Alicia Tyring, Medicare Insurance Broker

Answer: Sometimes, but not always. While advantage plans may have a low or $0 monthly premium, there is a much higher cost sharing if you use the plan. You would see this in your MOOP for the advantage plan. With a supplement, you're paying up front, but aside from the monthly premium and your 1 time per year deductible, that's all you pay. Whereas the advantage is pay as you go, so every service is going to result in a charge that goes towards your MOOP for the year. MOOPs are typically much higher than a supplement cost.

Medicare Advantage often reduces upfront costs and can save money for seniors who remain relatively healthy. However, for people who later develop significant medical needs, the combination of copays, network limitations, and the potential inability to obtain affordable Medigap coverage can make it more expensive—or at least more restrictive—over the long run. The key tradeoff is usually lower premiums today versus greater flexibility and potentially lower risk of large medical expenses later.

Answer: Medicare does not pay for full-time in-home supervision or “custodial care” for dementia patients, even when wandering or 24/7 monitoring is needed. Medicare generally views supervision, safety monitoring, companionship, and help with daily activities as non-medical long-term care. It will cover part-time skilled nursing visits, physical, occupational, or speech therapy, limited home health aide services tied to skilled care, medical social work or hospice care (if eligible). The person usually must be considered “homebound” and need intermittent skilled services ordered by a clinician.

Answer: Original medicare & supplements you can usually keep when you move from place to place. If you have a Medicare Advantage plan (Part C), you should absolutely review your plan because these plans are county based & use local provider networks. Supplements you can usually keep when you move from place to place. It's best to speak with a local agent to review!

Answer: Brokers are paid by the insurance companies directly when a client enrolls through them. This does not cost you or effect the plan that your decide on. A good broker recommends a plan based on your medical, costs, and other needs.

Answer: Know that you have a 60day window prior to your 65th birthday to enroll in your Medicare part A/B with Social Security Office. Make sure to get enrolled. Once you're enrolled, then your can set up your medicare coverage, whether you go with a Supplement or a Medicare Advantage plan. Be sure to work with a licensed agent to know the pros/cons to both options!

Answer: Plan K = lower premium, more out-of-pocket risk. Plan G = higher premium, very predictable costs. Essentially, you save money each month, but you need to be okay paying more when you actually use care.

Answer: For 2026, the Medicare Part B premium is $202.90. This may be different for any beneficiaries subject to Irmma. The increases are resulting from higher medical costs, increased usage, & overall cost projections.

Answer: Make sure to have a list of name, dosage, frequency, & your preferred pharmacy. You personally can used Medicare.gov to compare Part D plans. It will guide you through the deductibles, copays/coinsurances, & coverage phases. Keep in mind that you can always reach out to a licensed agent for all those hard to answer questions!

Answer: If you elect to have your son or daughter as your power of attorney, yes. If they are not your power of attorney, they can assist with your verbal permission, however any enrollments will need to be made by you.

Answer: Relocating to another state does present some options. Medicare coverage will remain the same, however if you have a supplement or medicare advantage plan, you will need to confirm that the plan is available or enroll in a plan that is. After the move, you have 60 days to make that update or change.

Answer: Higher ratings resemble higher quality. Whether it be better preventative, care coordination, member satisfaction, or clinical outcomes, you know that you'll receive excellent quality closer to the 5 star scale.

Answer: Increasing health care costs would be the first that comes to find. These will also increase due to beneficiaries having such complex needs & influx of chronic conditions. There's also quite a rapid aging of the population, more commonly called Baby Boomers. With fewer workers in the contributing it tends to put strains on the Medicare payroll tax revenue that funds everyone's Part A coverage.

Answer: Medicare agents or brokers do not charge the clients a fee for reviewing your options or helping you enroll. Financial advisors or consultants typically charge $100-300/hr or a flat rate fee. Be sure to reach out to a Medicare agent as we're paid by the carriers or programs!

Answer: In short, yes, IRA or 401K withdrawals can increase Medicare costs. You will see or notice the impact 2 years later. For instance, your 2026 Medicare premiums are evaluated based off your 2024 income, resulting in an IRMAA charge. Appealing IRMAA if income rose due to a one-time life event (retirement, divorce, death of spouse, etc.)

Answer: Unless the purchase of this watch is considered a medical necessity by your Doctor, it would not be approved by Medicare. This is similar to a blood pressure kit that Medicare does not see as a medical necessity under DME monitoring devices. A Medicare Advantage plan may pay for the smartwatch, but it would require prior approval.

Answer: Fewer workers in the workforce decreases the payroll tax revenue. This directly effects and weakens the Medicare Part A trust fund. This particular fund relies heavily on worker contributions.

Answer: Basic, medically necessary services are covered under Original Medicare. Supplements work wonderfully if your providers accept Medicare. If you have other chronic conditions, such as diabetes or heart disease, a chronic special needs plan may offer more coordinated/tailored care compared to a regular medicare advantage plan.

Answer: Medicare has a special eligibility category specifically for individuals with End-Stage Renal Disease or ESRD. This does not change your medicare eligibility if you're already on Medicare.

Answer: It is meant to prevent those types of issues, especially with providers and drug formulary changes. I would recommend using a licensed agent that's knowledgeable in the field. They can check the providers carrier directories as well, but keep in mind that contract and provider negiotiations happen all the time. It's not always preventable.

