Chad Watkins, Medicare Insurance Agent

Answer: What is the difference between an insurance agent and an insurance broker? A captive agent is an employee of a given insurance carrier, and that is the only carrier that they can offer. An insurance broker is someone who is self-employed, and they have contracted with multiple carriers so that they are free to pick and choose whatever carrier and plan is in the best interest of the client. So if you want an unbiased opinion, you're much better off going with an insurance broker or an insurance agent.

Answer: Well, Medicare covers medical expenses outside of the United States. Typically, original Medicare is not gonna be much help except in rare circumstances. If you do have a Medicare Advantage plan, those plans typically will give you some emergency coverage outside of the United States, but that coverage will vary from plan to plan. So, you would need to check your plan details to see exactly what your coverage is.

There are also Medicare supplement plans that will give you some coverage in an emergency outside the United States, referred to as foreign travel. And that will cover up to 80% up to $50,000. You pay the first $200 and 20% of the first $50,000, and then anything over $50,000. So, you do have some coverage with those Medicare supplement plans.

Answer: How do prescription drug plans work? Most carriers are going to break down their prescription drugs into different tiers. It's very typical. There will be five tiers, with preferred generic drugs being tier one. That's going to be the least expensive. So you have tier one and tier two, which are generic, broken down into preferred and non-preferred. Tier three and four are brand name, broken down into preferred and non-preferred. And then tier five is for specialty drugs.

As you go up into tiers, you're going to pay more on the copay for that prescription. There is a deductible maximum. This has been set at $590 for 2025. It will be going up to $615 for 2026. And that is the maximum amount of deductible that a plan can charge. But they might make it less or even zero, depending on the plan.

So then you will pay the copays based on the tiers until you've reached the true out-of-pocket, known as true OOP. For 2025, it's $2,000, going up to $2,100 in 2026. So actually, after you've paid that actual amount out of pocket, then you will pay zero for your prescriptions.

There are a few programs you can look into that might help you pay for those prescriptions. There's the pharmaceutical assistance for the aged and disabled, and hearing aid assistance for the aged and disabled.

Answer: What is Extra Help for Medicare? The Medicare Extra Help program assists people who have limited income and resources to pay for costs with Medicare Part D. It can help with paying the premium, the deductibles, and the copayments. In order to qualify, you typically have to have income under $24,000 per year and assets under $18,000. Some people get it automatically, but you can always apply through the Social Security Administration.

Answer: What is the difference between Medicare Supplement and Medicare Advantage plans? Many people think these things are the same. They're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan where you have to worry about doctors and hospitals being in network. They are usually a lower premium than a Medicare Supplement. Depending on where you are, certain service areas have a zero premium plan, which does not cost you anything above and beyond what you would normally pay for just the Part B premium.

Medicare Advantage plans typically do include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of maximum $9,350. So that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing. But it's usually not comprehensive, but more preventative. So for dental, things like checkups and cleanings, sometimes they will offer a rider to give you more comprehensive dental.

The Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. With a Medicare Supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks. You can go to any doctor or any hospital that you want. Medicare Supplements do not include prescription drugs, so you'd probably also want to get a standalone prescription drug plan. Medicare Supplements will also not give you anything towards dental, vision, and hearing. But again, you can get a standalone dental, vision, and hearing plan.

Medicare Supplements can also be changed at any time throughout the year. Unlike Medicare Advantage and prescription drug plans that you're locked in for the year and can't change until the end of the year for a January 1st effective date. The first time you get a Medicare Supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. And there are no service areas that you have to worry about.

Answer: Do I need to get a new Medicare Advantage plan if I move to a different county within the same state? The answer to this is only for Medicare Advantage plans. If you have a Medicare supplement plan and you move to another county in the same state, your Medicare supplement plan will work fine because it is not subject to service areas like Medicare Advantage plans are. If you have a Medicare Advantage plan and you move to a new county within the same state, you will want to check to see that that plan works in that county. And if not, you will have a special election period where you can change to a new Medicare Advantage plan.

