Andrew Dooly, Medicare Insurance Broker

Answer: There are many reason's people are leaving Medicare Advantage (MA) plans. There are also many reasons why people are joining these same plans.

Some choose to leave because their doctors, medications, local hospital, copays, etc have changed. Other times (more rare) is there plan is no longer available in their area.

Keep in mind that Medicare Advantage isn't going anywhere anytime soon. Even when some plans leave, there is a reason for it, and other plans are generally still available in that area.

People are still joining MA in huge amounts each year. The main thing we as agents aim to do, is to have a yearly review with each client to make sure their current plan still makes sense based on their individual needs. MA can be a great option for the right person, but it's not a one-size-fits-all approach.

Answer: You don’t need to fill out any form right now. Medicare doesn’t require proof while you’re still covered under your spouse’s employer plan. When you’re ready to sign up for Part B later, you’ll complete the CMS-L564 form (Request for Employment Information) to show you had employer coverage and avoid any penalty. Connect with a local agent and they can help you navigate the process. It doesn't cost anything to work with an agent.

Answer: It would be suspicious if someone was offering a gift card to enroll, but that’s actually not allowed under CMS rules. Agents and plans can’t offer anything of value tied to enrollment. Most of the time what people are seeing are member rewards after enrollment for things like completing a health risk assessment, getting a wellness visit, getting a flu shot, etc. Those programs are allowed because they’re meant to encourage preventive care rather than influence someone’s enrollment decision.

Answer: Yes. If you lose employer health coverage, you may qualify for a Special Enrollment Period that allows you to enroll in Medicare outside of the normal enrollment windows.

The timing rules can vary depending on your situation and the type of coverage you had through your employer, so it’s usually a good idea to review your options with a Medicare agent to make sure you enroll at the right time and avoid penalties or gaps in coverage.

Answer: When someone is new to Medicare, I usually start with the basics and break it down step by step. Medicare can feel overwhelming, so my goal is to simplify it so they understand how everything works. I also give clients a small book I created that explains Medicare in simple terms so they can review it at their own pace.

From there, we go through their specific situation. I help them enroll in Medicare if needed, review the plans available in their area, and determine whether a Medicare Advantage plan or a Medicare Supplement makes more sense for them. It’s a fairly detailed process, but taking the time upfront helps make sure everything is set up correctly the first time and gives them peace of mind.

Answer: The easiest way is to review your plan’s Evidence of Coverage or Summary of Benefits, which will explain whether hearing aids are included and what the limits may be. Many Medicare Advantage plans offer hearing benefits, but the amount covered and the providers you can use can vary from plan to plan.

You can also call the Member Services number on the back of your insurance card to confirm your benefits. If you have a Medicare agent, they can help review your plan details and do the legwork to figure out what is covered. Remember, it doesn't cost anything to have a local agent.

Answer: Some people can qualify for Medicare before age 65. The most common situation is if someone has received Social Security Disability Insurance for 24 months. People with End Stage Renal Disease or ALS (Lou Gehrig’s disease) may also qualify for Medicare earlier.

Answer: The best way to know is to review your plan each year. Prescription costs can change each year based on things like your plan’s formulary, pharmacy, and the tier your medications are placed on. Even if you stay on the same plan, those details can change and affect what you pay.

A best practice is to compare your current medications against next year’s plan information during the Annual Enrollment Period. Many people also find it helpful to review this with a local Medicare agent who can run the comparisons and make sure there aren’t better options available for the upcoming year.

Answer: Absolutely! There are still additional programs that can help lower medication costs in 2026. One of the biggest is Extra Help, also called Low Income Subsidy, which can reduce or eliminate Part D premiums, deductibles, and copays for those who qualify. Some people may also qualify for a Medicare Savings Program, which can help pay Medicare costs and could automatically qualify you for Extra Help.

Since there are several factors that affect eligibility, it can be helpful to speak with a trusted local Medicare agent who can review your situation and help you see what programs may be available to you.

Answer: What I enjoy most is helping people make sense of something that can feel very complicated. Medicare has a lot of moving parts, and I’ve found that I have a knack for simplifying complex topics, which really helps with Medicare because I can help seniors clearly understand their options.

It’s also rewarding to build relationships with clients over time. Helping someone enroll in a plan is fine, but I really enjoy being there afterward to answer questions, review coverage each year, and help clients navigate changes as they come up.

Answer: One of the biggest differences is how they approach the conversation. An experienced Medicare broker will usually ask about your doctors, prescriptions, and overall needs before recommending a plan. They should also be able to clearly explain the differences between Medicare Advantage, Medicare Supplement, and Part D options without pushing just one company.

It’s also helpful to work with someone who represents multiple insurance companies and offers ongoing support after enrollment. A local Medicare broker can be especially valuable since you may have the option to meet in person and have someone you trust to help review your coverage year after year.

Answer: In most cases, no. During the Annual Enrollment Period you can leave a Medicare Advantage plan and return to Original Medicare, but that doesn’t automatically mean you can enroll in a Medigap plan without answering health questions. In several states, once your initial Medigap enrollment window has passed, insurance companies will to use medical underwriting.

There are a few exceptions, such as certain guaranteed issue situations or if you’re within the first 12 months of trying a Medicare Advantage plan. Since there are a lot of variables that can affect your options, it’s usually a good idea to speak with a trusted local Medicare agent who can review your situation and help make sure you’re not accidentally putting your coverage at risk.

Answer: Working with a Medicare agent can make the process much easier. There are a lot of plan options, and an independent agent can help you compare plans from multiple companies to find one that covers your doctors, prescriptions, and fits your budget. If you work with a local Medicare agent, you also have the option to sit down in person, if you prefer, rather than trying to sort everything out on your own or over the phone.

Another big benefit is ongoing support. A good agent doesn’t just help with enrollment. They are there afterward to answer questions, review your coverage each year, and help if any issues come up down the road. The nice part is that there’s zero cost to work with an agent!

Answer: Medicare actually covers quite a few preventive services at no cost if you meet the guidelines. This includes things like the Welcome to Medicare visit, yearly wellness visits, certain vaccines, and screenings for cancer, heart disease, diabetes, and several other conditions. It’s a good way to stay on top of your health and catch issues early.