Cody Brown, Medicare Insurance Agent

Answer: Why do some people get huge medical bills even if they're on Medicare? The average seven-year-old that's only on original Medicare Part A and B would pay about $8,000 a year in medical claims. Under Part A, you'll have a hospital deductible of $1,736 in 2026. Part B deductible is $283, and then you have to pay 20% out of pocket. That's not different than most insurance plans, but with Medicare, there's no ceiling to that 20%. So your limit to the exposure of medical bills at $8,000 could be $500,000 if something really bad happened. Most people will buy a Medicare supplement plan or a Medicare Advantage plan to go along with their Medicare. So it gives them that maximum out-of-pocket. So don't leave yourself exposed like that. Educate yourself on your options before you turn 65. My name is Cody Brown with Senior Benefit Services, and I make Medicare easy.

Answer: What advice would you give to seniors who are feeling overwhelmed by all the Medicare options available? There's thousands of options out there, 50 different insurance companies trying to get you to sign up for their plans. It can be very overwhelming, but it doesn't have to be. My advice is to find someone local that represents all the plans and can be completely unbiased and not try to persuade you toward one option or the other. I help my clients every single day shop for the plans that are best for them and not in my best interest. So make sure that you work with someone that you can trust. That's going to show you all your options and help you navigate through it, and not just sign you up and sell you an insurance plan.

Answer: The question is, I'm on original Medicare without a Medicare supplement plan. How much will I have to pay if I take an ambulance ride to the hospital tomorrow? Well, it's difficult to predict because it falls under Part B of Medicare, which has a percentage. So after the $283 deductible has been met for the whole year, then you're subject to 20% of the total cost of that bill. So if your ambulance was $1,000 before insurance paid, you pay the first $283 and then 20% after that. So it could be costly if that total bill is pretty expensive. Cody Brown, Senior Benefit Services. Happy to answer all your Medicare questions.

Answer: Cody Brown, Senior Benefits Services. The question is, in your experience, what are the best Medicare supplement insurance companies to choose? There's no supplement company that's better than the next, and here's why. I'll read you a sentence here out of the Medicare new handbook, which you can get directly from Medicare. It says, if you're thinking about buying Medigap, be sure to compare plans. The cost can vary between plans offered by different companies for exactly the same coverage. So right here, there's a chart of all the different supplement plan letters that you can choose from. All the insurance companies have to follow this chart, and they're all standardized, which means they can't charge you anything different from the next company. They all give you the same exact coverage. So it's not your insurance company that decides how much coverage you get. It's the same across the board. They also don't decide which doctors and hospitals you can go to and what's covered. If Medicare covers something first, that supplement company has to pay second, no matter what. So it's important to get quotes from all the companies because if not, you could find yourself way overpaying for your coverage. It's not a whole lot different than having two different gas stations right next to each other, where one charges you $3 a gallon and the other charges $2 a gallon.

Answer: I'm Cody Brown, a senior benefits services agent. The question is, is it okay to meet with multiple Medicare brokers and agents as I start looking for help? I think it's important to do so, and I encourage my clients to. I tell them there are three things to look out for.

Number one, make sure they have access to you and show you many different insurance companies, not just one or two.

Number two, make sure they're not biased towards Medicare supplement plans or Medicare Advantage plans. I've had many clients tell me their old agent never even showed them the other option. So, there are many pros and cons to both, but it's important to make sure they present the facts to you and let you choose, not tell you which to choose.

Number three, try to figure out who's going to give you the best service and add the most value. We can't compete in products because they're all the same. Service is really what separates the bad agents from the good agents. Our clients have access to our back office customer service team. So, we tell our clients to make us your first phone call instead of having to spend time on hold with your insurance company, saving you a lot of time and stress.

So, it's important to check their reviews and really try to vet them first.

Answer: I'm Cody Brown, a senior benefits services agent. Today's question is, "I'm turning 65 in three months but still working with employer coverage. Do I need to sign up for Medicare now or can I wait?" This is probably the most common question I get from people aging into Medicare, and it's very important that you figure this out in advance because they don't automatically enroll you into Medicare. Just because you are continuing to work and keep your insurance doesn't mean that it's the better option compared to going on to Medicare.

Now, for most people, it's just convenient for them to continue with their insurance through work, and sometimes that's the better option. Sometimes it saves you more money and gives you better coverage. But what I find is Medicare typically beats most employer-provided insurances. Usually, you can get it for a lower premium and less out-of-pocket costs. It's not always the case, but it's important to make sure that you review your employer plan with Medicare to see if, even if you do keep working, you want to get off of it and go on Medicare because it might be more beneficial to you.

