Christian Marti Del Campo, Medicare Insurance Broker

Answer: The best way to avoid surprise lab bills with a Medicare Advantage plan is to verify coverage before having the test done. Ask your doctor which laboratory they are sending your test to, and confirm that the lab is in your plan’s network. Also check whether the test requires prior authorization and what your copay or coinsurance may be. Don’t assume that because your doctor is in-network, the laboratory they use is also in-network. A quick call to your Medicare plan or your agent before the test can help prevent unexpected costs.

Answer: The Maximum Out-of-Pocket (MOOP) is the most you would have to pay during the year for covered medical services under a Medicare Advantage plan. For example, if your plan has a $5,000 MOOP and your copays and coinsurance for covered medical care reach $5,000, the plan generally pays 100% of covered medical services for the rest of that year. Your monthly premium and prescription drug costs generally do not count toward the plan’s medical MOOP. This is why it’s important to look beyond a $0 premium and compare the MOOP, copays, network, medications, and benefits when choosing a Medicare plan.

Answer: Medicare has a few different times when you can change your plan. The main one is the Annual Enrollment Period from October 15–December 7, when you can review and change your Medicare Advantage or prescription drug plan for the following year. There is also a Medicare Advantage Open Enrollment Period from January 1–March 31 for people who are already enrolled in Medicare Advantage. You may also qualify to make changes during the year if you have a Special Enrollment Period, such as moving, losing coverage, or qualifying for certain assistance programs. If you’re not sure whether you can make a change, a Medicare agent can check your situation and explain your options.

Answer: Generally, you do not receive both Social Security benefits in full. If your husband passes away and you qualify for survivor benefits, Social Security will generally pay your own retirement benefit first and then add enough survivor benefit to bring your total up to the higher amount you qualify for.

For example, if your Social Security benefit is $1,200/month and your eligible survivor benefit based on your husband’s record is $2,000/month, you would generally receive a total of $2,000/month—not $3,200.

The exact amount depends on factors such as your age when you claim the survivor benefit, whether you’ve reached survivor full retirement age, and your husband’s benefit/record. Survivor benefits can sometimes be available starting at age 60 (or 50 if disabled), but claiming before survivor full retirement age can reduce the amount.

Answer: Yes. The cost of Medicare can be different for each person. What you pay can depend on your income, work history, when you enroll, the Medicare plan you choose, prescription medications, and whether you qualify for programs that help with Medicare costs. Some people may have a $0 monthly premium Medicare Advantage plan, while others may pay additional premiums depending on their coverage. It’s important to compare your individual options because the lowest-premium plan isn’t always the lowest-cost plan overall.

Answer: Yes. If traveling around the U.S. is important to you, there are Medicare options that can provide much more flexibility. Original Medicare paired with certain Medicare Supplement (Medigap) plans generally allows you to see any provider nationwide who accepts Medicare, without being limited to a Medicare Advantage provider network. Some Medicare Advantage PPO plans may also provide out-of-network coverage, but the costs and rules can vary by plan. Emergency and urgently needed care are generally covered when traveling within the U.S. under Medicare Advantage plans. For international travel, coverage is more limited, although some Medigap plans and certain Medicare Advantage plans may provide emergency coverage outside the U.S. The best option depends on how often and where you travel, your doctors, medications, budget, and eligibility.

Answer: Working with a local Medicare agent gives you personalized, face-to-face support and someone who understands the doctors, hospitals, pharmacies, and Medicare plans available in your area. A local agent can help you compare your options, check your doctors and prescriptions, assist with enrollment, and most importantly, continue helping you throughout the year when questions or problems come up. Virtual agents can be convenient, but with a local agent, you have a trusted person in your community you can call or meet with when you need help. Medicare can be complicated—you don’t have to navigate it alone.

Answer: Yes — there are a number of changes and updates coming for Medicare in 2026. Some are relatively modest, others more substantive. Here’s a breakdown of the most important ones to watch (and how you should prepare for them).

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📌 Key Medicare Changes for 2026

Here are some of the biggest changes already finalized or expected. (Always double-check your state, plan, and carrier for specific impacts.)

