankers Life and other firms/agents, we cover all areas of retirement to help people be prepared and covered for final/burial expenses, long term care and helping people move their retirement accounts (401k, IRAs, etc.) fee and tax free to protect the money you have earned from market volatility.

Answer: That is a good question. If you are turning 65 and are in your initial enrollment period, you qualify for a Medicare supplement no matter what. If you are coming off of work coverage, you should qualify as well. If you are past that period, you now have to go through underwriting, just like with a life insurance policy. You still have Parts A and B no matter what. Are you past 65? You can qualify for a Medicare Advantage plan or private Medicare that is handled by the private carriers.