Bill Green, Medicare Insurance Broker

Answer: So whatever Medicare plan you need in order to have in-home caregivers, there's two types of home caregivers. There's the medical skilled ones, like someone who's coming in to change your wound or help with IV infusions and that sort of thing. Those could be covered under any Medicare plan, whether it's a Medicare supplement or your deductible.

With Medicare Advantage plans, you'll have some costs with it. More likely, though, you might be asking about in-home caregivers, like just a home health aide, someone to help around the house with what's called custodial care. So unfortunately, Medicare does not pay for any custodial care, really anywhere. It used to many years ago, but they don't have that built in anymore.

That's why it's important when you're able to qualify health-wise that you purchase either a home health care policy or a short-term or long-term care plan. Care here has gotten really expensive for the past three years. There are new ways of doing it to make it more cost-effective and better overall. Short-term care can really suffice for a lot of situations. It’s relatively inexpensive, and home health care as well is even less costly.

It can provide what you need, so it's important to look for those things before you actually need care. If there's any question about this, I'm happy to help out. Here at Grand Church,

Answer: Hey, so this is a great question. Moving on to Medicare, Medicare supplement is different than an Advantage plan. So in Medigap Medicare supplement, you don't necessarily have to change plans. However, I will say that New York is known for some very high premiums on their Medigap plans. So it could very well be worth it to explore those new plans here in Florida, where we're located, to see if you can save some money. Worst case, we can’t save you some money. Well then, keep what you got. Best case, you'll save yourself a few dollars a month, 20, 30, or even $100 more per month. It just depends on where you live, what your health is like, if you qualify, and then what other plan you want to look at. Hope that helps y’all!

Answer: So if you're on disability, that means you are on Social Security early or you got your full retirement early because of a disability. There's two ways to look at this. One is you're under age 65 and you're now going to go on Medicare. This works 24 months after your Social Security disability date. This could be prior to age 65. Your card is going to show up in the mail 24 months after your disability date.

Let's say you're disabled at age 64. It's not been 24 months, but you're not turning 65. So then you'll just go on Medicare at age 65. So essentially, it's either you're going to turn 65 before you're 24 months or if you're going on disability and you want a disability more than two years prior to turning 65, you'll be enrolled into Medicare 24 months after that.

If you're already on Medicare disability and you now turn 65, that's a little bit different. You can certainly keep your current plan. No changes required at all. It does open up a window, though. We can get into a Medicare supplement or Medigap plan without any health questions. Many of the people we work with who go on disability prior to age 65 and upon an average plan just because of the costs overall. And then at 65, we always work with them to see if they'd rather switch to a Medicare supplement or a plan that doesn't trade off if you're going to pay for that plan. But the other pockets are significantly less.

So I hope that answers your question. And we're always here to help you.

Answer: Hey, so looking at your question, you picked the plan with the lowest premium and you're getting surprise bills. Without more context, it's kind of hard to know whether you picked a Medicare Advantage plan or a Medicare supplement plan. I'll go on the supplement first. It sounds like you probably picked a high deductible Medicare supplement. They're generally very low premium, but you pay a deductible first.

Next year, we're looking at $2,800. Usually, I recommend those to people who are either very healthy and barely gonna use it at all but still want complete freedom and access, or people who could afford to pay a higher out-of-pocket. So it gives you freedom, access, choice—any doctor, anywhere, at any time. But you do have a rather large $2,800 plus deductible to satisfy before it kicks in 100% like a regular plan.

You would. It could be a Medicare Advantage plan as well. Many Medicare Advantage plans are a very low or no premium, but then you pay copays basically as you do everything other than usually primary care and lab work. So again, it's hard to know which one you have based on this information. But again, hierarchical plans we usually recommend to people who are healthier or at least a whole lot in the Medicare Advantage.

More good news is the type of shopping—you can pick a different plan. Or even if you're unhappy with your high deductible plan, annual normal is time period. We can shop those plans as well. I hope that was helpful and answered some questions for you.

Answer: Having Plan G, Part D, and some expensive medication costs is rather not ordinary. When it comes to medications, it's a matter of where the medication is filled. If you're getting it from a pharmacy, Walgreens, CVS, your local grocery store, wherever it is, it would fall under your Part D drug plan, which this year, as long as the medicine is on the formulary, has a max out-of-pocket of $2,000. However, if, say, your medication is not on the formulary and you're paying full retail costs for it, then it would not count towards the $2,000 max. If it's not on formulary, that's when people want to work with their agent to try to ask for it to be added to a formulary. I won't say it's a 100% success rate, but I've seen a vast majority get approved. The other thought or option is if it's administered in a medical setting, like a doctor's office, hospital, or cancer treatment center, even if it's not a cancer medication, it should be billed under Part D. This would mean once you measure a doctor for medical care, you're covering anything else for it. It sounds like there's something either funky going on with the billing or maybe if it's through your Part D, it's just not on the formulary. Either way, this doesn't sound normal. I would definitely reach out to the agent, and they'll just set you up on this plan and ask them to help out.

