Allen McGirl, Medicare Insurance Broker

Answer: It depends on the State and your Medicare Part B effective date. If you are in a non-guarantee issue State and have had another Medicare Supplement plan longer than 6 months, then you would need to answer health questions to qualify. Contact us to see if you qualify.

Answer: Due to lack of funding from the Government and lack of planning on the insurance company are some reasons seniors are losing coverages.

Answer: You should try and qualify for Low Income Subsidy or Medicaid by going to ssa.gov/prescriptionhelp. We provide this service at no charge to all out clients and prospects.

Answer: We shall see. Raised rates yearly will determine this. Costs are important and many people may not be able to afford it.

Answer: It all depends on the plan you choose. Not all plans have this and some have plans similar. Be sure to check your plan benefits and ask the correct questions.

Answer: It depends if you have coverage through your employer and if they have more or less than 20 employees. It is important to speak to an agent like myself to help you understand your options.

Answer: Climate change-related health issues are increasingly expected to affect Medicare policy because older adults are among the most vulnerable populations during extreme weather events, poor air quality, and infectious disease outbreaks.

Answer: If you miss the main Medicare Open Enrollment Period, you may still have options depending on your situation and the type of change you want to make.

Main Enrollment Windows

Medicare Annual Enrollment Period (AEP)

October 15 – December 7

You can:

switch Medicare Advantage plans,

move from Medicare Advantage to Original Medicare,

join/change/drop Part D drug plans.

Coverage changes start January 1.

Medicare Advantage Open Enrollment Period (MA OEP)

January 1 – March 31

If you already have a Medicare Advantage plan, you can:

switch to another Medicare Advantage plan once,

or return to Original Medicare and add Part D.

You cannot switch from Original Medicare to Medicare Advantage during this window.

If You Missed Both

You may still qualify for a Special Enrollment Period (SEP).

Common SEP triggers include:

Moving to a new service area

Losing employer or union coverage

Medicaid eligibility changes

Qualifying for Extra Help

Moving into or out of a nursing facility

Plan termination by the carrier

FEMA or disaster-related issues

Gaining or losing a Special Needs Plan condition

Recently leaving incarceration

Centers for Medicare & Medicaid Services allows SEPs for many life events, but the rules and timelines vary.

Answer: The biggest disadvantage of Medicare Advantage for many people is usually network restrictions and prior authorization requirements compared with Original Medicare.

With most Medicare Advantage plans (especially HMOs and PPOs):

You may need to use specific doctors, hospitals, and specialists.

Out-of-network care can be limited or much more expensive.

Some services require prior authorization before the plan approves payment.

That can become a major issue if:

you travel often,

want access to top specialty hospitals nationwide,

develop a serious illness,

or your doctors leave the network.

Answer: Not necessarily. Medicare can provide strong coverage, but it often works differently than employer-sponsored insurance, and there can be gaps depending on which Medicare option you choose.

Answer: Medicare Part A is primarily funded through payroll taxes from current workers.

As the population ages, the number of beneficiaries grows faster than the workforce paying into the system.

People are also living longer and using more healthcare services, especially hospital and skilled nursing care.

Answer: Original Medicare does not cover you outside of the United States. Some Medicare Supplement and Advantage plans may cover Emergencies, but you should consider purchasing a travel policy from my website.

Answer: If you have plan F, then your Medicare part A started before Jan 1, 2020. Plan F does not have a copay or deductible for Part A or B. You will only pay a premium and your emergency visit is covered 100%

Answer: If a senior does not take Medicare when first eligible or do not have credible health insurance to waive Medicare, then you may incur penalties for the rest of your life.

Answer: NO, This is not true. Medicare does not pay for any dental vision or hearing unless it falls under medical in which it may be covered under part B.

Answer: This is a bummer. You can go online and order a new one. Call Medicare and order one. We help people log in and do it for them.

Answer: I ask them to complete a Medicare review form. I want to know all your doctors, hospitals, prescriptions and the pharmacy you use. This will help me educate you on your options.

Answer: Work with an agent to review your drugs on Medicare.gov. Also, you have the right to use Good RX or any other source. Some folks use Canadian Meds. There are many options, but the money you spend on these programs do not go toward your catastrophic amount. So sometimes, not advised.

Answer: The federal Government subsidizes Medicare Advantage plans. The insurance companies create plans with the money to offer a $0 premium plan that includes copay, coinsurance and possible deductibles.

Answer: Medicare is complicated and if you do not work with a true professional who educates you on ALL options, then you could make a big mistake when you need medical care. I have helped thousands of people the past 30 years and I help educate and enroll a person on the plan they chose once they have all the information.

Answer: Ultimately, your doctor is making these decisions. However, it depends on what plan you have and what the procedure is. There are a couple of factors you need to be aware of. Prior authorization and preapprovals within Medicare Advantage plans. Not so much with Original Medicare, but five States as of 2026 are required to use Prior Authorization on some procedures. Reach out to me for more information.