Answer: How does collecting Social Security affect my Medicare? The answer to this question is that it does not. So whether you're collecting Social Security or not, nothing changes with your Medicare coverage. The only exception is that if you are collecting Social Security, the premium for Medicare Advantage plans and prescription drug plans can be paid by having that money taken out of your Social Security check, which you can only do if you're collecting Social Security. Other than that, having Social Security does not affect your Medicare.

Answer: The better to get my medications? I stand along Prescription Drug Plan or Medicare Advantage Plan. The answer to this question is that neither one is better than the other. All you need to do is look at the formulary to see what medications are covered. To say that your medications are covered and then also to compare not only the premium but the deductible for the plan as well as the copays for your specific drugs. And that holds true whether you're comparing a standalone prescription drug plan to another standalone prescription drug plan or to a Medicare Advantage plan.

Answer: Do doctors need to stay in network on Medicare Advantage plans? No, doctors are under no obligation to stay in network for any length of time on a Medicare Advantage plan. They can leave at any point. This is why it’s important, when deciding on a Medicare Advantage plan, to call your doctors and make sure that they’re not only in network but that they plan to stay in network for the next year, because you’re going to be locked in for that year.

Answer: The difference between Medicare Supplement and Medicare Advantage plans. Many people think these things are the same. They're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan where you have to worry about doctors and hospitals being in network. They're usually a lower premium than a Medicare Supplement. And depending on where you are, certain service areas have a zero premium plan which does not cost you anything above and beyond what you would normally pay for just the Part B premium.

Medicare Advantage plans typically do include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of a maximum of $9,350. So that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing. But it's usually not comprehensive, but more preventative. So for dental, things like checkups and cleanings, sometimes they will offer a rider to give you more comprehensive dental coverage.

The Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. With Medicare Supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks. You can go to any doctor or any hospital that you want. Medicare Supplements do not include prescription drugs, so you'd probably also want to get a standalone prescription drug plan. Medicare Supplement will also not give you anything towards dental, vision, and hearing. But again, you can get a standalone dental, vision, and hearing plan.

Medicare Supplements can also be changed at any time throughout the year. Unlike Medicare Advantage and prescription drug plans, you're locked in for the year and you can't change it till the end of the year for a January 1st effective date. The first time you get a Medicare Supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or different carrier, you will need to go through health underwriting and answer health questions. And there are no service areas that you have to worry about.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has part A, which is your hospital coverage, and part B, which is your medical coverage. Part A, typically, people do not pay a premium for part A unless you did not work for at least 40 quarters within your lifetime. But part A is gonna cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. And if you're there more than 60 days, there's a co-pay of $419 per day. From date 91 to 150, it goes up to $838 per day. And then after that, you'll be paying for everything as it is not covered. For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, $209.50 per day up to day 100. And then after day 100, you're not covered. So everything will be out of pocket. Your part B covers your doctor services, your outpatient services, including surgery and some other services and supplies that are not covered by part A. There is a premium for your part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. And then after that, 20% is what your co-insurance would be. So there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare Part A is your hospital coverage, and Part B is your medical coverage. For Part A, typically people do not pay a premium unless you did not work for at least 40 quarters within your lifetime. But Part A is gonna cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. If you're there more than 60 days, there's a co-pay of $419 per day. From day 91 to 150, it goes up to $838 per day. After that, you'll be paying for everything as it is not covered. For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket.

