Angela Wainright, Medicare Insurance Broker

Answer: IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional amount that some higher-income beneficiaries must pay on top of their Medicare Part B and Part D premiums. It’s important to note that IRMAA is not a penalty. Instead, it is calculated based on your Modified Adjusted Gross Income (MAGI) from two years prior; this is often referred to as a "look-back" period.

If IRMAA applies to you, the Social Security Administration will notify you formally by mail. If you think you might be subject to IRMAA, I strongly recommend that you contact your tax advisor to ensure your information is accurate. Additionally, Medicare.gov offers a Medicare Premium Eligibility tool that can help you estimate whether you will incur IRMAA.

Answer: Medicare covers a variety of preventive services, including an annual wellness visit and screenings for breast, colorectal, prostate, lung, and cervical cancers, among others. It also provides coverage for vaccines like the flu, COVID-19, and pneumonia shots. However, it is important to note that Medicare does not cover routine physical exams, nor does it include routine vision, dental, or hearing exams. Due to these limitations, many individuals opt for additional coverage, such as standalone dental, vision, and hearing policies or Medicare Advantage plans, depending on their specific needs.

Answer: That’s a great question — and honestly, I would never tell anyone they’re not capable of figuring things out for themselves. Of course, you know your needs and preferences better than anyone.

That said, I’d ask, “Why not take advantage of professional guidance that costs you nothing?” Working with a licensed health insurance agent allows you to review your options with someone who studies these programs every year. Agents are required to complete ongoing training, certification, and compliance courses annually to stay current on Medicare rules, plan changes, and enrollment processes.

It’s really about helping you make informed decisions with confidence — not about taking that decision away from you.

Answer: Not if ordered by a Chiropractor. The order would have to come from a medical doctor, then it might be covered. Medicare only covers the chiropractic spinal adjustment itself, nothing else chiropractors generally do.

Answer: There is no set limit for chiropractic coverage, but it is more so determined by whether or not the treatment is deemed medically necessary by Medicare. The chiropractor would have to document that it’s medically necessary spinal manipulation for subluxation. If it's simply for general wellness, it won't be covered.

Answer: Original Medicare is extremely limited when it comes to holistic care. Some medically necessary chiropractic services may receive coverage, but things like acupuncture, massage therapy, naturotherapy, and other services are not covered. Medicare Advantage plans may offer extra benefits like acupuncture or additional chiropractic care, but coverage is not guaranteed and varies by plan and carrier.

Answer: A special needs plan, or (SNP) as we call it, is for individuals with specific health conditions or circumstances. Individuals who are on Medicare and Medicaid may be eligible for a special needs plan. Or those with chronic conditions such as cardiovascular diseases or diabetes. These plans tailor their benefits toward the needs of such individuals and conditions.

Answer: Every Medicare Advantage and Prescription Drug Plan receives an annual quality rating from CMS (1-5 stars). If a 5-star plan is available in your area, you have a one-time Special Enrollment Period each year to switch to it.

Answer: No, Medicare cannot drop you for health reasons. It is a Federal entitlement program. As long as you continue to pay your premiums, you cannot be dropped.

Answer: The first step is ensuring your preferred doctors, clinics, and prescriptions are included in the plan. Once these essentials are confirmed, compare the financial details — premiums, deductibles, and copays. This step-by-step approach ensures your plan is both cost-effective and tailored to your unique healthcare needs.

Answer: CALL ME! In all seriousness - as long as you’ve had credible coverage through your (or your spouse’s) active employment since turning 65, you won’t be penalized for waiting. When you retire, you’ll qualify for a Special Enrollment Period that lasts 8 months to sign up for Part A and/or Part B.

To avoid a coverage gap, it’s best to apply a month or two before your employer coverage ends, since Medicare usually starts the first of the month after you apply.

You can enroll in Medicare Part A and Part B through Social Security (either online, by phone, or in person). I often assist my clients with their Part A and Part B enrollment online.

We may also need to submit form CMS-L564 – this verifies you had employer coverage and protects you from late-enrollment penalties.

Once A and B are active, you can decide which coverage path you would like to take: 1. Medicare Supplement with a Drug Plan or 2. A Medicare Advantage Plan.

Answer: There's no need to navigate Medicare alone. Work with a trusted educator who can help guide you.

Answer: You’re absolutely right—Original Medicare Parts A and B do come with costs. First, there’s a monthly premium for Part B coverage. Additionally, both Part A and Part B have deductibles. Part A’s deductible applies per benefit period, while Part B has an annual deductible. After the Part B deductible is met, you’re typically responsible for 20% of the Medicare-approved amount for covered services (this is called coinsurance).

Answer: I enjoy working with this demographic. I have great respect for my elders, and helping them with their Medicare decisions is one way I can give back to show my appreciation. I love to visit and learn more about people and their needs, which leads me to finding the best solution for each set of circumstances.

Answer: First, I much prefer to have a face-to-face meeting. 2nd, we break Medicare into smaller, more digestible pieces of information. I spend as much time as needed to ensure my clients understand each part. If we have to loop back around further into the conversation to revisit a piece, we will do that. Sometimes it might take more than one visit or conversation to ensure full understanding and I am always more than happy to do it, in fact I encourage it where necessary.

