Alondra Arce, Medicare Insurance Agent

Answer: Yeah, it’s actually happening! Starting in 2025, Medicare’s putting a $2,000 cap on how much people have to pay out of pocket for prescription drugs each year. It’s part of some new changes they passed a while ago to help lower costs for seniors. Pretty big deal, especially for folks who have to take a lot of meds.

Answer: Honestly, if you’ve got something like diabetes, the best way to estimate your Medicare costs is to look at what meds and treatments you need regularly, like insulin, test strips, doctor visits, stuff like that. Then check what’s covered under Part B and Part D. Some plans are better than others depending on what prescriptions you take, so it helps to compare. Medicare’s website actually has a tool where you can plug in your prescriptions and see how much you’d pay with different plans or I can also help you estimate the costs depending on the plans that are available in your area.

Answer: If you’ve got Medigap Plan C, that’s actually one of the more solid plans. Since it works alongside Original Medicare, most of the time your bloodwork, if it’s medically necessary and ordered by your doctor should be covered by Medicare Part B, and then Plan C usually picks up the leftover costs like the deductible and coinsurance. So chances are, you’re not paying much, if anything. But it’s always good to double-check with your provider just in case something’s considered non-routine.

Answer: Yeah, the donut hole's going away in 2025, which is great news. Basically, it means there's gonna be a $2,000 cap on how much you have to spend out of pocket for your meds each year under Medicare Part D. After you hit that, you don’t have to pay for your prescriptions for the rest of the year. So no more weird coverage gap where things suddenly got super expensive halfway through the year.

Answer: Yep, Medicare does cover the shingles vaccine now, finally! If you have a Medicare Part D plan, it should be covered with little to no cost, depending on your plan.

Answer: Honestly, the best way is to go straight to the source. I usually check the plan details on Pverify or call the insurance company directly. You can also ask a licensed agent (like me!) to double-check everything for you, some ads make things sound better than they really are, so it’s always good to verify.

Answer: There are a few reasons why that could be happening. Sometimes plans update their formularies at the start of the year, which can change how certain drugs are covered, even generics. It’s also possible that your medication moved to a different tier, or that the pharmacy you’re using is no longer a preferred one with your plan, which can raise the cost.

Answer: If you lost your Medicare card, don’t worry! Just go to Medicare.gov, log into your account, and you can request a new one. Or you can call 1-800-MEDICARE and they’ll send you a new card. Easy!

Answer: Original Medicare lets you see almost any doctor, but it doesn't cover everything. Medicare Advantage (Part C) usually has extra perks and lower costs, but depending on the plan you have to stick to their network.

Answer: An experienced Medicare broker will ask about your doctors, meds, and budget — not just push one plan. A newbie might seem unsure, skip important questions, or only talk about one company.

Answer: Find new in-network doctors if you’re in a Medicare Advantage plan. Mark your special enrollment window — you usually get 2 months after moving to switch plans. Check if your plan works in your new state (especially Medicare Advantage or Part D — they may not!). Update your address at Social Security (that updates Medicare too).

Answer: Meeting with multiple Medicare brokers or agents helps you compare options and find someone who really listens to your needs, not just sells a plan. Just make sure they’re independent and not tied to only one company.

Answer: If you’re still working past 65 and have good health insurance through your job, you might not need to sign up for Medicare right away but it depends on your employer size and coverage. Always check to avoid late penalties later!

Answer: If they have employer insurance with 20 or more employees: They can delay signing up for Medicare without penalty and keep their work insurance. Once they retire or lose that insurance, they’ll need to enroll in Medicare.

If they have employer insurance with fewer than 20 employees: They must sign up for Medicare at 65 to avoid gaps in coverage and potential penalties.

Answer: Tip: Always ask your doctor’s office about what exactly is covered during your visit to avoid surprise bills! If your doctor billed you, it might be because they did a more detailed physical exam, which isn't fully covered under the Medicare wellness visit.

Answer: I love helping people understand Medicare because it can be so confusing, and simplifying it brings peace of mind. It’s great to see people feel confident about their healthcare options once they know what’s best for them.

Answer: I totally get your frustration! The Open Enrollment period is meant to help you review your plan and make sure it fits your needs, but sometimes changes like doctor networks can be tricky. If your new plan doesn't include your specialist, you can appeal the decision or look into switching plans again during the next enrollment period, or even during a Special Enrollment Period if you qualify.