Answer: So, which people know about Medicare and its parts? Well, it's the alphabet soup of Medicare. Part A covers your hospitalization and stay in a skilled nursing facility. I like to relate it to your lumpy bed and your bad food. Part B is your doctors, labs, exams, tests, procedures, ambulance, emergency room, even medications when it comes to things like chemotherapy and IV infusions. Basically, any medicine that's not a medicine out of the pharmacy. But D is your drug plan. Something new with drug plans for this year is it may not have a $2,000 max in the pocket, which is great for those who have expensive medications. And then there's also what's called Part C of Medicare. Somehow A plus B plus D equals C. Thank you, government math. A C plan is a Medicare Advantage plan that combines your A, your B, and most of the time your D into an all-in-one plan. And then also, it's not one of the parts of Medicare, but you have Medicare gap or Medicare supplement plans that fill in the gaps of Medicare A and B. I hope that was helpful, and I look forward to welcoming you soon if we can help you out.

Answer: So this is a question we get asked all the time. Why do I have to pay $200 plus per month when my friend pays nothing? Well, if you're paying a premium for a plan, $200, you are almost certainly in what's called a Medicare supplement or a Medigap plan. The way I describe those is you're paying for freedom, choice, and access. Almost any doctor, anywhere, anytime, no questions asked. And you have a very low out-of-pocket. On a Plan G, you have a deductible of $257. On a Plan N, you've got the deductible. Then the most you pay at any doctor's office is $20. That's when you're paying a $200 premium versus your friend who pays nothing for their plan. They're almost certainly on what's called a Medicare Advantage plan. Those are the HMOs and PPOs of the world. There is nothing wrong with them. There's no one size that fits all in this world except for Jesus. Everybody needs him. But that's why not everyone should be on a Medicare Advantage plan, and not everyone should be on a Medicare supplement plan. It's a matter of what's the right fit for you. So a supplement plan, again, you're paying for freedom, choice, and access. A Medicare Advantage plan is very much like your group health insurance. You pick from a network of doctors. You have to pick a plan that has your medicines covered. You have co-pays for basically everything you do. You might have referrals on HMOs, not all of them though. You don't have referrals required on PPOs. You'll have prior authorizations. These plans throw in extras like dental, vision, hearing, gym membership, and money spent at the pharmacy. If you have Medicare, Medicaid, or a chronic health condition, you can even get one of those elusive food cards that you've probably seen a million commercials about. That's really just a bit. If you're paying a premium, you have freedom of choice. Any doctor, anywhere, any time. If your friend or you decide not to pay a premium, you'll stick to a network of doctors. I hope that answers your question.

Answer: Yes, if you're retiring next year and will be losing employer coverage, there are a few important Medicare steps to plan for. First, make sure you enroll in Medicare Part A (unless you have a HSA plan). Then when you are at least 3 months from retirement apply for Part B using the proper forms from social security (CMS40B and CMSL564) if your employer coverage is ending. You’ll want to time your enrollment so there’s no gap between your work coverage ending and Medicare starting. If you’ve delayed Part B because you were still working, you qualify for a Special Enrollment Period, which helps you avoid penalties and let's you pick any plan you want without health quetions. You’ll also need to decide whether to add a Medicare Advantage plan or a Supplement plan, and a Part D drug plan, depending on your health needs and budget. Talking with an experienced agent ahead of time can help you make a smooth transition and avoid any surprises.

Answer: This is such an important question, and one that doesn’t get asked enough. Medicare clearly states in the Medicare and You handbook that it does not cover long-term care—things like help with bathing, dressing, or full-time nursing home care. Many people assume it’s included, only to find out later that it’s not, and by then it's almost always too late to get it because they can no longer qualify based on their health. The good news is there are several ways to prepare for long-term care costs, and we can help you explore options that don’t follow the old use-it-or-lose-it model. Today’s plans often provide a benefit whether you use the care yourself or pass it on to a beneficiary. Planning early not only protects your retirement savings—it also gives you more choices and peace of mind for the future.

Answer: One Medicare decision too many people regret later is not considering a Medicare Supplement plan when they first become eligible. At that point, you're usually in what I call a "get out of jail free" window, meaning you can get a plan with no health questions asked. But if you wait and try to enroll later, you may have to go through medical underwriting—and could be denied based on your health. Some people start with a Medicare Advantage plan to save on monthly premiums, only to find out later that their out-of-pocket costs are higher than expected or that their preferred doctors aren’t in-network. By then, switching isn’t always simple. That’s why it’s so important to look at your long-term health needs and not just what seems cheapest upfront.

