Andrew Firmin, Medicare Insurance Broker

Answer: Can you change your supplement plan, your Medigap plan, at any time? Technically, yes. The general rule is there is not an enrollment period for your Medicare supplement plan. Now, one thing to consider in most states is that after you've already been on Medicare for a certain period of time, if you want to change your supplement plan or enroll in a different one, there may be medical underwriting. The insurance company may ask about your current or past health history. Based on that, the insurance company may decide to charge you more money or to not cover you at all. So, yes, while you can change your supplemental plan at any time, you may not be able to based on the insurance company's underwriting process and your health or condition. In those circumstances, I hope that provides some direction. Until next time, be healthy and be well.

Answer: How can I lower my Part B premium if my income drops once I'm in retirement? Now, your Part B premium is based off your income as reported on your tax return two years prior. Depending on what that income is, Medicare and Social Security may charge you what's called an income-related monthly adjustment amount, or IRMAA, for sure. Now, if your income drops because of a life-changing event, for example, if you reduce your hours or retire and that brings your income to a much lower level than it was two years ago, you can often file what's called a redetermination. Basically, this indicates to Medicare and Social Security, "Hey, I am no longer working, and therefore I'm not earning the same amount I was two years ago." Therefore, I shouldn't be held liable to continue paying this added amount.

Additionally, if your income drops significantly below certain levels—and this depends on your state—you may be eligible for programs such as Medicaid, a low-income subsidy, or the Medicare savings program. Each state may have additional programs. So, it's important to understand those are opportunities to review the coverage and available plans within your service area and seek alternative methods should your income drop significantly. Hope that provides some direction. Until next time, be healthy and be well.

Answer: What is the biggest mistake seniors make when they enroll in Medicare? I think a number of mistakes folks make. They listen to their friends and family, and our friends and family are well-intentioned, but we don't know what we don't know. So along that line, listening to our friends and family about what is the best plan for them may not be the most suitable plan for you. I think one of the biggest mistakes seniors make when transitioning to Medicare is treating the decision just like you've treated your healthcare decisions all of your life.

Now, I believe Medicare is the intersection of your health coverage and financial wellness. So it's important to understand what your financial risk is under any option of Medicare, what your appetite for that risk is, and what your propensity for care is. Treating the decision the same way you have for the first 65 years of your life is not necessarily the best way to transition into Medicare. It truly is a financial decision coupled with what your healthcare needs look like and what coverage is available in your area. I hope that provides some clarity. Until next time, be healthy and be well.

Answer: Do I need to have a hospital indemnity plan if I have a Medicare Advantage plan? What happens is, from hospital stays multiple times throughout the year, I always recommend that if you're on a Medicare Advantage plan, you also include a hospital indemnity plan and a cancer plan. Here's why: under a hospital stay, your Advantage plan may have a high cost-sharing, a couple hundred dollars for the first five, six, or seven days. Whatever your plan's design is, that will often lead to, especially if you have multiple hospitalizations, you hitting the plan's maximum out-of-pocket.

In my view, Medicare is the intersection of your health coverage and financial wellness. And for that reason, under a Medicare Advantage plan, we want to help protect your financial wellness by marrying the plan or adding additional coverage such as a hospital indemnity plan and even a lump sum cancer plan. It's all about protecting your financial wellness and protecting your out-of-pocket and retirement savings. I hope that provides some clarity. Until next time, be healthy and be well.

Answer: Can I just have original Medicare Parts A and B and still have good coverage? Well, that depends on your financial situation. What you need to understand is under original Medicare, under Part A, there's a deductible per hospital occurrence. And you may have co-pays for extended skilled nursing stays. For your Part B coverage, things that cover your medical needs, like doctors' appointments, lab work, and durable medical equipment, Medicare has a small Part B annual deductible. But after that, Medicare only covers 80%. This means you're on the hook for paying the other 20% of your doctor's bills, emergency room visits, and medical equipment.

Now, that 20% does not have a cap, so your financial risk could be unlimited based on what your healthcare needs are. For that reason, there are two ways you can go about protecting your financial wellness in covering those gaps. The first is a Medicare supplement, also known as a Medigap plan. And then option two, the other way, is what is called a Medicare Advantage or Part C.

Now, which way you go to fill in those coverage gaps depends a lot on what your healthcare needs are, what the available plans are in your area, and what your overall financial well-being is, along with your appetite to manage risk. So yes, you can only have Medicare Parts A and B; however, that will leave you significantly exposed to high co-pays and potentially unlimited cost-sharing for your doctor's appointments. I hope that provides some direction. Until next time, be healthy and be well.