Your Part B covers your doctor services, your outpatient services, including surgery and some other services and supplies that are not covered by Part A. There is a premium for your Part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. After that, 20% is what your co-insurance would be. So there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Answer: The difference between Medicare Supplement and Medicare Advantage plans. Many people think these things are the same. They're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan where you have to worry about doctors and hospitals being in networks. They usually have a lower premium than a Medicare supplement. Depending on where you are, certain service areas have a zero premium plan, which does not cost you anything above and beyond what you would normally pay for just a part B premium. Medicare Advantage plans typically do include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of maximum $9,350. So that is your worst-case scenario. Even if something catastrophic were to happen, they won't give you some coverage, usually for dental, vision, and hearing. But it's usually not comprehensive, but more preventative. So for dental, things like checkups, cleanings, and sometimes they will offer a wider range to give you more comprehensive dental. The Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. With Medicare supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks. You can go to any doctor, any hospital that you want. Medicare supplements do not include prescription drugs, so you probably also want to get a standalone prescription drug plan. Medicare supplement will also not give you anything towards dental, vision, and hearing. But again, you can get a standalone dental, vision, and hearing plan. Medicare supplements can also be changed at any time throughout the year. Unlike Medicare Advantage and prescription drug plans that you're locked into for the year, and you can't change it till the end of the year for a January 1st effective date. The first time you get a Medicare supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. And there are no service areas that you have to worry about. So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: How much will I pay for my Medicare? This is a pretty typical question for anyone who is becoming eligible for Medicare.

For Medicare Part A, most people will get that for free, assuming you've worked at least 40 quarters within your lifetime and paid into Social Security. If you've worked less than that, there will be a premium for Part A: $285 if you worked 30 to 39 quarters, and $518 if you've worked less than 30 quarters.

For Part B, most people will pay $185 per month. But there is a sliding scale based on your income, which is known as the income-related monthly adjustment amount, or IRMAA. Depending on your income, if it's above $106,000 per year, you will pay more, which you can see on the chart here.

Your Part D is very similar in that it also has an income-related monthly adjustment amount. The breakdowns are the same on the income, and these will be the amounts that you will be charged in addition to the premium you pay for your prescription drug plan.

You'll also pay an additional premium for Medicare supplement if you choose to get one, and possibly also for a Medicare Advantage plan, depending on which plan you go with.

If you still have questions or need help in applying for a plan, please feel welcome to contact me.

Answer: The difference between Medicare Supplement and Medicare Advantage plans. Many people think these things are the same. They're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan where you have to worry about doctors and hospitals being in networks. They usually have a lower premium than a Medicare supplement. Depending on where you are, certain service areas have a zero premium plan which does not cost you anything above and beyond what you would normally pay for just a Part B premium. Medicare Advantage plans typically do include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of maximum $9,350. So that is your worst-case scenario. Even if something catastrophic were to happen, they won't give you some coverage, usually for dental, vision, and hearing. But it's usually not comprehensive, but more preventative. So for dental, things like checkups and cleanings, sometimes they will offer a wider range to give you more comprehensive dental. The Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. With Medicare supplements, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks. You can go to any doctor or any hospital that you want. Medicare supplements do not include prescription drugs, so you probably also want to get a standalone prescription drug plan. Medicare supplements will also not give you anything towards dental, vision, and hearing. But again, you can get a standalone dental, vision, and hearing plan. Medicare supplements can also be changed at any time throughout the year. Unlike Medicare Advantage and prescription drug plans that you're locked into for the year and can't change until the end of the year for a January 1st effective date. The first time you get a Medicare supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. And there are no service areas that you have to worry about. So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: What are the pros and cons of Medicare Supplement Plan G compared to a Medicare Supplement Plan N? To answer this question, we need to look at what each plan covers.

With Medicare Supplement Plan G, it covers everything but the Part B deductible for 2026. That amount is $288 annually. Plan N is very similar; it does not cover the Part B deductible. There's also a $20 copay per doctor visit and a $50 copay if you go to the emergency room. Plan N also does not cover the Part B excess charge. Medicare will come up with what they consider a reasonable amount to charge for any given service, but doctors are allowed to charge an additional 15% above that. If your doctor does that, Plan G would cover it, but Plan N would not.

So what it really boils down to is how often you go to the doctor. You can calculate the break-even point of doctor visits by simply taking the premium for Plan G, subtracting the premium for Plan N, multiplying it by 12 months, and then dividing by the $20 copay per doctor visit.

For example, if you got a Plan G that was, say, $150 a month, and your Plan N is $115 a month, the difference of $35 times 12 months divided by the $20 copay equals 21 doctor visits. In other words, you would have to go to the doctor 21 times before you saved your money over Plan G.

