Brenda Trejos, Medicare Insurance Broker

Answer: For the most part the answer is "Yes." Just because I don't use my Medicare even if I'm in the US or overseas, I still have to pay for it. Its insurance. That said, the question is, "will you have credible health insurance while living abroad?" If so, you could talk to your Agent/Broker and see if there's a lesser cost option, BUT you will have to talk to Medicare directly to "pause" your Medicare. Medicare is a government program and has lots of rules.

Travel insurance is not credible coverage. If you have an emergency overseas, you will want to still have the additional coverage (Medigap or Advantage Plan) that can cover you overseas (check with your Agent) in case of emergencies and especially have it if you return to the US for medical attention. If you cancel or pause Medicare, you can face penalties when you restart it if not done in an official manner.

Its a little complicated, to say the least. If I was you, I'd keep Medicare with the additional coverage and even get travel insurance. The protection & peace of mind are worth every penny.

Answer: Well the gaps exist because your Medicare coverage is basically an 80/20 Health plan with no Max of of pocket (MOOP) limit. That could be a very expensive situation if you have to pay 20% of a large hospital or medical bill, again with no cap or MOOP.

You would be much better off reaching out to an Agent/Broker that can help you find the best coverage & search different Companies for your situation and can help protect you from having to possibly pay $1000's of dollars with no limit.

Your Agent/Broker is there to guide you and should do so without obligation or cost to you from them.

Answer: In regards to Medicare, it comprises 2 parts and they happen to be called Part A and Part B.

Part A is for Hospital coverage. In other words, In-Patient care like hospitalization, skilled nursing & hospice care.

Part B is for Medical coverages. In other words, Part B is for Out-Patient care like office visits, ER and Urgent Care, Surgeons, labs and Ambulance services.

Most Americans have contributed enough through their employment so they have no monthly premium for Part A. Part B does pay a portion (about 20-25% of the total cost) which in 2025 is $185 per month.

Even though Medicare is good medical coverage, it is still advisable that everyone complete their coverage through a Supplement/Medigap Plan or through an Advantage Plan. Talk with an Agent/Broker to guide you through your options.

Answer: Yes, its confusing! Basically, a deductible is a higher amount (usually $500 on the low end and up to $5000 or more) that you need to meet before your Insurance Company starts paying for your medical costs.

A copay on the other hand is usually a set amount (usually around $10 and up to $500) that you pay for a certain appointment or procedure. For ex: a Primary Care appointment might cost a $20 copay, while with your deductible you might pay over $100 for that same appointment. That said, deductible plans usually have a lower monthly premium and Plans with copays are usually more expensive per month.

Until recently, most Advantage Plans did not have a deductible, only copays. Because of the Inflation Reduction Act, more Advantage Plans are now adding deductibles to their Plans.

Answer: Like so many "unique" situations in regards to Medicare, it depends. If the smartwatch is prescribed by a Dr and is needed specifically for your Atrial fibrillation, then there is a chance that it will be covered. It is best to call your Insurance Company directly and ask if they will cover it AND what exactly is needed for you to prove this. You might also be limited to which smartwatches will be accepted. Always jot down the name, date and time of the person you talked to if you need to refer to them later.

Answer: The coverages that will most likely cover you during your time in FL. would be the Medicare Supplement Plans as they cover care with any facility or Dr. that takes Medicare throughout the USA.

Another option would be the Medicare Advantage PPO Plan as it offers nationwide coverage with in & out of network options. In-network would have lower cost than out of network options. It's always wise to double check with your Insurance Company or Broker/Agent and ask about coverage in the area that your will be "snow-birding" to ask about your coverage.

Answer: With a Medicare Supplement Plan F, also know as a Medigap Plan F you would not have to worry about any additional out of pocket expenses that are not covered through Medicare. In other words, if its a Medicare accepted procedure, you do not pay any extra copays or cost. Your Plan covers the "gaps" in costs. You most likely have higher monthly premiums than all the other Medigap Plans, but you also have no additional out of pocket copays for hospital stays, medical visits or procedures.

Answer: "Hum... interesting question." I think that a challenging issue for me to overcome is when a client simplify doesn't care. They're not interested is understanding Medicare, the options that they have and how it works. They're pretty apathetic and probably frustrated with Medicare and/or Insurance as a whole. As understandable as this might be, its not helpful when meeting with an Agent. I do my very best to keep things as simple as possible and still give you all the information you need to make an educated decision about your Medicare coverages. This is a big and important decision and an Agent/Broker can help guide you through this process.