Answer: Doctors dislike Advantage plans, not because they are bad plans, but because of how they are structured behind the scenes. MA plans are run by private insurance companies, which often have prior authorization requirements, more paperwork, and tighter utilization controls. It can slow down the process of administering care to patients, which is certainly frustrating for all involved. Some plans also have limited networks, meaning doctors have to be in-network to get properly paid. Speed of payment can be another point of frustration: traditional Medicare pays promptly, some MA plans might reimburse doctors less, take longer to pay, or deny more claims. In short, Medicare Advantage Plans aren't a bad option; many people are very satisfied with their MA plan. Staying in-network and having minimal prior authorizations makes for a good experience. And so many enjoy the extra benefits like dental, vision, over-the-counter, and fitness benefits.

Answer: Once your out-of-pocket drug costs reach $2,000 for the year (in 2025) (this includes deductibles, copays, coinsurance, and what you’ve paid for medications), you’ll pay nothing for your covered prescriptions for the rest of the year.

That's right—$0 copays for all covered medications once you hit the cap!

Answer: If you're taking multiple medications, the key to choosing the right drug plan is making sure it's tailored to your prescriptions. First, I'll use my comparison tools to identify which plans cover your exact prescriptions and what each will cost each month. Second, we'll want to pay attention to tiers and copays. Not all plans treat your medications the same. Some might put a drug on a higher tier, which means higher copays or coinsurance-even if it's technically covered. 3rd, we want to check for requirements like prior authorization, quantity limits, or step therapy. These can delay access or require extra steps to get your meds filled. Lastly, the pharmacy you use matters. Some plans offer significantly lower copays at "preferred" pharmacies. This can make a big difference over time.

Answer: You’re right to feel confused. This is one of those tricky Medicare gray areas that catches a lot of people off guard.

Medicare does cover cataract surgery if it's medically necessary, and most plans will cover basic, standard intraocular lenses (IOLs). But if your doctor recommends upgraded or premium lenses—like ones that correct astigmatism or reduce your need for glasses—those are usually considered elective or “not medically necessary.”

That’s how they “get away with it.” The coverage stops at the basic option, and anything beyond that becomes your responsibility—just like choosing frames at the eye doctor beyond the covered pair.

It's not always well explained ahead of time, and that’s part of the problem. I always encourage people to ask up front whether any part of a procedure involves “upgrades” that aren’t fully covered, so there are no surprise bills.

Answer: The biggest mistake seniors make when enrolling in Medicare is trying to do it alone.

There’s no need to navigate the process by yourself—working with a licensed Medicare agent costs you nothing.

Why not enlist the help of someone who specializes in Medicare every day?

It can save you time, reduce your stress, and help you avoid costly mistakes down the road.

Answer: There are many good reasons to work with a local agent versus someone remote; 1. You receive face-to-face support. I enjoy meeting and getting to know my clients. Building that relationship also ensures I fully understand their unique situation and needs. It's nice to be able to ask questions, see printed materials, and walk through everything at your own pace. No technical issues! 2. A local agent will be most familiar with and understand which doctors, hospitals, and pharmacies are in-network in your community. We can flag differences in plan networks that others might overlook. 3. We know the regional landscape. Whether it's how Medicare interacts with MN Medigap plans, county-specific Advantage Plans, or local Veteran services, we have more local insight and connections. 4. Availability and support AFTER enrollment. I won't disappear after the paperwork is done. I am here-ALWAYS to support and guide my clients with whatever challenge they are facing, sometimes, it's not even plan-related. 5. Most importantly, you are likely working with a small local business with a trusted community presence. You're not a number, you're a neighbor.

Answer: This is a common question. When you apply for Social Security, you’re typically enrolled in Medicare Part A and Part B automatically if you're 65 or older. Part B isn’t free—it comes with a monthly premium, which is likely what you're seeing in those bills.

If you're already receiving Social Security benefits, that premium is usually deducted directly from your monthly check. But if you’re not yet receiving payments (or only recently started), Medicare bills you quarterly for Part B instead.

So in most cases, you didn’t miss anything—this just means:

You are enrolled in Part B, and Medicare is billing you directly because they’re not taking it out of Social Security (yet or at all).

Answer: It's a great question—and one that gets a lot of attention. It could have both positive and negative effects, depending on how it's done. On one hand, bringing in younger, generally healthier individuals could help stabilize long-term finances by balancing out costs. It could also improve access to care for people who currently struggle with high insurance premiums or go without coverage.

On the other hand, Medicare is already facing funding challenges. Adding millions of people without a clear plan to pay for it could strain the system. It could also impact provider access or current beneficiaries if payments to DRS and hospitals are stretched too thin.

Any major change would need to be carefully planned and funded to ensure it strengthens, not weakens, the program.

My role is to help individuals navigate the system as it exists today and prepare for changes if and when they happen.

Answer: Medicare is a complex subject. I love being able to break it down into simplified, understandable pieces of information. Taking a client from confusion to clarity and confidence is very rewarding for me. Additionally, I love helping my clients long after the education and policy selection. I am there to help decipher documents, such as explanations of benefits, and assist with prescription drug coverage, costs, and refill processes. I'll take questions from clients and find the answers, so they don't have to spend their time waiting on hold to speak with someone.