Answer: You're moving from one state to another. How will your move affect your Medicare coverage? Well, it depends on what type of plan you have. If you have a Medicare supplement, a Medigap plan, and a standalone prescription drug plan, you can usually bring your Medicare supplement, Medigap plan with you as long as you continue paying the premium. Now, it may make sense to review the coverage and the plans available in the state you move to, to see if there's similar coverage at a more affordable price. However, you can generally move your supplement, Medigap plan with you and carry that as long as you continue paying premiums.

Now, if you're on a Medicare Advantage plan or with your standalone prescription drug plan, you will have to update and change that plan to one that is within your new location. Medicare Advantage and prescription drug plans, by large, are run by county. So, when you move, you may have to update that plan. Now, your plan will give you a certain period of time to do that. Generally, once you update your address with Social Security, you're given a time period where you can make that change. Your insurance company should also be sending you notification if your plan is going to terminate and your need to enroll in something else.

When you do need to enroll in something else, you can contact your insurance company, Medicare.gov, or your local independent Medicare broker. I hope that helps provide some clarity. Until next time, be healthy and be well.

Answer: I picked the Medicare Advantage plan last year, and I'm not sure if hearing aids will be covered. Many Medicare Advantage plans provide coverage for not only the screening and audiologist, but also an allowance for hearing aids. The best way to see that is to contact your insurance company. You can go to your online account or even medicare.gov and look up your plan and review that plan's Summary of Benefits or its Evidence of Coverage (EOC). Both of those documents will highlight what your potential coverage may be.

Now, for this reason, it's important to review your coverage annually. One plan may provide one set of benefits, while a different plan could offer more favorable coverage for you. Your opportunity to review that is annually during the Annual Enrollment Period from October 15th through December 7th. I hope that helps give some guidance. Until next time, be healthy and be well.

Answer: Can a Medicare Advantage plan offer extra benefits for breast cancer? So I think the first place to start here is that a Medicare Advantage plan has to offer the same services as Original Medicare. That's things like your annual screening, your mammograms, diagnostic manual grants, and medically necessary treatment.

Now under the Advantage plan, there may be a cost-sharing just like there is under Original Medicare, where Medicare Advantage can provide you with additional services. These can include expanded screening, access to additional tools, transportation to and from doctor's appointments or lab visits, and care coordination. That's oftentimes coordinating care among various different doctors, which can be a very useful tool, especially when you have a family member helping you guide your treatment.

Potential access to genetic treatments or genetic testing far in advance of a diagnosis may also be available. And then post-treatment support may be available under your Medicare Advantage plan. Now every plan is going to be different. Some plans may offer some services while another may not.

I think the other thing to consider prior to a diagnosis with Medicare Advantage plans is that if you have a cancer diagnosis, you may have some significant cost-sharing up to the plan's maximum out-of-pocket. To help cover that and protect your financial wellness, we always recommend a standalone cancer plan with a Medicare Advantage plan. So if you're pre-diagnosis, that might be something to look at.

If you have any questions, Medicare.gov provides a lot of resources. Reach out to your local senior center or to your insurance company to find out which specific services they have available to you. Until next time, be healthy and be well.

Answer: How do you stay up to date with your Medicare plan changes from one year to another? It's really important that you review your coverage annually. Your health coverage needs may change, your prescriptions may change, and your insurance company may change. How your plan works and what it covers every September is crucial.

For those who are on a Medicare Advantage or a standalone prescription drug plan, you will receive what's called an annual notice of change. It's important for you to read that annual notice of change. Within the first four or five pages will be a summary that summarizes if any copays have changed, if the formulary of covered prescriptions has changed, any changes to the network, and any changes to the plan premium will be summarized on one page within the first couple of pages of the document.

It's important to read that document to understand it, and then review your coverage and compare it to all other plans available in your area. The most appropriate time to do this is during the annual enrollment period, which runs from October 15th through December 7th. I hope that provides some guidance. Until next time, be healthy and be well.

Answer: How do discount cards affect your Medicare prescription drug coverage? This is important to understand. In 2025, a new maximum out-of-pocket was introduced under your Medicare Prescription Drug plan for 2026. That maximum out-of-pocket is $2,100. However, only prescriptions that you obtain through your prescription drug plan and prescriptions covered by your prescription drug plan count towards that maximum out-of-pocket.