Answer: The new $2,000 out-of-pocket maximum for drug costs, starting in 2025, is a game changer for many people on Medicare. Prior to 2025 there’s been no true cap on what you can spend each year for prescriptions, and that’s left some people paying thousands—especially for specialty drugs. Starting in 2025, once you hit $2,000 in out-of-pocket costs for covered medications, you won’t pay anything more for the rest of the year. But here’s what’s even better—you might not actually have to spend the full $2,000 yourself. Some enhanced Part D plans are structured to help you reach that cap sooner, meaning your actual out-of-pocket costs could be much lower. It’s a big step forward for making medications more affordable and helping people stay on track with their treatment.

Answer: One piece of advice I wish every senior knew before picking a Medicare plan is to talk to an independent agent who can walk them through all their options based on their specific doctors, prescriptions, and health needs. Too many people choose a plan just because a friend or family member recommended it, but no two people have the exact same medical situation. What works great for someone else could end up costing you more or limiting your access to care. Medicare isn’t one-size-fits-all, and the wrong decision can stick with you for the rest of your life! An independent agent can compare multiple companies and plans without being tied to just one option. It’s one of the smartest steps you can take to avoid surprises down the road.

Answer: Yes, absolutely. In addition to paying Medicare Part B, Part D, and Medicare Advantage (Part C) premiums, you can also use your HSA funds tax-free to cover out-of-pocket costs like copays, coinsurance, and deductibles for those plans. That includes copays at the pharmacy under Part D or doctor visit copays under a Medicare Advantage plan. HSA funds can also be used for dental, vision, and hearing expenses—even if Medicare doesn't cover them. Just remember, once you're enrolled in any part of Medicare, you can no longer contribute to your HSA, but you can continue to spend what you've already saved. It's a great preplanning tool for managing healthcare costs in retirement with tax advantages.

Answer: An underrated benefit of Original Medicare is the flexibility to see any doctor or specialist in the U.S. who accepts Medicare, without needing referrals or staying in a network. This level of access is especially valuable for snowbirds, frequent travelers, or anyone wanting care at top hospitals across the country. But what many people overlook is that while the access is great, Original Medicare only covers 80% of approved services, and there's no cap on what you pay out of pocket. That means you're potentially responsible for an unlimited 20% of the costs unless you add a Supplement (Medigap) plan. For people who want both freedom and predictable costs, pairing Original Medicare with a Supplement can be a smart move. It’s not ideal for everyone, but for those who value nationwide access and lower financial risk, it’s definitely worth considering.

Answer: That’s a common question, and the answer is—it depends. During the Annual Enrollment Period (Oct 15–Dec 7), you can leave a Medicare Advantage plan and return to Original Medicare, and you can apply for a Medigap (Supplement) plan. However, in most states, Medigap insurance companies are allowed to ask health questions and can deny coverage if you're not in a guaranteed issue window. The good news is that different companies have different underwriting guidelines—some may be more lenient with certain health conditions than others. That’s where working with a knowledgeable agent really makes a difference—we know which carriers are more likely to accept specific health issues and can help you navigate the process. So while switching is possible, having expert guidance can increase your chances of getting the coverage you want.

Answer: Annuities can play a valuable role in retirement planning, especially for those looking to create stability and peace of mind. While they’ve been criticized in the media, many people don’t realize that pensions and Social Security are both forms of annuities—guaranteed income for life. Just like any financial tool, there are good annuities and bad ones, and the key is finding the right fit based on your goals. We typically look at annuities for people who are risk averse, want to replace bonds in their portfolio, need a guaranteed income stream, can’t qualify for long-term care insurance, or want to leave a financial legacy. They’re not right for everyone, but for the right person, they can offer protection, predictability, and tax advantages. The most important thing is working with someone who can help you sort through the options without a sales pitch.

Answer: For people with disabilities, Social Security and Medicare are closely connected. If you're under 65 and approved for Social Security Disability Insurance (SSDI), you’ll automatically become eligible for Medicare after receiving disability benefits for 24 months. At that point, you’ll be enrolled in both Part A and Part B. If you have ALS, Medicare starts right away with no waiting period. Your Part B premium will typically be deducted from your Social Security check, just like it is for those 65 and older. From there, you can choose to add a Medicare Advantage or Part D drug plan—or even a supplement, depending on your situation. It's a complex process, but having someone guide you through your options can really make it easier.