Answer: Not necessarily. Coverage like Critical Illness is supplementary coverage, its not required. It would add value if you thought you could benefit from the policy in case you had a critical illness and then you would benefit from this policy. Its hard to know, but I would suggest it if you can afford it and think there is a possibility that you might use it.

Answer: Yes, most likely. There are certain rules to follow but if you work for an Employer with more than 20 employees (Not kidding... This is a CMS rule), then while you're at that Employer you have "credible coverage" through your work. This means you will not face any penalty when you start Medicare after you're 65+ years old. Now, you will have to have a form filled out by your Employer confirming that you've had coverage before you apply for Medicare. (Form CMS L564) You submit this signed form with your Application for Part B of Medicare.

In summary, when you end employment (voluntarily or not)after you're 65 and 3 months old, you can apply for Medicare through a Special Enrollment Period (SEP) and start the following month on the 1st of the month.

I recommend reaching our with any further questions to a Licensed Broker/Agent to guide you through the process.

Answer: Nothing really... You can stay on your spouse's employer plan and delay enrolling in Part A until you want to transition to Medicare as your primary coverage. As long as your coverage with your spouse is "credible," meaning there are at least 20 employee's in the Group Plan you have nothing to worry about. That said, there is no problem applying for Part A at 65 because you will not have to pay a premium and that way you will already have a Medicare # in the system when you are ready to start Medicare with Part B. Talk to a licensed Agent that can help you understand this and prepare you with cost to you for their expertise.

Answer: I would suggest you meet with an experienced Medicare Agent/Broker to discuss the pros & cons of each Plan as well as go through the nuances that a change would cause. There are options to try out a Advantage Plan for the 1st time called a "trial right." This would allow you to experience having an Advantage Plan for up to 12 months and if you do not like it you can return to your original Supplement Plan. Again, talk to an experienced Agent/Broker that can guide you and talk through the details.

Answer: There are so many benefits to working with an Agent/Broker...

Firstly, these individuals are licensed and certified individuals that help others as their livelihood. This is their business and they are part of your communities.

Secondly, independent Agents don't charge you to help you as they are compensated (commission-based) through the several Insurance Companies they represent and its at no additional cost to you. As Broker's they represent many Companies so you have have comparisons and YOU choose which Company is best for you. We work for you, not the Insurance Companies.

Additionally you have a direct person to work with and not just an 800#. Your Agent is available year around and usually available in person, over the phone or virtually.

Answer: Unfortunately these scams are prevalent and getting worse! Its advisable to be very careful when a person or phone # calls you that you are not familiar with. Be cautious and NEVER give them any of your personal information. I recommend calling your Agent/Broker or calling the Insurance Company directly from the # that you have, not one they give you. Your Agent can help you and/or clarify information.

One BIG scam is commercials or calls offering more benefits than you qualify for because you are not receiving aid, but they do not care nor explain this.

Answer: Depending on your additional coverage (i.e. your Advantage Plan or Medigap) on top of having Medicare, you might have coverage during your international travels. It is important to ask your Agent/Broker for details or calling your Insurance Company Customer Service #.

There is also an option to purchase additional coverage know as Travel Insurance or International Medical Insurance that could be good additional options and to cover scenarios not covered by your Medicare Plans.

Answer: It's important b/c its much lower than it has been in the past, which will especially save money for folks taking expensive medications. Having this $2000 Max out of pocket will allow folks to budget and plan their Drug costs as well as take advantage of the monthly prescription payment plan if needed. Ask your trusted Agent/Broker for additional information.

Answer: Approximately 70% of Medicare Advantage Plans (MAPD) do not have a monthly premium, but all MAPD's do have costs associated with them when they are used for most medical services. These are known mostly as copays and can be quite reasonable, especially when you use In-Network services. Many MAPD's also come with additional extra benefits that are attractive to many consumers. Benefits such as Dental, Hearing, Vision, Gym coverage, etc. Its important to understand the pros & cons for MAPD's, as well as Medicare Supplements. There is not a "one size fits all" Plan out there and talking to an experienced Agent/Broker is a wise option. Plan ahead before starting Medicare and learn as much as you can.

Answer: The first step is to find a reputable Agent/Broker that can help you b/c of their experience and at no cost to you. They should make this confusing Medicare maze easier to understand and walk you through the steps.

Secondly, you need to apply for Medicare Parts A&B immediately as it is recommended to do so at least 3 months before your 65th Bday start date. With only 1 month of time, I highly recommend signing up online through the www.SSA.gov website and look for "Apply for Medicare" to fill out the application. You can hopefully have your Medicare # online within 3-4 weeks and continue the process with your Agent's help to complete your coverage with supplemental coverages that fit your individual needs.