So if you use a discount card, you're going outside of your prescription drug plan, and any prescriptions you get covered using that discount card will not count towards that maximum out-of-pocket.

So what's important to do is at the beginning of the year, review your prescription drug coverage, compare it to other plans, and take a look at when you might hit that $2,100. Because it may be more advantageous to use your plan. Pay more money upfront, but have little or no co-payments at the back end of the year versus using a discount card.

Always review your prescription drug coverage. Understand what the different levels are. Understand what your prescription drug plan covers and does not cover. I hope that provides you some guidance. Until next time, be healthy and be well.

Answer: Will your Medicare plan work when you're traveling in Europe? Great question. If you only have a regional Medicare Parts A and B, you will not have coverage outside of the country. Now, if you marry a regional Medicare with a Medicare supplement plan, some supplement plans do provide coverage outside of the United States. There may be certain maximum amounts that are covered, so that's something to be on the lookout for and to review in your plan.

Now, if you are enrolled in a Medicare Advantage plan, many of those have coverage for outside of the United States. Now, whether it's through a supplemental plan or your Advantage plan, while you may have coverage, the international doctor or hospital may not have a relationship with your United States-based insurance company. The international doctor or hospital may require you to pay them upfront. Then you come back to the United States with the receipt and provide that to your insurance company for reimbursement.

Now, there are a couple of things that you can do. There are some international health insurance plans that not only cover routine care and emergency care while you're outside of the country, but they may also provide a benefit for emergency travel back to the United States. Now, that would be a separate international health insurance plan that you would purchase for the country that you're traveling to and for the dates you're traveling. I hope that helps. Safe travels! And until next time, be healthy and be well.

Answer: There are a number of reasons why a Medicare Advantage plan may not be in your best interest. If you're predisposed to routine and frequent care, you're gonna be going to the doctor's for tests or something else. Every couple of weeks, you're predisposed to routine and frequent hospitalizations. You have a critical or chronic disease. A Medicare Advantage plan may actually cost you more money with all the different co-pays you have for the various services.

Additionally, Medicare Advantage plans are managed care, which means if you need a service or a procedure done, your doctor may need to put in a request for prior authorization. There's no guarantee that's going to get approved.

The other areas where a Medicare Advantage plan may not be most suitable for you are if you live in a part of the country where there is not a large doctor network. If your doctors are not in-network for a Medicare Advantage plan, then you might want the freedom and flexibility that Original Medicare and a Medicare supplement plan provide. Because you no longer need to worry about doctor networks.

So really, I think it boils down to what your healthcare needs are and what the available plans are in your area. It's important to understand all of your options.

Again, to summarize a couple of situations where a Medicare Advantage plan may not be most suitable: if you're predisposed to routine or frequent care and if your doctors are not in-network for any Medicare Advantage plan. I hope that provides a little bit of guidance for you. Until next time, be healthy and be well.

Answer: Why are people unhappy with Medicare Advantage plans? I think it's largely in how the plans are marketed and enrolled. The plans are marketed very heavily on the extra ancillary nice-to-have benefits, and nobody explains to the consumer when they call seeking these benefits how the Advantage plan works. So the commercials lead you to believe that everything is free in what happens.

Two things happen. The first, after you enroll in an Advantage plan, you may go to your doctor's office and find out your doctor is not in network, and you now need to change doctors. So the person who enrolls that Medicare beneficiary should have asked who your doctors are and should have made sure and confirmed that those doctors accept that certain particular Medicare Advantage plan. So that's the first thing that happens.

The second thing that happens is the marketing. The marketing leads you to believe everything is free. And we know that's not true in life. So somebody may go to the hospital, may have a surgical procedure, and three months later they get a bill because there are co-pays that are part of the plan. And they say, "Wait a minute, why am I getting this bill? Everything is free." Well, shame on the person who enrolled you in that Medicare Advantage plan because they should have explained to you how the Advantage plan works.

And while you might be saving money upfront without a monthly premium or a low monthly premium, there are co-pays for pretty much every service you may have under the plan. I think that's what drives the majority of complaints associated with Medicare Advantage plans. What's important here is to understand how your plan works and to review all of the available options in your specific area. I hope that helps. Until next time, be healthy and be well.