Answer: If you're already retired and collecting Social Security when you turn 65, you’ll be automatically enrolled in Medicare Parts A and B. Your red, white, and blue Medicare card will typically arrive about 3 months before your 65th birthday. Part A is usually premium-free since you've paid into it through taxes, but Part B does come with a monthly premium, which will be deducted from your Social Security check. If you don’t want Part B right away—for example, if you have other coverage—you’ll need to actively opt out. This is also the time to look at whether a Medicare Advantage or Supplement plan makes sense for your situation. It’s a good idea to talk through your options with someone who can help make sure your coverage fits your needs and budget.

Answer: That’s a great question, and one we hear a lot. Even though you’ve paid into Medicare through payroll taxes, that mainly covers Part A, which is hospital insurance—not everything. Part B, which covers outpatient care like specialist visits, has its own monthly premium and usually only covers 80% of the cost after you meet the deductible. That means you’re responsible for the remaining 20%, and there’s no out-of-pocket max unless you have additional coverage. This is where a Medicare Advantage or Supplement plan can help reduce or cap those costs. It’s frustrating, but you're not alone—Medicare can feel like a maze, and that's why it's worth reviewing your options to see what might lower your expenses moving forward.

Answer: The biggest disadvantage of Medicare Advantage is that it typically comes with a network of doctors and hospitals, so you’ll want to make sure your providers are in-network to avoid higher costs. But for most people, this isn’t a big shift—it’s similar to the HMO or PPO group or marketplace insurance you’ve likely had throughout your working years. Just like before, staying in-network usually gives you the best coverage and cost savings. These plans often have low or even $0 premiums, which can make them a more affordable option than Medicare Supplement plans. Not everyone can afford a monthly premium for a supplement, and that’s okay—what matters most is finding the right balance between cost and coverage. There’s no one-size-fits-all answer, and that’s why working with someone who understands both options really makes a difference.

Answer: People under 65 can qualify for Medicare if they meet certain conditions. The most common reason is receiving Social Security Disability Insurance (SSDI) for at least 24 months. Individuals with End-Stage Renal Disease (ESRD) who require dialysis or a kidney transplant can qualify without waiting 24 months. Those diagnosed with ALS (Lou Gehrig’s disease) qualify for Medicare immediately after they start receiving SSDI benefits. Some people may also qualify through a spouse’s work history, even if they haven’t worked enough themselves. It’s always a good idea to speak with a knowledgeable Medicare agent to understand your specific eligibility and coverage options.

Answer: The biggest mistake seniors make when enrolling in Medicare is assuming all plans work the same or that they’ll be automatically covered the way they expect. Many choose a plan based on a friend’s recommendation or a TV ad without checking if their doctors, prescriptions, or hospitals are actually in-network. Others miss key enrollment deadlines, which can lead to lifelong penalties or gaps in coverage. Some don’t realize that Medicare doesn’t cover long-term care or dental, vision, and hearing without additional coverage. It’s a complex system, and one-size-fits-all doesn’t work. That’s why working with a local, experienced agent who understands your specific needs can save you time, money, and a lot of headaches.

Answer: Following up with your parents after discussing Medicare can be helpful for clarity, especially since they are almost certainly on Medicare as well. However, it’s important to remember that parents often bring their own medical and financial biases into the conversation—based on their experiences, not necessarily your current options or needs. Medicare has changed significantly over the years, and what worked well for them may not be the right fit for you. Still, having the conversation can help them understand your decisions and avoid confusion down the road. It can also open up discussions about family medical history, long-term care planning, and future caregiving roles. Just be sure you’re making choices based on your situation, not theirs

Answer: One client came to us after receiving a large bill for a surgery they thought was fully covered. They had enrolled in a plan over the phone with a national call center and weren’t aware the surgeon was out-of-network. After reviewing their plan details, we discovered that while the hospital was in-network, the surgeon wasn’t—something the call center never explained. We helped the client file an appeal, connected them with the right billing department, and ultimately got a portion of the charges waived. Then, during the next enrollment period, we switched them to a plan that included all their preferred doctors and hospitals. They’ve been with us ever since and now call us anytime something feels off.

Answer: Working with a local Medicare agent means you get personalized, face-to-face support from someone who truly understands the plans and providers available in your area. At Green Insurance Agency, we’ve been helping people in our community navigate Medicare since 2014, and we know how to find plans that keep your doctors and prescriptions covered. Unlike a call center, you’ll have a dedicated agent you can meet with anytime, not just during enrollment. We’re available year-round to help with billing issues, plan changes, and any questions that come up. Plus, we host in-person educational events and offer free resources like our Medicare Breakdown book to make understanding Medicare easier. When you work with a local agent, you're not just a number—you’re a neighbor.