The place where people will actually get this to work against them a little bit is if you ever need physical therapy because then you're paying $20 every time you go. Typically, for physical therapy, you need to go a few times a week, maybe for several weeks or months. That can add up to actually cost you more than you would have just paid for the premium for Plan G.

So that's really the difference between the two. If you don't go to the doctor a lot, Plan N might be the way to go. Some people just like to stick with Plan G just because this way they don't have to worry about being nickel-and-dimed by all those little $20 copays, especially for physical therapy.

If you have any other questions, you can feel welcome to call me.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare Part A is your hospital coverage, and Part B is your medical coverage. For Part A, typically people do not pay a premium unless you did not work for at least 40 quarters within your lifetime. But Part A is gonna cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. If you're there more than 60 days, there's a co-pay of $419 per day. From day 91 to 150, it goes up to $838 per day. After that, you'll be paying for everything as it is not covered. For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery and some other services and supplies that are not covered by Part A. There is a premium for your Part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. After that, 20% is what your co-insurance would be. So there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Answer: What is the cost of the nursing home that is covered by Medicare and which is covered by long-term care insurance? When we look at what's covered by Medicare, original Medicare will cover 20 days of skilled nursing facility care. From days 21 to 100, there's a $204 copay. And then after day 100, there is no coverage, so everything would be paid for out of pocket. Medicare Advantage plans typically do not add any additional coverage, so it's pretty much gonna cover the same thing that original Medicare covers. Medicare supplement, depending on which plan you get, can bring it up to 100 days. It's gonna depend on the plan. So that's your best case scenario, which you have about three months' worth of coverage. And that's where long-term care insurance comes in. Now, the amount that the long-term care insurance is gonna cover will depend on the benefits that you choose. Some of these plans have an unlimited benefit that will just pay forever. But typically, there is a lifetime limit. So you're essentially buying a bucket of money to use in the future for long-term care. And then if you do have a long-term care event, they don't give you all that money all at once. You will have a limit. It's either a monthly or a daily limit that will pay out.

Answer: What are the Medicare enrollment periods? There are actually several of them. The first is the initial enrollment period, known as IEP. That starts three months prior to turning 65 and continues for the three months after you turn 65. Next is the annual enrollment period, known as AEP. This runs every year from October 15th through December 7th to get an effective date of January 1st. The open enrollment period, OEP, is the six months following your Part B effective date. Many times, people delay getting their Part B, so whenever you get that, six months after that will be the open enrollment period.

There's also a special enrollment period, known as SEP. There are many different reasons why you might be eligible for an SEP. The most common is if you're coming off your employer coverage or you have a Medicare Advantage plan that you move out of their service area. They don't make you wait till the end of the year. You can get enrolled right at that time.

The general enrollment period, known as GEP, is for people who have delayed getting their Medicare Part A or Part B and did not have credible coverage through an employer. Every year in January, February, and March, you can enroll at that time with an effective date of July 1st. Lastly, there's the Medicare Advantage open enrollment period, known as MA OEP. This runs in January, February, and March as well. The effective date will be the first of the month whenever you apply. This is specifically for people who already have a Medicare Advantage plan and want to switch to a different plan or go back to original Medicare. At that time, they could also get a standalone prescription drug plan.

Answer: How much will I pay for my Medicare? This is a pretty typical question for anyone who is becoming eligible for Medicare. For Medicare Part A, most people will get that for free, assuming you've worked at least 40 quarters within your lifetime and paid into Social Security. If you've worked less than that, there will be a premium for Part A: $285 if you've worked 30 to 39 quarters, and $518 if you've worked less than 30 quarters.

For Part B, most people will pay $185 per month, but there is a sliding scale based on your income, which is known as the income-related monthly adjustment amount, or IRMAA. Depending on your income, if it's above $106,000 per year, you will pay more, which you can see on the chart here. Your Part D is very similar, and that also has an income-related monthly adjustment amount. The breakdowns are the same based on income, and these will be the amounts that you will be charged in addition to the premium you pay for your prescription drug plan. You'll also pay an additional premium for a Medicare supplement if you choose to get one, and possibly also for a Medicare Advantage plan, depending on which plan you go with.