Answer: Star ratings, do they really mean anything? They do. The government, the last couple of years, is changing how the star ratings are calculated. Now, when you look under the hood, a lot of people think star ratings are just based off whether a consumer, a Medicare beneficiary, calls in and complains about the company or if they call in with a positive review of the company. There are a number of items that go into the star ratings. Now, consumer complaints is one aspect, but it's a minor aspect. The other aspects are how healthy the plan is at keeping you healthy. How likely are you to get a doctor's appointment? How many surgical procedures or hospitalizations do you have? What are the programs that people are using under the plan to maintain a healthy lifestyle?

So it is a complicated formula that goes into creating the star rating. It's important to pay attention to whether a 4 or 5 star plan is better than a 1 or 2 star plan. The answer to that is yeah, most likely it is. A 4 or 5 star plan, or even a three and a half star plan, is going to give you likely better service, better response from the insurer, and a better overall experience.

So as the government changes star ratings, stay on the lookout for that. And do consider what the star rating is on your plan. But that shouldn't be the only consideration. I think that's the important key here. Until next time, be healthy and be well.

Answer: Do Medicare Advantage plans save seniors money in the long run? That's a great question. Hypothetically, yes. The whole idea around Medicare Advantage plans is proactive care. Managed care means having one person coordinating your care so that we can be proactive. When we're proactive, we're keeping you healthier and keeping you out of the hospital. So from that perspective, Medicare Advantage may save money throughout the entire system, and it may save you money.

Now, if we look at it over a course of time, if you're enrolled in original Medicare and you're paying for a supplement plan, if you go 25 years and you're super healthy and you never need your health plan, well then, yeah, Medicare Advantage is likely saving you money. Now, if something happens early on after you get on Medicare and you develop a chronic illness or chronic disease that you now need treatment for the rest of your life, in that scenario, Medicare Advantage is likely going to cost you more money.

So the question shouldn't be, "Is Medicare Advantage saving you money?" The question should be, "What type of health care coverage do you need? What is your financial situation?" And to marry those things and make the best decision on what your coverage options are based off of the area in the part of the country that you live in. So it all depends. It's hard to answer. Hypothetically, the whole point of Medicare Advantage is proactive care to keep you healthy, to keep you out of the hospital, and across the entire system. That should save money. That is why Medicare Advantage was introduced in the first place. And that is the goal.

I know that may not answer your entire question, but it all depends on the health care coverage you need. And that's what you need to understand as you make your decision. Until next time, be healthy and be well.

Answer: Your neighbor thinks you're crazy for having a Medicare supplement plan when Medicare Advantage is free. Let's talk about this. Medicare Advantage is free? No, that's a fallacy. Nothing in life is free. Right now, it is true that you're paying more money upfront for a Medicare supplement or a Medigap plan. But when you look under the hood, when you understand how Medicare Advantage plans work, one, they're not free. There's zero premium. The money you're paying the federal government is basically being forwarded on to the Medicare Advantage company. So from that perspective, it's not free.

Additionally, Medicare Advantage, the way it works, you have cost sharing up to a maximum out-of-pocket or your ceiling. So when you go to the doctor, when you go to the hospital, when you have surgical procedures or other work done, you have a co-pay that is not free and can often be more expensive than a Medicare supplement plan. Because if you're frequently using care, if you are predisposed to routine and frequent care, multiple hospitalizations, your co-pays may add up to be more than what you might pay on a Medicare supplement plan.

Now, does that mean you should do it? Maybe. What is good for one person may not be good for another. You need to evaluate what your health coverage needs are and what your financial situation is because your situation is different than your neighbor's. So what is a good plan for your neighbor may not be a good plan for you.

What's important here is to understand what the different coverage options are that are available in your area. How much do they cost? What is the coverage? And for you to make a decision based off of what your health care needs are and what your financial situation is? I hope that helps. Until next time, have a great day and be well.

Answer: When you enroll in Medicare, should you keep Original Medicare or go with a Part C Medicare Advantage plan? Which is better? Great question! Now, the term "better" is subjective. What is better for one person may not be what is best for another. It's important to understand what your healthcare needs are and what your financial situation is.

Now, the way Medicare Advantage works, it's managed care, just like the health coverage you had when you were working. Now, what does that mean? That means you may need to adhere to a network of doctors and hospitals. There may be prior authorizations for certain procedures or services, and you may have co-pays up to a certain dollar amount. So, it's important to understand what your coverage is, what your propensity or appetite for risk is, whether or not you're interested in staying with a certain network of doctors, and whether or not you want co-pays in exchange for trying to pay a lower dollar amount upfront.

So, what is best for one person may not be best for another. It's important to understand what the plans are in your area and what all of your options are. I hope that helps! Until next time, be healthy and be well.

