Andy Kelly, Medicare Insurance Agent

Answer: What are the measurable differences between "Original Medicare" and "Medicare Advantage? (The pros/cons of both)

Answer: Medicare Advantage plans may have a zero premium each month, but they will also have a annual "out of pocket" maximum. This amount may be significant and certainly may be equal or greater than the premiums that you might have paid for a Medicare Supplement with Original Medicare. It's important to review the pros/cons of both and to choose the plan that best meets your individual needs.

Answer: You should seek out a plan that hits the "sweet spot" between monthly premium and potential "out of pocket liability."

Answer: A shrinking workforce in the U.S. over the next 20 years is likely to increase financial pressure on Medicare, leading to higher costs, potential funding shortfalls, and challenges in providing adequate care to the aging population. Policymakers will need to make difficult decisions about how to balance the needs of an older population with the realities of a smaller tax base, possibly through increased taxes, reduced benefits, or other reforms. Ensuring the sustainability of Medicare in the coming decades will require a combination of strategies, including workforce policies, healthcare reforms, and fiscal adjustments.

Answer: Doctor's have to, annually, engage with the various Medicare Advantage plans. I'd suggest double-checking with your doctor to see if they are connected with your MAPD provider. If they are, you're good to go! If they are not, I'd reach out to your MA plan and question the initial sign up communication. If your MA provider used to be in network and now is not...they have created a "special enrollment period" and you should be able to try and move to a new MA plan that your doctor is enrolled.

Answer: Many people leave Medicare Advantage plans because they don't like the restrictions regarding "in network" doctors. Many seniors also like the stability of knowing 100% what their out-of-pocket medical expenses will be. With the "Maximum Annual out of Pocket" in MA plans the out of pocket can actually be significantly more than with original Medicare and a supplement.

Answer: Since Medicare Supplements are guided by Federal Expectations, the most important question relates to the agent who sells and manages the supplement, as well as provides Part D coaching on an annual basis. I work with Bankers Life and pride myself in offering the very best customer service possible to my clients.

Answer: The Medigap Birthday Rule is a regulation in certain U.S. states that allows Medicare beneficiaries to switch their Medigap (Medicare Supplement) insurance plans without medical underwriting around their birthday. This gives people a chance each year to change plans without worrying about being denied or charged more due to health conditions.

States with a Medigap Birthday Rule (as of 2025):

California

Oregon

Idaho

Illinois (similar rule, but not called the Birthday Rule)

Answer: I'm happy to help! It makes things so much easier to sit down with an agent who specializes in Medicare. I work with both Original Medicare and Medicare Advantage and am committed to helping you find the policy and coverage that best meets your needs and the needs of your family!

Answer: From my perspective, the "N" plan offers the best value for most seniors. The only significant difference between the "N" and "G" plan is a $20 co-pay at the doctor and $50 co-pay at the ER if you're not admitted, with the "N" plan. The difference in monthly cost typically makes the "N" make the most sense for many of my clients.

Answer: Nothing really :-) But there is no reason to delay because there is no out of pocket expense at 65 to start your Part A. I encourage clients to start their Part A and just have it as back up to their spouses' insurance.