Answer: How much will I pay for my Medicare? This is a pretty typical question for anyone who is becoming eligible for Medicare. For Medicare Part A, most people will get that for free, assuming you've worked at least 40 quarters within your lifetime and paid into Social Security. If you've worked less than that, there will be a premium for Part A: $285. If you've worked 30 to 39 quarters, it's $518. If you've worked less than 30 quarters, it will be more.

For Part B, most people will pay $185 per month, but there is a sliding scale based on your income, which is known as the income-related monthly adjustment amount, or IRMAA, also known as ARMA. Depending on your income, if it's above $106,000 per year, you will pay more, which you can see on the chart here. Your Part D is very similar in that it also has an income-related monthly adjustment amount. The breakdowns are the same based on income.

These will be the amounts that you will be charged in addition to the premium you pay for your prescription drug plan. You'll also pay an additional premium for a Medicare supplement if you choose to get one, and possibly also for a Medicare Advantage plan, depending on which plan you go with. If you still have questions or need help in applying for a plan, please feel welcome to contact me.

Answer: What is the difference between Medicare supplement and Medicare Advantage plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage plan is typically either an HMO or a PPO type of plan where you have doctors and hospitals being in network. They usually have a lower premium than Medicare supplement, and depending on where you are, there are certain plans that have a zero premium, which means it doesn't cost anything above and beyond what you would normally pay for just the Part B premium. Medicare Advantage plans typically include prescription drugs. They do have a maximum out-of-pocket referred to as MOOP, with a maximum of $9,350, so that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing, but it's usually not comprehensive, more preventative, so for dental, things like checkups and cleanings. Sometimes they will offer a wider range to give you more comprehensive dental coverage.

Medicare Advantage plans are locked in for one year. You can only get the plans that are in your service area. With Medicare supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or any hospital that you want. Medicare supplements do not include prescription drugs. You probably also want to get a standalone prescription drug plan. Medicare supplement will also not give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan. Medicare supplements can also be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans that you're locked in for the year, and you can't change it till the end of the year for a January 1st effective date.

The first time you get a Medicare supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. There are no service areas that you have to worry about. So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: The difference between Medicare supplement and Medicare Advantage plans. Many people think these things are the same, but they're actually quite different. A Medicare Advantage plan is typically either an HMO or a PPO type of plan where you have doctors and hospitals in network. They usually have a lower premium than Medicare supplements, and depending on where you're at, certain services may have a zero premium plan, which does not cost anything above and beyond what you would normally pay for just the Part B premium. Medicare Advantage plans typically do include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of $9,350, so that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing, but it's usually not comprehensive, more preventative, like checkups and cleanings. Sometimes they will offer a wider range to give you more comprehensive dental coverage.

Medicare Advantage plans are locked in for one year. You can only get the plans that are in your service area. With Medicare supplements, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or hospital that you want. Medicare supplements do not include prescription drugs, so you probably also want to get a standalone prescription drug plan. Medicare supplements will also not give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

Medicare supplements can also be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans, where you're locked in for the year and can't change it until the end of the year for a January 1st effective date. The first time you get a Medicare supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. There are no service areas that you have to worry about.

So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and D.C.

Answer: Yes, that is really happening not just talk. There is no more coverage gap known as the "doughnut hole".

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has Part A, which is your hospital coverage, and Part B, which is your medical coverage. Part A, typically, people do not pay a premium for unless you did not work for at least 40 quarters within your lifetime. Part A is going to cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. If you're there more than 60 days, there's a copay of $419 per day from day 91 to 150. It goes up to $838 per day. Then after that, you will be paying for everything as it is not covered.