Answer: One of my clients, a 72-year-old gentleman with diabetes, was struggling to afford his insulin under his current Medicare coverage. He had been paying hundreds of dollars each month and wasn’t aware that there were Medicare Advantage plans and Extra Help programs that could significantly reduce his out-of-pocket costs.

I sat down with him and carefully reviewed his medications, his doctors, and his eligibility for savings programs. Together, we compared several plans available in his county that included enhanced Part D coverage for insulin at a capped cost. I also helped him complete the application for the Low-Income Subsidy (Extra Help) program through Social Security.

The result was life-changing for him: his insulin dropped to $35 a month, and he also gained dental and vision benefits he never had before. What mattered most to him wasn’t just the savings, but that he felt someone had taken the time to explain the options in simple terms and guide him step by step.

That experience reinforced why I love this work — helping people cut through the complexity of Medicare and find a plan that truly supports their health and financial well-being

Answer: Medicare Advantage plans are paid by the federal government (CMS) to manage members’ care.

• Instead of Medicare paying hospitals and doctors directly under Original Medicare (Parts A & B), CMS pays a fixed monthly amount (capitation) to the insurance company for each enrollee.

• This amount is risk-adjusted — meaning plans get more for members with chronic conditions and less for healthier members.

Answer: Good afternoon, you should contact an agent who has experience in that, as it is a process that requires a couple of steps, starting from a need analysis, though helping you to cancel whatever supplements you currently have

If you wish, you can contact me so that is can assist you in the process

Christian

Contact me.

Answer: Yes you can but you will be missing on lots of ancillary benefits like dental vision and hearing aids

Answer: You sure do

Starting from changing your address with social security all the way to review your benefits due to the fact that some times benefits changes on different zip codes

Please contact a representative or Medicare.gov or 1-800-Medicare

Answer: The likelihood of Medicare covering gene therapy as it becomes more common is moderate to high, but with significant conditions and constraints. Here’s a breakdown of how this is evolving:

Answer: Yes, your friend’s more detailed plan is likely because:

• Their city or ZIP code has different available plans.

• Their state’s rules or insurer options might offer richer benefits or more competition.

If you’re ever considering switching or comparing plans, you can visit Medicare.gov and use their Plan Finder tool to compare options based on ZIP code.

Let me know if you want help understanding a specific plan or ZIP code!

Answer: That’s a great question — and one that many people wrestle with. Whether Medicare Advantage or Original Medicare is better depends on your personal health needs, budget, and lifestyle.

For better understanding of your options reach out a professional to help guide you through the process

Answer: Step 1: Review the Denial Notice

You will receive a denial letter or Notice of Denial of Medical Coverage (for Medicare Advantage) or a Part D Explanation of Benefits. This notice should include:

• The reason for the denial

• Instructions on how to file an appeal

• Deadlines for submitting your appeal

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Step 2: Request a Redetermination (First Level of Appeal)

Original Medicare

• Fill out a “Redetermination Request Form” (optional— you can also write a letter).

• Send it to the address listed in the denial notice.

• You must file within 120 days of the date you received the denial.

• A Medicare Administrative Contractor (MAC) will review your case.

Medicare Advantage (Part C) or Part D Drug Plan

• You (or your doctor) can request a reconsideration.

• Call your plan or submit a written request.

• For urgent cases, request an expedited (fast) appeal if waiting could seriously harm your health.

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Step 3: Add Supporting Documentation

It’s helpful to include:

• A letter from your doctor explaining why the procedure or medication is medically necessary

• Relevant medical records

• Any prior approvals or evidence of similar cases being approved

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Step 4: Follow the Appeals Process Through the 5 Levels (If needed)

If your first appeal is denied, you can continue through these levels:

1. Redetermination/Reconsideration by the plan or Medicare contractor

2. Review by a Qualified Independent Contractor (QIC)

3. Hearing before an Administrative Law Judge (ALJ)

4. Review by the Medicare Appeals Council

5. Federal District Court Review

Each level has deadlines and procedures, and you’ll be notified how to proceed to the next step if necessary.

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Need Help?

• 1-800-MEDICARE — for guidance on appeals

• State Health Insurance Assistance Program (SHIP) — free, local help

• Your doctor or medical provider — can assist with medical justification

• Medicare.gov — has forms and additional details

Sample Medicare Appeal Letter

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