Answer: Will you get an annual notice of change every year, or an ANOC? Those who are on a Medicare Advantage Part C plan or a prescription drug plan Part D will receive an annual notice of change annually as the annual enrollment period approaches every October. It's important to review that annual notice of change because it will share with you any changes the insurance company is making to the plan and to coverage.

Now, those who are on original Medicare with a supplemental plan, your supplemental plan will not send you an annual notice of change. The annual notice of change, or ANOC, is only sent to those who are enrolled in Medicare Advantage or a Part D standalone prescription drug plan. I hope that helps. Until next time, be healthy and be well.

Answer: Does Medicare cover hearing aids? In most circumstances, almost every circumstance, Original Medicare will not cover hearing aids. However, if you are on a Medicare supplement or Medigap plan, you should check that plan and call your insurance company or your local Medicare planning advisor. Many supplement plans may offer some type of discount program where you can save money on your aids.

Now, if you are already on a Medicare Advantage, a Part C plan, many Medicare Advantage plans offer some type of reimbursement or allowance for hearing aids. So it's always best to check your coverage and to review your coverage annually during the annual enrollment period to see if there are other suitable options out there that may give you more coverage and lower your cost for hearing aids.

I hope this helps. Until next time, be healthy and be well.

Answer: Irmaa. Now, we're not talking about your great aunt that you only see at Thanksgiving. Irmaa means the income-related monthly adjustment amount. It is effectively a tax placed on higher income earners who are on Medicare. Here's how Irmaa works.

When? Every year, November and December. When you first go on Medicare, Medicare requests information from the IRS about what your adjusted gross income was two years prior. And this is redetermined every year, every November, every December.

Now, if your income is in certain thresholds, then you're going to pay more for your Part B services and your Part D. It's going to be what's called an income-related monthly adjustment amount, or Irmaa for short.

Now, there are guides in the Medicare and You handbook. You can search online and find what those different threshold points or break points are. And you can review this annually because it does change.

Now, if you have a life-changing event, they look two years back. So if you're no longer making the same amount of money that you were two years ago because of a life-changing event, probably the most common is you've retired or reduced your hours. You can ask the federal government for a redetermination, basically saying, "Hey, I'm no longer earning what I made two years ago, and therefore I can't afford nor should be subjected to this higher, effective tax."

I hope that helps. If you have any questions, reach out to a local Medicare planning advisor, contact Medicare.gov, or reach out to your local Council on Aging or Senior Center. All great resources. Until next time, be healthy and be well.

Answer: What do I love most about being an independent Medicare planning advisor? Without a doubt, it's the people. It is helping those find clarity and confidence in their health care decisions. When folks come to us, they're confused, they're stressed, and they're nervous about what their health care coverage looks like and what it costs. Being able to bring the time into that decision and helping give people relief and that clarity and confidence is by far the most rewarding aspect of what we do. Until next time, be healthy and be well.

Answer: What is the best Medicare plan option for somebody that has chronic kidney disease? Now, the word "best" can be subjective. However, with that said, there are a couple of differences that you should be aware of. If you have chronic kidney disease and you have managed care, that is a Medicare Advantage or Part C plan. The managed care may have a doctor network or facilities that you're required to adhere to. There may also be prior authorizations that may be needed.

Now, the other option would be a Medicare supplement or Medigap plan. That plan gives you a lot more freedom and flexibility. You no longer need to adhere to doctor networks. Under original Medicare and a Medicare gap or supplement plan, you can see any doctor, any provider, and facility in the United States that accepts Medicare. So for someone with chronic kidney disease, that may be something that is desirable—the freedom and flexibility to go anywhere or if you need to get care in a different part of the country.

Additionally, with a Medicare supplement or a Medigap plan, you're locking in your healthcare needs or your healthcare costs through that monthly premium, and you're spreading that out over the 12 months of the year. In contrast, with the Medicare Advantage plan, you may have co-pays for all your services, so you may be getting bills every time you get something done. That can add up to a maximum out-of-pocket of several thousands of dollars.

So what is best for one person is not necessarily best for the other, but understanding what your ability is with your freedom and flexibility to get care is the important key. Again, under a Medicare Advantage plan, you may have co-pays up to a certain dollar amount, you may have prior authorizations, and you may need to adhere to a network of doctors and facilities. Under original Medicare with a Medigap or supplement plan, you have the freedom and flexibility to see any provider, any facility within the United States who accepts Medicare.