For skilled nursing facility care, Medicare will cover you for the first 20 days. Then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery, and some other services and supplies that are not covered by Part A. There is a premium for your Part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. Then after that, 20% is what your co-insurance would be.

There are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover. If you still have questions or need any help applying for our plan, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: Medicare Supplements can also be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans that you're locked in for the year, and you can't change them until the end of the year for a January 1st effective date. The first time you get a Medicare Supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. And there are no service areas that you have to worry about. So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: What is the difference between Medicare Supplement and Medicare Advantage Plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage Plan is typically either an HMO or PPO type of plan, where you have to worry about doctors and hospitals being in-network. They usually have a lower premium than a Medicare Supplement, and depending on where you're at, certain service areas have a zero premium plan that doesn't cost you anything beyond what you would normally pay for just the Part B premium.

Medicare Advantage Plans typically include prescription drugs. They do have a maximum out-of-pocket limit, referred to as MOOP, of a maximum of $9,350. So that is your worst-case scenario, even if something catastrophic were to happen. They usually provide some coverage for dental, vision, and hearing, but it's typically not comprehensive, more preventative. For dental, things like checkups and cleanings are covered, and sometimes they will offer a rider to give you more comprehensive dental coverage.

Medicare Advantage Plans are locked in for one year, and you can only get the plans that are in your service area. A Medicare Supplement has a higher premium, but you get better coverage. You don't have to worry about networks; you can go to any doctor or hospital that you want. Medicare Supplements do not include prescription drugs, so you'd probably want to get a standalone prescription drug plan. Medicare Supplements also won't provide anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and D.C.

Answer: What is the difference between Medicare Supplement and Medicare Advantage Plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage Plan is typically either an HMO or PPO type of plan where you have to worry about doctors and hospitals being in network. They are usually lower premium than a Medicare Supplement, and depending on where you are, certain service areas have a zero premium plan which does not cost you anything above and beyond what you would normally pay for just the Part B premium.

Medicare Advantage Plans typically do include prescription drugs. They do have a maximum out-of-pocket amount, referred to as MOOP, of a maximum of $9,350. So that is your worst-case scenario, even if something catastrophic were to happen. They will give you some coverage, usually for dental, vision, and hearing, but it's usually not comprehensive, more preventative. For dental, things like checkups and cleanings are covered, and sometimes they will offer a wider range to give you more comprehensive dental.

The Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. With a Medicare Supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or hospital that you want. Medicare Supplements do not include prescription drugs, so you'd probably also want to get a standalone prescription drug plan. Medicare Supplement will also not give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has Part A, which is your hospital coverage, and Part B, which is your medical coverage. Part A, typically, people do not pay a premium for unless you did not work for at least 40 quarters within your lifetime. Part A is going to cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital, and if you're there more than 60 days, there is a copay of $419 per day from day 91 to 150. It goes up to $838 per day, and then after that, you will be paying for everything as it is not covered.

For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery, and some other services and supplies that are not covered by Part A. There is a premium for your Part B; most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257, and then after that, 20% is what your coinsurance would be. So, there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Answer: What's the difference between Medicare Supplement and Medicare Advantage plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan, where you have to worry about doctors and hospitals being in-network. They usually have a lower premium than a Medicare Supplement, and depending on where you're at, certain service areas have a zero premium plan that doesn't cost you anything above and beyond what you would normally pay for just the Part B premium.

Medicare Advantage plans typically include prescription drugs. They do have a maximum out-of-pocket, referred to as MOOP, of $9,350, so that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing, but it's typically not comprehensive—more preventative. For dental, things like checkups and cleanings are covered, and sometimes they will offer a rider to give you more comprehensive dental.

Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. A Medicare Supplement will have a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or hospital that you want. Medicare Supplements do not include prescription drugs, so you probably also want to get a standalone prescription drug plan. Medicare Supplements also won't give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

Medicare Supplements can be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans, which lock you in for the year and you can't change them until the end of the year for a January 1st effective date. The first time you get a Medicare Supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions, and there are no service areas that you have to worry about.

