Bill Brann, Medicare Insurance Agent

Answer: I understand why that's frustrating. The Annual Enrollment Period review is intended to help identify changes in coverage, costs, provider networks, and prescription drug coverage before you make a plan change. However, provider networks can be complex, and sometimes a specialist may leave a network, accept only certain plan products, or there may be misunderstandings about network participation.

That's why it's important to verify that your specific doctors and specialists participate in a plan before enrolling. If you've already switched plans and discovered your specialist isn't covered, there may be options available depending on your situation, such as finding an in-network specialist, requesting a continuity-of-care exception, or determining whether you qualify for a Special Enrollment Period.

Every situation is unique, so it's worth reviewing your plan details and provider status to see what options may be available.

Answer: If your doctor certifies that you need home health services and you're considered homebound, Medicare Part A and/or Part B may cover:

✅ Skilled Nursing Care

Wound care

Injections

Monitoring serious illnesses

Medication management

Education about your condition

✅ Physical Therapy

Strength and mobility exercises

Fall prevention

Recovery after surgery or hospitalization

✅ Occupational Therapy

Help regaining skills needed for daily activities such as dressing, bathing, and cooking

✅ Speech-Language Pathology Services

Speech therapy

Swallowing therapy

Cognitive rehabilitation

✅ Medical Social Services

Counseling related to illness

Help locating community resources

✅ Home Health Aide Services (Limited)

Personal care such as bathing and grooming

Only when you're also receiving skilled care

Not covered as a stand-alone service

✅ Certain Medical Supplies

Wound dressings

Catheters and similar supplies used during treatment

Answer: A lot of people are shocked to learn that even with Original Medicare, a Medicare Supplement Plan G, and a Part D drug plan, specialty medications can still be very expensive. Unfortunately, Medigap plans like Plan G do not help cover your Part D prescription drug costs.

The good news is you still have options.

First, it’s very important to review your Part D drug plan every year. Not all plans cover specialty medications the same way. Sometimes simply changing your Part D plan during Annual Enrollment can save thousands of dollars a year depending on your medication.

You should also look into the Medicare Extra Help program. Many seniors qualify and don’t even realize it. This program can help reduce prescription drug costs significantly.

Another option is checking directly with the drug manufacturer. While Medicare recipients usually can’t use regular copay coupons, many pharmaceutical companies have patient assistance programs for people taking high-cost specialty medications.

It’s also worth asking your doctor if there are:

* lower-cost alternatives,

* biosimilars,

* or different treatment options

that may still work well for your condition.

Make sure you are using the correct preferred or specialty pharmacy required by your Part D plan. This alone can sometimes lower your costs considerably.

Beginning in 2025, Medicare Part D also includes a yearly out-of-pocket maximum for covered medications, which should help protect people from unlimited prescription drug spending.

Every situation is different, which is why I always recommend having someone review your exact prescriptions and Part D coverage every year.

Answer: Medicare Part B is actually what covers your urgent care visits because they fall under outpatient care. Usually, once you've met your Part B deductible for the year, Medicare covers 80% of the cost, and you'll be responsible for the remaining 20% coinsurance.

Medicare Part A doesn't really come into play here since it’s for hospital stays, unless the urgent care visit results in you being admitted to the hospital. To keep your costs as predictable as possible, just make sure the clinic you're visiting accepts Medicare assignment.

Answer: Short answer: No—your Medigap (Medicare Supplement) policy is guaranteed renewable.

As long as you keep paying your premium, the insurer cannot cancel you because of your health or claims.

This protection is required by the Centers for Medicare & Medicaid Services.

Answer: Short answer yes. Common preventive screenings that would normally be covered:Cardiovascular (cholesterol) screening

Diabetes screening

Mammograms

Colon cancer screening (colonoscopy, stool tests)

Bone density tests

Depression screening

Answer: In most cases, you can keep your Medicare Supplement plan when you move—even to another state.

Medigap plans are portable nationwide and work with Original Medicare, which is administered by the Centers for Medicare & Medicaid Services.

Answer: Always look for A rating or better (A.M. Best). You want a company that's going to be around awhile.

Medicare Advantage (MA) plans are graded every year using a 1–5 (5 being the highest rating) star rating system by the Centers for Medicare & Medicaid Services—think of it as a report card for plan quality.

Use these ratings to help guide you to the better plans that are available.

Answer: No, Medicare typically does not cover smart watches or fitness trackers. Durable Medical Equipment (DME).

Answer: Medicare brokers and agents are generally paid by insurance companies, not by the people they help. Using a broker or assistance in choosing a Medicare plan does not cost the beneficiaries any additional money.

Answer: If you tell your plan before you move, 1 month before you move and 2 months after you move.

You get two full months after the month you notify them.

Answer: No, getting married does not cause you to lose your Medicare benefits.

Medicare eligibility is based on age, disability status, and work history, not your marital status.

Answer: Medicare agents and brokers are typically paid by insurance companies, not by you. That means in most cases, you don’t pay anything extra to work with an agent.

When you enroll in a plan, the insurance carrier pays the agent a commission. These payments are regulated by the Centers for Medicare & Medicaid Services to keep things fair and standardized.

Answer: Short answer: No — you cannot be denied a Medicare Advantage plan because of your health.

Medicare Advantage plans are required to accept you regardless of pre-existing conditions, as long as you meet a few basic eligibility rules set by the Centers for Medicare & Medicaid Services.

Answer: If we're discussing original Medicare, such as supplements to Medicare (Plan G, Plan N etc.) then no. These plans are not regulated by the federal government. We are free to discuss pricing, carrier comparisons and underwriting. These are regulated more at the state level.

A scope of appointment is required if we're discussing Medicare Advantage (Part C) or prescription plans (Part D). These are federally regulated by the Centers for Medicare & Medicaid Services (CMS), which mandates documenting the scope of the conversation before the appointment.

Answer: Medicare isn’t a one-size-fits-all program. You’re not just selecting a plan—you’re making important decisions about coverage types, prescription drug benefits, provider networks, and long-term costs. A Medicare agent helps simplify all of that by breaking down your options in a way that’s easy to understand and tailored specifically to your needs.

One of the biggest advantages of working with an agent is personalized guidance. Your health situation, medications, preferred doctors, and budget are unique. An experienced agent takes the time to evaluate all of those factors and match you with a plan that fits your lifestyle—not just a generic recommendation.

Another key benefit is access to multiple insurance carriers. Independent agents aren’t tied to just one company, which means they can compare plans across several providers to help you find the best value and coverage.

Best of all, there’s no cost to you for this service. Medicare agents are compensated by the insurance companies, so you get expert advice and support without paying extra.

Beyond enrollment, a good agent becomes a long-term resource. As your needs change, they can review your coverage annually, help you adjust your plan, and assist with any questions or concerns along the way.

In short, working with a Medicare agent gives you clarity, confidence, and peace of mind—so you can make informed decisions and avoid costly mistakes.

If you’re approaching Medicare eligibility or just want a second opinion on your current coverage, having a trusted advisor by your side can make all the difference.