I hope that helps. Until next time, be healthy and be well.

Answer: How do you know if a Medigap, or Medicare supplement plan, policy is right for you? Well, there's a number of things you need to consider here.

One, what is your financial condition? What are your financial needs? What does your retirement savings and retirement picture look like? What are your health care and health coverage needs? Those all factor into which direction you should go.

And if you go with a Medicare supplement plan, which plan? Type? There are a couple of ways that you can get some assistance with this. You may find some resources with a local senior center or Council on Aging. You can talk directly with an insurance company. You can research on your own. Medicare.gov has a lot of great information out there. And you can also seek the assistance of a professional. An independent Medicare planning advisor can help you determine what are the most suitable options for your coverage in your financial needs.

Now, when is the right time to enroll in a Medicare supplement plan? This may depend on the state you live in. Most states guarantee issue Medicare supplement plans when you first go on Medicare Part B. What does that mean? That means the insurance company is not going to look at what your current or past health history is. If you don't get a Medicare supplement plan in most states later on in life, you may be subject to medical underwriting. Based on your current or past health conditions, the insurance company may charge you more money or may decide not to cover you at all.

So, the most appropriate time to get on a Medicare supplement plan is usually when you first go on Medicare, if that's the way you want to go. If you want one later in life, you should try to make that switch before your health needs dictate that, before you develop a critical illness, chronic injury, or predispose yourself to routine and frequent care.

Now, if you are on a Medicare Advantage plan, which terminates, that provides you with a guaranteed issue right into a Medicare supplement plan. So if you do have past or current health conditions and you want a Medicare supplement plan, that may be one of the few guaranteed issue rights for you if your state requires medical underwriting.

I hope that helps. Until next time, be healthy and be well.

Answer: All right, you have Medicare. You have a supplemental Plan G and a Part D prescription drug plan, but you're still facing some very expensive prescription drug co-pays. When you go to the pharmacy, it's important to review your coverage and your plan annually because every insurance company has a different plan formulary, a list of covered prescriptions.

Now, if you're continuing to pay a lot of money for your prescriptions, there may be another plan out there that has a more favorable plan formulary or coverage for you. Not all prescriptions are covered by Medicare and Medicare Part D. If your prescription is not covered, there are a number of solutions for you.

First, you can look towards a grant or a foundation to provide you with financial assistance. You can look to Medicare's low-income subsidy or Medicaid, or the Medicare savings program. You can also look towards services, discount coupon services such as GoodRx. And finally, you can look towards a Canadian pharmacy. Perhaps the Canadian Med Store or Maple Leaf Funds are both reputable Canadian pharmacies that you may search.

I hope that helps. Until next time, be healthy and be well.

Answer: What are the challenges with the Medicare Part A funding from an aging population? Great question! Medicare Part A is funded from the Medicare trust fund. Now, the Medicare trust fund is funded from payroll taxes. A portion of an employee's payroll in the company contribution funds Medicare Part A in the Medicare trust fund.

Now, with an aging population, we're seeing higher utilization. What do I mean by higher utilization? We're seeing more hospitalizations, more operations, and surgical procedures. We're seeing more and more people needing other assistance while under Medicare care. So, an aging population coupled with fewer workers paying into the Medicare trust fund certainly presents structural challenges.

There may need to be regulation changes, perhaps increasing payroll taxes to further fund the Medicare trust fund. Perhaps changing how the government is allowed to invest those funds. There are a number of options that our legislation is going to have to consider and going to have to make in order to continue having a properly funded Medicare trust fund.

Great question! Until next time, be healthy and be well.

Answer: Every year, you stress about your Medicare plan when it comes to the annual enrollment period in October, November, and December. It is a challenging time. Their plan changes, your healthcare needs change, and you choose your plan. You stress about that. You get into the new year and you receive a lot of bills. Are there any ways that you can just simply have peace of mind? There are. If you're receiving a lot of bills, it means you're either on original Medicare A and B with no additional supplemental coverage, or perhaps you're on a Medicare Advantage Part C plan. If you want coverage where you don't need to worry about doctor networks and receiving a lot of bills when you go to the doctors or the hospital, original Medicare paired with a Medicare supplement, a Medigap plan, and a Part D prescription drug plan may be a good solution for you. I think overall the importance is to meet with a well-versed and knowledgeable independent Medicare planning advisor who can help you understand your coverage and take a lot of that stress off of your shoulders. It is by far the best way to become educated and to understand what your options are and what you might be looking at in total cost over the coming year. I hope that helps clarify some of your questions. Until next time, be healthy and be well.

