Adam Paul, Medicare Insurance Broker

Answer: For Medicare in 2026, eligibility itself doesn’t change for people with military benefits, but the rules around enrollment and coordination do. Those eligible for TRICARE must enroll in Medicare Parts A and B at age 65 to keep coverage, at which point they move into TRICARE For Life, with Medicare as the primary payer and TRICARE acting as secondary “wraparound” coverage—skipping Part B can mean loss of TRICARE and permanent penalties. In contrast, Veterans Affairs (VA) health benefits are based on military service rather than age and do not require Medicare enrollment; however, VA and Medicare generally do not coordinate for the same care, so veterans often enroll in Medicare (especially Part B) to avoid late penalties and to have access to non-VA providers. In short, Medicare enrollment is mandatory to keep TRICARE but optional (though strongly recommended) for those relying on VA benefits.

Answer: Original Medicare (Medicare Parts A&B) generally do not cover Ozempic and other weight loss drugs. However, there are Medicare Advantage Prescription Drug (MAPD) plans that do. I am appointed with many MAPD plan companies.

Answer: Medicare Advantage Prescription Drug (MAPD) plans are a great option because they include hospital, medical, prescription drug, and other ancillary benefits at no additional cost.

Answer: An agent is contracted and work with only one insurance company. A broker is contracted with multiple insurance companies.

Answer: Helping Medicare beneficiaries navigate the healthcare system and getting them the care they need. It is difficult for them to do this on their own.

Answer: I recommend having a one-on-one conversation with a certified Medicare agent, like me to guide you through the process.

Answer: If your Medicare is active on or before January 1, 2026, then yes. Do you already have parts A & B active?

Answer: No, they are not there as a sales disguise. They are specifically there to educate people on Medicare about how the federal health insurance program works. Moreover, they educate Medicare beneficiaries on Medicare Advantage, Medicare Supplement, and Stand-alone Prescription Drug (Part D) plans, how they work, and how said beneficiaries can make an educated decision on which plan best fits their needs. If an individual wants to enroll in one of these programs, they can follow up with the agent who gave the presentation and schedule a one-on-one appointment.

Answer: It covers medical, such as doctor visits. No, it is not enough. You will need a Medicare Supplement or an Advantage Plan.

Answer: I wouldn't say one is better than the other than the other because everyone has different needs. Most of the people I have served go on a Medicare Advantage plan because they usually include prescription drug coverage (Part D) at no additional cost. If you enroll on a stand-alone prescription drug plan (Part D), you will have to pay a monthly premium for it.

Answer: There are certain provisions within the inflation reduction act that are expiring by December 31, 2025. As a result, the cost of prescription drugs and healthcare are increasing. so to answer your question, the inflation reduction act is not fixing it.

Answer: Are you referring to credible prescription drug coverage? If so, you will be subject to paying a fine. Medicare Part D Late Enrollment Penalty, calculated as 1% of the national base premium for each month you didn't have creditable drug coverage, is added permanently to your monthly premium. For example, in 2025, the base premium is about $36.78, so 12 months of delay means an additional 12% of that, or about $4.41 (rounded), added to your bill.

Answer: I recommend that you contact licensed agents like me who can sit down with you one-on-one and help you navigate Medicare. This makes it much less overwhelming and simplifies the entire process.

Answer: I sit down with them one-on-one and walk them through Medicare, so they understand precisely what it is and how it works. I also do Medicare 101 presentations at senior centers.

Answer: You get through this by contacting me.

Answer: No, not necessarily. There are many options that can satisfy your needs. I can certainly help you with this. Would you like to schedule a phone call or an appointment.

Answer: Yes, you can meet with me, and I will be happy to assist you with this? I can also do phone calls and video calls, too. What is your phone number?

Answer: You should typically review it during the Annual Election Period (AEP), which is every year from October 15 to December 7.

Answer: You can select richer Part D plans that cover more, but have a higher monthly premium. Medicare Advantage plans are a good option, too.

Answer: Yes, Medicare Part D typically covers Repatha (evolocumab), a medication used to lower high cholesterol.

Answer: They are legitimate if they are licensed insurance agents with an American Health Insurance Plans (AHIP) Medicare credential, such as me.