Answer: What is the difference between Medicare supplement and Medicare Advantage plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage plan is typically either an HMO or a PPO type of plan where you have doctors and hospitals being in network. They usually have a lower premium than Medicare supplement, and depending on where you are, there are certain services that have a zero premium plan, which does not cost anything above and beyond what you would normally pay for just the Part B premium.

Medicare Advantage plans typically include prescription drugs. They do have a maximum out-of-pocket referred to as MOOP, with a maximum of $9,350, so that is your worst-case scenario. Even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing, but it's usually not comprehensive; it's more preventative, so for dental, things like checkups and cleanings. Sometimes they will offer a wider range to give you more comprehensive dental coverage.

Medicare Advantage plans are locked in for one year. You can only get the plans that are in your service area. With Medicare supplement, you will pay a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or any hospital that you want. Medicare supplements do not include prescription drugs. You probably also want to get a standalone prescription drug plan. Medicare supplement will also not give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

Medicare supplements can also be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans that you're locked into for the year, and you can't change it till the end of the year for a January 1st effective date. The first time you get a Medicare supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, in the future, if you want to change to a different plan or a different carrier, you will need to go through health underwriting and answer health questions. There are no service areas that you have to worry about. So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and DC.

Answer: What's the difference between Medicare Supplement and Medicare Advantage plans? Many people think these are the same, but they're actually quite different. A Medicare Advantage plan is typically either an HMO or PPO type of plan, where you have to worry about doctors and hospitals being in-network. They usually have a lower premium than a Medicare Supplement, and depending on where you are, certain service areas have a zero premium plan, which doesn't cost you anything beyond what you would normally pay for just the Part B premium.

Medicare Advantage plans typically include prescription drugs, and they have a maximum out-of-pocket limit, referred to as MOOP, of $9,350. So that's your worst-case scenario; even if something catastrophic were to happen, they will give you some coverage, usually for dental, vision, and hearing, but it's typically not comprehensive—more preventative. For dental, things like checkups and cleanings are covered, and sometimes they offer a rider to give you more comprehensive dental.

Medicare Advantage plans are locked in for one year, and you can only get the plans that are in your service area. A Medicare Supplement will have a higher premium, but you do get better coverage. You don't have to worry about networks; you can go to any doctor or hospital you want. Medicare Supplements do not include prescription drugs, so you'd probably want to get a standalone prescription drug plan. Medicare Supplements also won't give you anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

Medicare Supplements can be changed at any time throughout the year, unlike Medicare Advantage and prescription drug plans, which lock you in for the year and you can't change them until the end of the year for a January 1st effective date. The first time you get a Medicare Supplement, you will get a guaranteed issue, so you don't have to answer health questions. But after that, if you want to change to a different plan or a different carrier, you'll need to go through health underwriting and answer health questions, and there are no service areas that you have to worry about.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has Part A, which is your hospital coverage, and Part B, which is your medical coverage. Typically, people do not pay a premium for Part A unless you did not work for at least 40 quarters within your lifetime. Part A is going to cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital, and if you're there more than 60 days, there is a copay of $419 per day. From day 91 to 150, it goes up to $838 per day, and then after that, you will be paying for everything as it is not covered.

For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery, and some other services and supplies that are not covered. There is a premium for your Part B; most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257, and then after that, 20% is what your coinsurance would be. So, there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Answer: What does Medicare Part B cover and is it enough? Medicare Part B of original Medicare will cover doctor services, healthcare providers, outpatient care, lab tests, x-rays not covered by Part A while you're in the hospital, home healthcare in certain situations, and durable medical equipment if you need a wheelchair or walker and it's prescribed by a doctor. Part B handles that. Also, it covers preventative services, your vaccinations, your screenings, your x-rays, those types of things. Is it enough? Here's how it works. Part B, the government comes in and pays 80% of the total cost under that Part B. You're on the hook for the 20% out-of-pocket, and there is no out-of-pocket maximum, so it can get very scary what you owe. Talk to someone like myself here at my State Farm agency on Kelly Street in Manchester so we can talk to you about a Medicare supplement or Medigap policy, which will alleviate all your fear of that 20% payment because that will cover that gap. The only thing you'll pay is the Part B deductible, all of $275, which is much better than the 20%. No maximum out-of-pocket cost. But talk to someone like myself. Look for me under Medicare Agents Hub. I also send out to clients this Medicare and Social Security Cheat Sheet that helps people a lot, and I'd love to help you. Thank you.

