Anthony Mercado, Medicare Insurance Broker

Answer: Check if you qualify for a Special Enrollment Period (SEP), use the Medicare Advantage Open Enrollment Period if applicable, or wait for the next annual window.

Answer: Start the process to enroll in Medicare Part B and determine whether you will have any retiree company benefits. If not, do the homework and find an agent who is certified and can assist with getting the coverage and benefits you need.

Answer: They can be misleading at times because there are too many variables. Best to seek a professional. Certainly do not rely on those commercials to decide on a plan.

Answer: Remote Patient Monitoring (RPM) is a service that enables healthcare providers to monitor patients' health data remotely using connected devices. This is particularly beneficial for patients with chronic conditions, including heart diseases, as it allows for continuous monitoring without the need for frequent in-person visits.

Answer: There are deductibles and no prescription, HEARING, OR VISION coverage. A good Medicare Advantage plan goes a long way here.

Answer: Even if your insurance doesn't require a referral, some dermatology offices have their own internal policies and may ask for a referral from a primary care doctor before they will schedule you. This is more common for high-demand specialists or specific medical skin conditions.

Answer: The scope of appointment form Medicare agents use is not optional paperwork. It is a Centers for Medicare & Medicaid Services (CMS) requirement that must be completed before any substantive sales discussion begins. The form lists the categories of Medicare plans - such as Medicare Advantage (Part C), standalone Part D Prescription Drug Plans, and Medicare Supplement insurance - and you check only the ones you want to hear about.

Answer: 2026 Medicare Extra Help Updates

Income limits (updated annually)

To qualify, your income must be at or below 150% of the federal poverty level:

Single individual: ~$23,940/year

Married couple: ~$32,460/year

Resource limits (increased by 2.4%)

CMS ties annual resource limit adjustments to the Consumer Price Index (CPI). For 2026, the increase is the maximum allowed — 2.4%:

Answer: You should review/reconsider if any of these are true

Your condition requires new specialists you can’t access easily in-network

Your current plan doesn’t cover a new or changed medication (or covers it at a very high cost)

You’re facing repeated prior authorization delays/denials

Your likely care needs increased significantly (e.g., ongoing treatments, frequent therapy, more hospitalizations)

Your plan’s coverage terms now don’t match your reality (e.g., high copays for chronic care)

Sometimes you don’t need to switch immediately

If your doctors and meds are still covered well, you may only need to:

update your medication list for accuracy

ask for exceptions/appeals if something isn’t covered

use prior-authorization processes correctly

check whether you’re eligible for coverage changes within your plan

Answer: They can compare plans side-by-side. Plans vary by:

monthly premium

doctor/hospital networks

drug formularies (which medications are covered)

costs like copays/coinsurance/deductibles

A good agent can search multiple options, so you’re not stuck guessing. They ensure your doctors and prescriptions are covered

One of the biggest risks without help:

picking a plan where your favorite doctors aren’t in-network

choosing a plan that doesn’t cover your specific medications or covers them at high cost

Agents can check coverage details before you enroll.

Answer: Expanding dental/vision/hearing could reduce downstream medical costs such as:

Dental:

Untreated dental infections can worsen health conditions and drive ER/hospital use.

Better oral health is associated with improved overall outcomes (though estimates vary).

Vision:

Identifying conditions earlier can prevent serious complications (e.g., diabetic retinopathy detection).

Hearing:

Hearing loss is linked to higher risk of falls, depression, cognitive decline, and social isolation—though causality varies and studies differ.

Improved hearing can reduce those downstream risks.