Bruce Resnick, Medicare Insurance Broker

Answer: Once you have reached the Max Out Of Pocket or MOOP, you should have no more copays, co-insurance, or deductibles on your MEDICAL services. However, the MOOP cap does not apply to Part D prescriptions, if prescription coverage is included in your Medicare Advantage plan. Prescriptions have their own set of seperate rules and spending caps.

Answer: Best red flag would be if they asked for your Social Security number. All that is needed to complete a Medicare enrollment is your Medicare Beneficiary Identifier (MBI) number with effective dates, and your date of birth

Answer: Yes, absolutely. You wuld just need to grant her written, signed and notarized Power of Attorney (POA).

Answer: No, it does not automatically recalculate or go away if your income drops below the IRMAA threshold. The IRMAA amount is based on your MAGI income from 2 YEARS PRIOR. You can initiate a potential reduction by notifying the SSA of a life changing event by filing an SSA-44 form.

Answer: Cobtact the local agent you signed up with They are duly qualified to help with issues like these. If you made the mistake of signing up with a national 1-8XX number, your best bet would be to phone the Customer Service line for your plan.

Answer: It will most likely. AI bots are not going to be paying Medicare taxes. Additional critical threats to Medicare funding will originate via Executive Orders signed in the Oval Office. Trump has already made changes to current funding, and has put a TV doctor (Oz) in charge of the Centers for Medicare and Mediciad Services (CMS)

Answer: There is NO fixed rule or best standard answer for this. There are several other relevant financial considerations that cold make your start date swing one way or the other.

However, unless you absolutely NEED that income at 62,I personally recommend waiting for FRA. If you start at 62, you chop 8% off each payment for each year elapsed between 62 and FRA for the rest of your life. That could add up to substantial $$

Answer: You cant escape the IRMAA so that would be a question for your investment advisor or a CPA. You need to find a way to defer and/or even out those distributions.

Answer: It's better than OK. It's the best way.

Most brokers or agents represent only a limited subset of plans. The more you see, the more choices you can choose from.

Answer: That would be a question for your doctor.

Perhaps they improperly coded the procedure or there are other extenuating circumstances.

Answer: Absolutely. Yes you can be denied if attempting to join one more than six months after your Part B effective date.

This is due to underwriting, Underwriting is a series of medical questions the carrier will ask to determine their risk of insuring you. They can either deny you or quote a very high premium to make sure that they dont lose a bunch of money by insuring you.

If you want to get guaranteed enrollment on a MedSup (Medigap) plan, make sure to enroll within the first 6 months of your Part B effective date.

Answer: You have the same options as you would if you were living in your own private home. Be advised though that if you use on-site medical services provided by the community operators, they must accept Original Medicare, or a Medicare Supplement, or be in-network with your Medicare Advantage plan in order for their costs to be covered.

Answer: It's actually pretty simple. Once you hit the out-of-pocket max "catastrophic coverage" phase which is currently $2,000 for 2025, you pay nothing for additional Part D meds. Be advised that the out of pocket max (MOOP) threshold will be increasing to $2,100 for 2026

Answer: If currently receiving Social Security Disability Insurance (SSDI), you are supposed to be automatically enrolled in Medicare A&B upon receipt of your 24th SSDI payment. If you don't receive a Medicare card in the mail by your 25th SSDI payment, contact Social Security to inquire.

Answer: Per the CMS Medicare website:

Medicare Part B (Medical Insurance) covers:

A baseline mammogram once in your lifetime (if you’re a woman between 35-39).

Screening mammograms once every 12 months (if you’re a woman 40 or older).

Diagnostic mammograms more frequently than once a year, if medically necessary.

Your costs in Original Medicare

Screening and baseline mammograms: You pay nothing for the test if your doctor or other health care provider accepts assignment.

Diagnostic mammograms: After you meet the Part B deductible, you pay 20% of the Medicare-approved amount when on original government Part B Medicare.

If on a Supplement (Medigap) or a Medicare Advantage Plan your cost will probably be less then the 20% for diagnostic mammograms

Answer: Medicare covers hospital stays under Medicare Part A. Part A is provided at no cost to most Americans who have paid into the system through payroll deductions for at least 10 years. Part B covers doctors and other providers when not a hospital in-patient. Part D covers out-patient prescription drugs at home. When you are hospitalized Part covers all eligible charges incurred while you are an admitted in-patient. Your cheapest monthly premium cost ($0 per month) would be Part A only. But beware, Part A is contains a minefield of high deductibles, co-pays, and other limits. So although Part A is premium free for you, several short hospitalizations or one long major one could turn out more expensive than you were expecting. ALSO, and this is very important, If you decide to forego Part B and/or Part D, you will be penalized for all the months you did not have them if you should ever decide to enroll in either one in the future.