Answer: Okay, you're new to Medicare. You're approaching Medicare. How do you get educated about Medicare? Well, you can do it on your own. There's a number of extremely useful websites, like Medicare.gov, and a number of Medicare one-on-ones on YouTube. That can all be very good resources for you to learn about Medicare. Additionally, there should be a number of seminars or resources within your local community, either put on by insurance companies, local Councils on Aging, or senior centers, as well as independent Medicare planning advisors in your area. Those are all excellent ways to learn about Medicare and to understand what Medicare covers, what it does not cover, and your options to fill the gap.

I think some of the places you shouldn't learn about Medicare are while your friends and family are well-intentioned and mean well. We don't know what we don't know. So obtaining advice from a friend or family member could be detrimental to your health coverage and financial wellness. Additionally, a lot of people rely on their doctor's office. Now remember, doctors, and particularly the people at the front desk, I don't mean to disparage these folks. They're exceptional at what they do, but they are not taking into consideration your financial well-being, your financial means, and your overall total health care coverage requirements. They can be a good source for information, but in taking advice about what plan you should or should not enroll in, you should be speaking to a licensed Medicare planning advisor with the best advice in your area.

I hope that helps. Until next time, be healthy and be well.

Answer: What are the most common misconceptions when it comes to Medicare? Great question. I think the biggest is many people believe Medicare is free, and that's not the case. There's a premium for your Part B services, and then there's a deductible for your hospitalizations. There's a deductible for your doctor's appointments and other medical services. And then Medicare generally only covers about 80% of your health care.

Additionally, there is no coverage for dental or vision. There's no coverage for long-term care, and there are some significant gaps when it comes to skilled nursing rehab or home health care. Additionally, many people believe that you're automatically enrolled or that you're required to enroll. Neither are true. If you're already collecting Social Security, you may automatically be enrolled in Medicare. Now, if you're not, you need to proactively enroll yourself.

Now, when it comes to the question, are you required to enroll in Medicare? If you work for an employer that has 20 or more employees on their group health insurance and you have that group health insurance, you are not required to enroll in Medicare. I hope this helps answer some of the bigger misconceptions about Medicare. Until next time, be healthy and be well.

Answer: So you've just turned 65 and you have access to employer group insurance. Do you have to enroll in Medicare? Will you have a late enrollment penalty? This is a great question, and I think it's one of the biggest misconceptions folks have when they turn 65 and enter the Medicare age. As long as you have employer coverage with 20 or more employees, you do not need to enroll in Medicare Parts A or B. However, it is beneficial to review both from a cost-benefit analysis. Your group employer plan compared to what your options are under Medicare.

For many people, Medicare not only provides more affordable coverage but also provides more comprehensive coverage in terms of lower copays, lower deductibles, etc. So it's worth taking a look and seeing what is the best option for you and for your situation. Again, if your employer has more than 20 employees, you do not need to enroll in Medicare Parts A and B, and you will not be subject to the late enrollment penalty.

You will need to have your employer sign a form later on in life. That form does one of two things. That form will create a special enrollment period for you, and it will also tell the federal government that you had employer credible coverage. Hope you be well. Until next time, have a great day!

Answer: It is estimated that there is $120 billion worth of fraud in the Medicare system each year. One of the ways that you can help guard against this is to protect your Medicare number, just as you would your Social Security number. The other thing you can do is monitor your Medicare summary notice or your Advantage company's explanation of benefits. This is a notice that will list any claims that have been filed on your behalf. It's important to review these notices to make sure the claims that are being filed are for services or equipment that you actually had for yourself. If you find something on either of these notices, it's important for you to notify Medicare at 1-800-MEDICARE, or your Medicare Advantage insurance company. Again, the best thing you can do to avoid fraud and protect against this in the Medicare system is to protect your Medicare number, just as you would your Social Security number. Until next time, be healthy and be well.

Answer: I enjoy making what seems like a stressful and complex decision simple. When I break Medicare down to its most simplistic form we are able to help make Medicare Planning an enjoyable process.

Medicare is the intersection of your health coverage and financial wellness! I love helping individuals understand the gaps in coverage and the ways to fill those gaps to provide maximum coverage to protect their financial wellness!

In helping break Medicare Planning down into simple to understand steps, we love seeing the confidence and peace of mind clients have once making the transition to Medicare.

Answer: First and foremost- review your coverage annually! The plans may change what prescriptions are covered, and the plans may change your cost sharing structure. Also, your prescriptions may change.