Answer: What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has Part A, which is your hospital coverage, and Part B, which is your medical coverage. Typically, people do not pay a premium for Part A unless you did not work for at least 40 quarters within your lifetime. Part A is going to cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital, and if you're there more than 60 days, there is a copay of $419 per day. From day 91 to 150, it goes up to $838 per day, and then after that, you will be paying for everything, as it is not covered.

For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, you pay per day up to day 100. After day 100, you're not covered, so everything would be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery, and some other services and supplies that are not covered by Part A. There is a premium for your Part B; most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257, and then after that, 20% is what your coinsurance would be.

Answer: Anything is possible but Medicare adopting a tiered premium system based on non-health lifestyle factors is unlikely. Medicare supplement premiums already consider health lifestyle factors, for example, they charge a higher premium for people who smoke.

Answer: With Medicare Advantage plans, you will want to check if your doctor is in network as that will provide you with the lowest copay. You can always use an out-of-network doctor, but your copay may be higher possibly even costing you 100% out-of-pocket.

Answer: Medicare cannot drop you for health reasons nor can Medicare Advantage plans or Medicare supplement plans once you are approved for a policy, as it is guaranteed renewable. However, outside of your initial enrollment period, you may need to answer health questions in order to be eligible for a Medicare supplement.

Answer: Seniors with low income should look into these programs:

PAAD - Pharmaceutical Assistance for the Aged or Disabled

HAAD - Hearing Aid Assistance for the Aged or Disabled

Senior Gold

You can contact me

Answer: Original Medicare has large deductibles and copays so it helps to supplement that with either a Medicare Advantage or Medicare supplement plan. It is important to know that most Medicare Advantage plans will require you to deal with doctors and hospitals that are in network to pay the least in copays.

Answer: CA, ID, IL, LA, MD, OR, OK and NV all have a Medicare birthday rule. Rules vary by state (for example IL it is only available for ages 65 to 75) but the general idea is that around your birthday, you can switch your Medicare supplement plan to one of equal or less value without going through underwriting and worrying about pre-existing conditions.

Answer: You can qualify for Medicare under the age of 65 if you have been on disability for at least 24 months.

Answer: Anyone who has employer coverage does not need to activate their Medicare part B as they would be paying a premium for insurance that they do not need. Therefore, they should delay it.

Answer: While Medicare Part D and Medicare Advantage both provide prescription drug coverage, they are very different as Medicare Advantage also provides medical coverage, thus the two are not comparable.

Answer: The biggest mistake people make when enrolling in Medicare is doing so when they still have employer coverage. Most people get Medicare part A for free but part B has a premium. You do not need to get your part B in place if you have employer coverage, thus you can save that premium and never pay a late enrollment penalty as long as the employer coverage is considered creditable, i. e. it would pay the same as Medicare would.

Answer: The coverage gap known as the "donut hole" no longer being in effect means that instead of needing to pay different copay amounts after reaching a certain level, you will now pay nothing for prescriptions after your out of pocket expense has reached $2,000.

Answer: An agent asking for a scope of appointment is not only normal, it is a Medicare requirement. It is done to help keep seniors from being inundated with sales calls, thus the agent needs a prospects permission to even talk about it.

Answer: Preventative screenings are covered by Medicare. The reason for this is because it actually costs them less money because illnesses are caught early thus preventing expensive care.

Answer: The most frustrating misconception that I have to clear up is that people think they can only change their Medicare supplement plan during the Annual Election Period (AEP).

Answer: What I like most about being a Medicare agent is helping people find the plan that is best for them and the lowest cost