Answer: Your plan most likely doesn't cover the special advanced newer more expensive generation of lenses that automatically adjust to near vision or far vision unless your Ophthalmologist filed a Prior Authorization (PA) and carefully explained your requirement for the newer expensive lenses over the standard basic lenses. Ask your doctor what response they received on the PA they should have filed

Answer: An SOA or Scope of Appointment is normal and is actually required by Federal law. It documents the only type(s) of coverage you wish the agent to speak with you about. It also provides a 48 hour "cooling off" period if you should change your mind about speaking to an agent. Call centers must also process an SOA, although the 48 hour requirement is waived. The Federal SOA requirement is waived only under the following 3 conditions: 1) Waived for phone calls YOU initiate. 2. Waived when you walk into an agents permanent office or any place they are conducting a registered "informal sales event", like a table setup at a local retail store. 3) Another exception to the 48-hour rule include beneficiaries in the last four days of their enrollment period, although an SOA should be collected.

Answer: I hope I don't come off sounding rude, but turning 65 and gaining Medicare is a huge step that shouldn't' be taken as lightly as many folks do. Because it's a government program, it's incredibly complex and has many long lasting pitfalls and traps. The answer to your question is "this rule is not more well known only to the folks who have failed to do the basic research and planning. The rule is plainly posted here ==> https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

Answer: The biggest mistake most seniors make when enrolling in Medicare is calling a number seen in an ad or on TV and not contacting a qualified and experienced local agent who will carefully explain the "alphabet soup" of choices available, and assist them in enrolling into plan(s) that will best serve their needs and their healthcare risks and budget

Answer: Short answer is, you can't get either dental or vision coverage with original government Medicare only. You would need to enroll in a Medicare Advantage plan that bundles dental and vision coverage into their Plan

Answer: It is indeed most certainly heading for a crisis. It has already been heading there for several years now.

Answer: Although there are many more details that will affect your choice, as an agent of 10 years, I have found that many meds have very similar deductibles and co-pays either on Part D standalone or Medicare Advantage with embedded Part D. However, I have also observed that monthly premiums for standalone Part D plans frequently exceed the monthly premiums for Medicare Advantage plans.

Answer: Your annual Medicare wellness visit with an in-network provider is covered at no cost for someone with a Medicare Advantage PPO plan. Be advised though that a copay may be assessed if you have that done at an out-of-network provider.

Answer: You can show your card but that is likely to incur a bunch of billing issues. Once you have a Medicare Advantage plan, that plan becomes the PAYER of the bills and Medicare drops into the background asthey wont pay it.

Answer: Check out the informative publication at this government website: https://www.medicare.gov/publications/11579-medicare-costs.pdf

See page 2 for the IRMAA info. IRMAA premium adjustments start at $106,000 annual income and grow on a sliding scale

Answer: Check with your state department of Health and Human Services. It may have a different name in your state though. See if you qualify for a Medicaid Savings Plan (MSP). If you do, your state will pay your federal Part B premium. If your income is low enough, you may also qualify for full Medicaid benefits as well. If you do, and depending on your county of residence, you may be eligible for a Dual Special Needs Medicare Advantage Plan (D-SNP) which covers 100% of your copays.

Answer: Keep you Medicare ID private. Do not disclose it to anyone other than authorized medical providers, Do not respond to unsolicited "special offers" received by email or phone for things like back or knee braces.

Answer: There's a few ways to check. Look them up on the Medicare. gov website, directly contact a plan sponsor company, or contact a local licensed agent.

Answer: An Advantage may not (or possibly may depending on it's network) have allowed you to keep your doctors. Look into a Medicare Supplement (Medigap) plan which would allow you to keep all Medicare participating doctors and also limit your per visit, per procedure expenses.

Answer: Investigate the other letter plans available in your state. Plan N may have the porential to save you money.

Answer: No, you cannot backdate your Medicare enrollment for a missed window due to a medical emergency unless you are eligible for a Special Enrollment Period. Contact Medicare to confirm if available to you

Answer: As of January 1 of this year, the "donut hole" is banished and gone. And now there is a $2,000 cap on RX expenditures too. The downside is that many insurers have either instituted or increased deductibles to make up for the increased costs for them to supply meds without a donut hole

Answer: You can request Social Security to enroll you 3 months before the month of your 65th birthday, or the month of your 65th birthday, or up the 3rd month following your 65th birthday.

I recommend that you do it as soon as the above rules allow.

Answer: YES, it's really happening since January 1. The maximum out of pocket cap will be increased to $2,100 for 2026 though

Answer: No,. They should just stick with A&B because it would indeed make it more expensive for everyone. Or make those optional like Part D is now

Answer: I don't believe that Medicare itself will cover it, but I am aware of several carriers that will pay for it, or towards it, on certain Medicare Advantage (Part C) plans.

Answer: In order to maximize your access to upgraded plans that provide more benefits than Federally supplied basic Medicare provides, you must first enroll in Medicare parts A & B with the Social Security Administration.

Once you have secured federal A&B, you may then contact a licensed agent to evaluate the upgrades that are available in your area. Many upgrade plans are available with at no additional cost over what the federal government charges for their low benefit basic Medicare A&B.

I recommend that you contact a local independent agent as they offer a wide variety of plans from several companies, and will research the best plan for your particular needs and requirements.