What was a good prescription drug plan in one year, may not be the most comprehensive in the next.

Also, since you take different prescriptions than your friend or spouse, the plan that your friend or spouse loves may not be the most affordable for you.

For prescriptions that are expensive under Medicare Part D plans, or are not covered, there may be a foundation or grant that can provide financial assistance. And lastly, there are several online coupon sites that may provide more affordable coverage for certain prescriptions.

Answer: First, Thank you for your years of public service! The FEHB plan is amount the most comprehensive at the an most affordable rate!

I always recommend enrolling in both Medicare Part A and B. Part A usually does not have a cost and provides extra protection.

While there is a monthly premium for Part B there are two really good reasons to enroll in it: 1) If ever you should need Medicare A/B in the future you will avoid a late enrollment penalty, and 2) FEHB plans coordinate well with Medicare and will often reduce your cost sharing.

The prescription drug coverage under FEHB plans is usually more comprehensive than what you can get under Medicare Part D plans, so we usually recommend you skip adding one.

I always recommend you keep your FEHB plan, because it remains one of the most comprehensive retiree coverages out there.

Answer: It depends on:

1) Is it a sales seminar or educational?

2) the agent conducting the seminar

In the Medicare world there are educational seminars and sales seminars. Sales seminars talk about specific plans and benefits. An educational seminar cannot discuss specific benefits - but rather reviews Medicare Planning concepts.

In an educational seminar, agents are limited in the information they ask for from you and they cannot schedule an appointment with you before, during, or after the seminar. You must reach out to them. The agent is able to collect a consent to contact and will need to follow up with you at a later date.

In my opinion, you will know you have a good agent if they provide purely educational content. If there is a sales pitch - find someone else.

Answer: People are most comfortable with what they know and like. One of the greatest mistakes I see people turning 65 make is not comparing their group health plan to their Medicare choices. For those turning 65- it is important to review all the options.

For one, your group health plan may not be what Medicare calls "creditable". If its not creditable you run the risk of not having the coverage you thought you had, and you may be subject to a late enrollment penalty.

For most, we find moving off the group health plan onto Medicare is not only more affordable but provides more comprehensive coverage without deductibles or copays.

Answer: I am not aware any insurance plans that offer gift cards and incentives to enroll. Actually that is specifially prohibited by your states Division of Insurance.

I do think much of the advertising around Medicare Advantage plans - highlighting the annicillary benefits offered is a bit misleading. This is why it is important to work with an independent broker who represents multiple insurance companies AND shows you both supplemental (Medigap) plans and Advantage plans. The independent broker can help you understand the pro's and con's of each and help you identify which option is most suitable for your particular option.

An important question to ask anyone helping you is: Are you an independent broker and how many different insurance companies do you represent. And will you show me both Supplemental and Advantage plans. You want a broker who will show you both options and discuss the pros and cons of each. And you want an independent broker who represents multiple insurance companies.

Answer: Yes. However, you may have to pay a premium for your Part A coverage if you do not have the full 40 work credits. You should talk with a certified medicare planning advisor to review your particular situation. There may be enrollment period questions or late enrollment penalty situations that you might need to revew.

Answer: It is important to check in with your parents to make sure their enrollment was completed and completed with the plan they wanted. You should check in to make sure they recieved their insurance cards and documents. That way they (or you..) don't end up at the pharmacy or doctors office without their information. A lot easier to address any issues or concerns early on verse months later.

Sometimes the daily rigors of life can get in the way and submitting an enrollment is a lost in the daily grind. By following up you can ensure an enrollment period has not been missed and your parents are enrolled in the plan they intended to.

Answer: It may. This is a great illustration as to why it is important to check your prescriptions with each plans formulary (list of covered prescriptions). What is a good plan for your friend may not be such a great plan for you. You each likely take different prescriptions and each insurance company and plan covers prescriptions differently. Therefore, it is imperative to run your prescriptions through a tool that can compare your prescription needs with all the available plans in your area. And it is important to check annually during the annual enrollment period.

Answer: What are my current and future healthcare needs, and how will the decisions I make today affect the coverage I might be need in the future. As you think about this, know that Medicare doesn't provide coverage for everything and you may need to consider additional coverage such as: Cancer/Critical Illness, Hospital Indemnity, or Recovery and Homecare coverage. Build your Medicare Planning around protection packages. This is why we say Medicare is the intersection of your healthcare and financial wellness!