Answer: The most successful is purposeful check-ins, before, during, and even after assisting clients. Getting an understanding for how the client feels, clear understanding of information, & follow up are extremely important.

Answer: Medicare doesn't assist with dental, vision, or hearing. Prescriptions are not covered, you will need a Part D prescription drug plan. It also doesn't cover long-term or nursing care at home, for that, you'd need medicaid. As with most insurance, is won't cover cosmetics either.

Answer: When setting up a healthcare POA, make sure that you choose the correct person. Have clear open discussions about your wishes. Put your wishes in writing/paper form. Provide your copy of those wishes to the POA & any others directly involved in your care.

Answer: Some medicare supplements offer foreign travel emergency. There are international travel policies that can be purchased. Lastly, some Medicare Advantage plans offer additional travel benefits for international travelers.

Answer: There's no specific rule on no CT scans after 78 years of age. There are rule around being medically necessary, age related guidelines, exposure risks, and potential health status or comorbidities. If medically necessary, any 78 year old can be approved for CT scans.

Answer: HMOs are Health Maintenance Organization plans which require all doctors be in network. PPOs are Preferred Provider Organizations which allow in and out of network, as long as the provider is willing to bill out of network. Private Fee for Service plans allow both in and out of network. Special needs plans require a chronic condition, medicaid, or institutionalized.

Answer: Not all blood tests are covered. All tests have to be ordered by a physician and have a medical diagnosis that helps Medicare approve it. This would pertain to preventative or screening blood tests that Medicare deems as medically necessary.

Answer: The biggest mistakes would be not checking all of your medications on the plan's formulary. Allowing your plan to auto-enroll each year at potentially increased costs instead of completing an annual plan review during your annual enrollment period. Reach out to a licensed sales agent to assist & walk you through the process. Just cause the monthly premium is lower, it doesn't mean that your costs will be low.

Answer: For a supplement, you pay the monthly premium up front, regardless if you use your coverage or not. It's accepted by any provider that accepts a Medicare assignment. Medicare Advantage, is similiar to a pre-paid cell phone. You will pay a copay or coinsurance at the time of service. It's also broken down into network-based coverage. HMO you must see doctors in the network. PPO you can see both in & out of network physicians, as long as they're willing to bill the PPO out of network. Out of network rates are usually significantly higher copays/coinsurance rates.

Answer: Being young doesn't discredit the knowledge or experience in the field. The key things would be knowledgeable, licensed, & trustworthy. Just make sure they're properly trained, certified, & focus on your needs & best interests.

Answer: For medicare advantage, the max out-of-pocket is the most that your would pay per calendar year. Keep in mind that your part D and any non-medicare covered services do not contribute to the annual amount.

Answer: It is always best to check with a licensed agent to compare the carriers. If your health is in good condition and/or you can pass underwriting, you always have the option to price shop your supplement. Supplements are federally standardized, meaning they offer the same coverage, but some carriers will charge more than others.

Answer: Special needs plans are medicare advantage plans that limit members with certain charateristics. Chronic snp is for specific chronic or debilitating conditions. Dual snp is for members that have medicaid through the state. Institutional snp is for members who are living in an institution, such as a skilled nursing facility.

Answer: There are several prgrams available to assist with prescriptions. Extra help is a program offered by the Social Security office. Medicare Savings Programs are offered at a state level. Medicare also offers a prescription payment plan to assist in managing costs. There are also state pharmaceutical assistance programs at a state and local level.

Answer: All medicare plans are heavily dependent on zip copes, plan types, & how each plan is funded. Supplements may have a larger monthly premium, but less expenses anually. Reach out to a licensed agent to break down the costs in your area & find a plan that fits your budget.

Answer: Dental plans under the medicare advantages do have limited networks. I would reach out to a licensed agent or the carrier directly to get details on your dental network specifically. A plan can offer you $5000 in dental, however, it does you absolutely no good if there's not participating providers in your area.

Answer: Medicare's biggest requirement is that it be FDA-approved. There are current FDA approved genetic therapies already being used. The likelihood is very good, however, there will always be the justication of is it medically necessary or reasonable.

Answer: Medicare Advantage plans do not have a trap. What they do provide is an annual cap on your out of pocket expenses compared to no cap of original medicare. There are some less diserable attributes of network restrictions, prior authorizations, & sometimes even denials. I would encourage everyone to speak with a licensed agent that can break down the misleading marketing that revolves around medicare advantage, supplements, & original medicare.

Answer: Plan N covers the remaining 20% coinsurance that Medicare doesn’t pay. MRIs are billed underneath your part b coverage. You will still need to meet your annual deductible first, then the remaining charges will be covered.

Answer: Working with a Medicare agent can be a big help when you’re navigating your health insurance options. Agents can break down the plans in plain language. Most agents will complete a needs analysis to help you avoid costly mistakes. We're here to save you time & stress, along with offering ongoing support.

Answer: Due to being in your Annual Enrollment period Oct 15 - Dec 7th each year, I would reach out to a licensed agent to review your 2026 plan to ensure hearing aids are covered. You can also reach out to the carrier directly by calling member services on the back of your current card.