Andrew Sandlin, Medicare Insurance Agent

Answer: Yes. The reason a Medicare Supplement would be referred to as "Medicare Secondary Insurance" is because Medicare would be your primary insurance coverage and the Medicare Supplement would be your secondary insurance. Medicare pays first and then the supplement pays second. Important to note... the supplement will pay the balance after Medicare pays according to the "Plan Letter" of supplement you chose (i.e. Plan G, Plan N, etc.).

Answer: If you currently have a Medicare Advantage plan, you actually still have the opportunity in the first quarter of the new year (January-March) to change your plan. This is called the Medicare Advantage Open Enrollment Period which is different from the Annual Enrollment Period that runs from October 15th to December 7th of each year. If you don't have a Medicare Advantage plan, you may still be able to make a change if you qualify for a special enrollment period.

Answer: It sounds like you did everything correct and got both parts (A and B) of Medicare active. The reason you are seeing a bill is that Medicare part B does have a cost, and it is $202.90/month for the average American. When you begin taking Social Security, this monthly amount will actually come directly out of your benefit check. It sounds like you aren't taking Social Security yet since they mailed you a bill. Typically this is done in quarterly payments. To make things easier, you can ultimately set up "Medicare Easy Pay" where the monthly amount comes directly out of a bank account as opposed to having to pay it quarterly via paper bill.

Answer: I could answer this question with a novel but the parts I enjoy the most are the relationships, the stories, the "A-ha" moments and seeing the stress leave someone's face when they realize you are truly there to help them. Healthcare becomes an integral part of one's life as they age so being a source of knowledge, understanding and compassion is a pretty amazing feeling.

Answer: If you were working through an agent to sign up for the plan, I would contact them as they will be able to provide you a complete list of dentists in your area as well as highlight the specific dental benefits covered by your plan. They can even filter the results to tailor them to what you may be looking for. If you just signed up for a plan by calling the company, you could look through your member portal, the company website or by calling their customer service directly.

Answer: The easiest way to find out ahead of time is by visiting the medicare.gov website. If you google "What's covered by Medicare" and navigate to the search results associated to the medicare.gov website, you will find their tool to look up any procedure. From here you can search a specific test or procedure and see whether it comes back as covered or not.

Answer: I go about explaining this to individuals with two key points.

1) I point out that just because the Medicare Advantage plan is 0 premium doesn't mean you get out of paying the part B cost each month. Again, the part B cost is going to be there no matter what coverage route we choose to walk down. It is just 0 premium to add the Medicare Advantage plan through whatever carrier we choose.

2) I always explain Medicare Advantage as more of a "pay as you go" system. In other words, the plan itself may be 0 premium each month but we have to understand that when we use the coverage, doctors and hospitals are going to ask us for payments in the form of copays. Overall, we save money upfront by not paying premium dollars each month but we do pay for things when we use the plan.

Answer: My best piece of advice would be to find someone who is a local agent and represents multiple of the different companies. A local agent understands the area and plans where you live as well as the nuances that separate the multitude of options. You also want someone who does represent multiple different companies so they don't "have to try and make what they offer fit" for your situation but can instead show you what best fits your unique situation. An agent's services are also completely free, gives you someone to ask questions, and will remain attentive to your needs as they change over time.

Answer: Medicare covers eye exams that are tied to a condition of the eye (think diabetes or glaucoma) as this falls under an actual medical benefit. However, Original Medicare doesn't cover routine eye exams (think going in just to get your eyes checked) and glasses. With that being said, many of the Medicare Advantage plans (Part C) do cover routine exams and eyeglasses in their additional benefits.

Answer: IRMAA or "Income Related Monthly Adjustment Amount" looks back at income from two years prior. For instance, your 2025 Medicare costs would be determined by your 2023 tax year. With that being said, IRMAA won't automatically go away with an income drop due to the look back period. One of the things you can do is appeal your IRMAA with a change in circumstance (like a drop in income due to retirement). This can be done by completing Form SSA-44 and sending it into Social Security. This is essentially a request to lower your Medicare costs due to a life change.

Answer: Essentially, Original Medicare has two parts: Part A and Part B.

The easiest way to think about Part A is that this typically pertains to expenses associated to being an inpatient in the hospital. In other words, you have a room and I can send you flowers. It also deals with things like home health care, hospice, etc., but for simplification purposes think about it tying to an inpatient hospital stay. In most cases, Part A is premium free for individuals.

On the other hand, Part B is pretty much everything else on an outpatient basis. Think about going to see your doctors, having outpatient testing, an outpatient surgery or even outpatient chemotherapy. One of the biggest things to understand associated to Medicare Part B is that you are responsible for 20% of all costs that fall under this side of Medicare with no limit or "cap" on how much you can owe. Also, Part B has a monthly cost that is set to be $202.90 for 2026 for the average American.

We can certainly get much more in-depth but this is a good starting point for conversation.

Answer: That's a great question! When you sign up for a Medicare Advantage plan, you have a private insurer that is administering your Medicare benefits. With that being said, the part A deductible doesn't go away but your plan has chosen to administer that by charging a $350 copay per day for the first 7 days you are an inpatient. The easiest way to understand it is to simply disregard the part A deductible (as we have an advantage plan administering our Medicare benefits) and focus on the per day hospital copay.

For example... let's say we have a two day hospital stay. With your current Advantage plan you would get a bill for $700 (350 * 2). If you were just on original Medicare we would be working towards satisfying the $1,676 deductible once we checked in. If the two day hospital stay was $1500... that is what we would owe as we are working toward the deductible.

Answer: The main reason to work with an agent is because the Medicare landscape is complex, confusing and constantly evolving. Not to mention, each individual has unique needs, so finding a plan isn't a one size fits all solution since there can be anywhere from 50 to 100 options. Having someone who can break things down into simpler terms and help to put you in the best place possible year over year has huge value. An agent can be your first line of customer service (after all... no one likes calling an insurance companies 800 number) and remain attentive as your needs change. Additionally, working with someone local is also a huge plus as the plan nuances and local knowledge pays off. The best part of it all... our services are at no cost to you!

Answer: In most cases, the two most popular types of Medicare Advantage plans are HMO and PPO. With an HMO plan, you must receive care from in-network providers for expenses to be covered unless it was an emergency as this allows expenses to be covered both in and out of network. HMO plans may also require referrals to see specialists.

With a PPO plan, members find increased flexibility as it allows you to see both providers in and out of network. In most instances, PPO plans also don't require members to seek a referral prior to seeing a specialist.

Additionally, there are several other types of Medicare Advantage plans like PFFS and MSA, but these plans are much less commonly seen. Ultimately, desired plan type is subject to many factors like cost, copays and additional benefits and can be unique to each individual situation.