Answer: You can explore opportunities with a Medicare Advantage HMO Plan. Most of them include hospital, medical, prescription drug, and more at no additional cost to you.

Answer: All services have to be rendered in network unless it’s an emergency and you have to have an appointment with your primary care physician to give you the referral to see a specialist that is part of the same network.

Answer: Speak to a licensed professional like myself. We walk everyone through this process to make the most educated desicion.

Answer: Yes, the cost of Medicare is different for everyone due to factors like income, work history, and the specific plan chosen.

Answer: Yes, Original Medicare covers preventive services like your annual wellness visits, which include a review of your physical activities, while many Medicare Advantage (Part C) plans offer additional benefits like gym memberships, fitness programs, and even rewards for healthy activities. Original Medicare does not provide incentives for a healthy lifestyle, but Advantage plans often do through partnerships with companies like SilverSneakers or by offering rewards like gift cards.

Answer: You need to enroll in Medicare through a Special Enrollment Period (SEP) if you or your spouse are still working and have employer-sponsored health coverage, which starts when that employment ends. If you don't qualify for an SEP, you can enroll in Part B during the General Enrollment Period (GEP) from January 1 to March 31, but you may have to pay a late enrollment penalty. You can enroll for Part A and/or Part B online via the Social Security Administration website.

Answer: You can, but if you do, you will be responsible for paying the full cost. On a Medicare Advantage HMO plan, you must consult and have an appointment with your primary care physician. Then, he or she will refer you to an in-network cardiologist if you want your Medicare Advantage plan to cover the cost.

Answer: Yes, you must first meet your Medicare Part B deductible before it starts covering physical therapy visits. After you meet the annual deductible, Medicare Part B covers 80% of the Medicare-approved amount, and you are responsible for the remaining 20% coinsurance.

Answer: "Guaranteed issue" in a Medicare supplement policy means you are guaranteed to be sold a policy without having to go through a physical exam, medical underwriting, or answering health questions. Guaranteed issue for a Medicare supplement policy applies when you have a special circumstance, such as losing other health coverage or moving out of a Medicare Advantage plan's service area. You can usually apply 60 days before your coverage ends and have 63 days after it ends to get a policy with no underwriting, regardless of your health. Another common situation is if you're age 65 and enrolling in Medicare Part B, giving you a six-month open enrollment period where you have guaranteed issue rights. 

Answer: The different tiers and Medicare Part D plans affect what you pay for medications, since each medication can fall into a different tier. Depending on what tier they fall under, that will determine how much you pay for a given prescription medication.

Answer: That is difficult to answer because I can’t see your benefit structure. Have you contacted the insurance company and ask them to review the benefit structure with you? Did you have a broker that signed you up?

Answer: If you already have your Medicare red white and blue card with parts A and B, you do not have to renew that. However, if you are looking to enroll on a Medicare advantage, Medicare supplement plan, or stand-alone prescription drug plan, that will renew automatically, as well. From October 15 until December 7 you have the opportunity to enroll on one of those plans I mentioned above. I can certainly help you with these if necessary.

Answer: They end up paying penalties because they did not enroll when they were first eligible to do so. Therefore, the government makes them pay a fine.

Answer: Generally speaking, you can keep your doctors if you switch to a Medicare Advantage plan. What I do is sit down or have a phone call with an individual to ensure that all of your doctors are part of the same medical group and accept the Medicare Advantage plan. Over 90% of the people I enroll are on a Medicare Advantage plan, and they love it.

Answer: Yes, a bone density test is considered preventative care under Medicare. do you have a Medicare Supplement plan, Medicare Advantage plan, or just original Medicare?

Answer: The answer to that question depends on what level of Medicare you have. Do you have a Medicare Supplement Plan, Medicare Advantage, or just Medicare Parts A & B?

Answer: I can do that for you, or you can use Medicare.gov as a good resource. Company websites also allow you to compare costs for each plan and each drug you have.

Answer: No, you did not make a mistake. All Medicare Advantage plans have co-pays for services. Medicare Advantage plans are an excellent choice because they include hospital medical, usually prescription drug coverage, and other ancillary benefits, so long as you continue to pay your Part B premium. They have exceedingly rich benefits, too.