So make sure you're working with a local trusted expert who's going to give you unbiased opinions. I turn people away all the time and tell them to stay on their employer insurance if it's best for them. You don't have to sign up for Medicare whenever you turn 65. If you're not currently drawing Social Security and you just want to keep your employer insurance, you don't have to do anything.

It's a good idea to go ahead and make sure you keep Part A of Medicare, but you can delay your Part B for however long you want, as long as you keep that credible insurance through your employer. You don't have to pay any penalties down the road whenever you decide to get on Medicare.

Answer: I'm Cody Brown, a senior benefits services agent. Today's question is, what are the six things Medicare does not cover? This is probably my favorite question because it's so important to know what your insurance covers. But I think it's even more important to know what your insurance doesn't cover. We all hate surprises, and we don't want to have that unexpected bill one day and regret our decisions with our health care.

So the six things Medicare doesn't cover are dental, vision, hearing, cosmetic surgery, international care, and long-term care. The number one cause of bankruptcy among seniors is medical debt, and one of the biggest contributors to that is long-term care. Unfortunately, Medicare doesn't cover it, and people leave themselves exposed. So it's so important to make sure you're filling those gaps so that whenever you need the insurance, it's going to kick in.

Answer: I'm Cody Brown, a senior benefits services agent. Today's question is, "I'm living solely on Social Security of $1,400 monthly and can't afford my Medicare premiums and co-pays. What assistance programs might help someone in my situation?"

There are many assistance programs out there for people on Medicare who have a limited income. The two most common ones are Medicare Savings Programs and Extra Help with prescription drugs. The Medicare Savings Programs are funded and administered locally through your state Medicaid office. That can help pay for things like your Medicare premium and your health co-pays, or both. You can reach out to your local Medicaid office to see what you might qualify for.

There's also Extra Help with prescription drugs. That's the actual name of the program, and it is run through Social Security. So if you qualify for this program, you could get drastically reduced costs on your prescriptions. Someone who does not qualify for that program typically pays around $100 a month or so for a brand-name prescription on most prescription plans.

This assistance program would limit the amount that you pay for any brand-name prescription to $12.65 and any generic prescription to $5.10. So, there are lots of savings on the table out there for you. If you qualify for some of those programs, just make sure to reach out and see what's available for you.

Answer: Will I be penalized if I do not enroll in Medicare when I turn 65? There are two ways that Medicare can penalize you. If you don't take out Part B when you're first eligible for it in your 65th birthday month, or if you don't take out Part D when you're first eligible for it. Now, if you're continuing to work after age 65 and you keep insurance through your employer, you can come off that insurance at any time after the age of 65, and you will avoid those penalties because you kept credible coverage throughout that time. So as long as you keep credible coverage, you do not have to pay those penalties. But those penalties are 10% for every 12 months that you go without Part B. So if you go 10 years without Part B, you'd pay an extra 100% on top of what that Part B premium is that year. So you definitely want to make sure you keep that credible coverage and keep proof that you had that credible coverage throughout that time. There's a specific Social Security form that your employer would have to fill out and sign, showing that you had credible coverage during that time.

Answer: If I need long-term care in the future, how does Medicare fit into that plan? What should I be doing now to prepare? So, Medicare really does not cover long-term care. This is something that a lot of people don't realize until they get Medicare. But really, there are three ways to pay for long-term care: Medicaid, insurance, or private assets, just money that you have. Nursing homes can cost $8,000 to $10,000 a month in some cases, and most people don't have that much money to pay. So a lot of people that can't afford the insurance will be put on Medicaid once they need that type of care. But it's very important to prepare for this before you're eligible for Medicare, because the prices can get very, very expensive for long-term care insurance after the age of 55 or 60. It can get very difficult to qualify for. So you want to make sure that you're planning for this in your 40s or 50s, maybe even earlier. There are insurance plans out there that you can purchase. A lot of people get their long-term care coverage through maybe larger, what's called universal life insurance plans, but Medicare is not going to cover you for this. So you definitely want to prepare in advance and just know who you can go to for your resources.

Answer: How does Medicare Part B cover preventative screenings such as mammograms or colonoscopies? Part B should cover you 100% for those preventative screenings. Now, if they're considered diagnostic, there could be a 20% out-of-pocket cost. But it's always best to double-check with your insurance advisor or the doctor's office to make sure beforehand.

Answer: Can I change my Medicare supplement or Medigap policy at any time throughout the year? The answer is yes. Most people think they can only change those during the annual enrollment time in the fall, from October 15th through December 7th, but that's when you can change Medicare Advantage and prescription drug plans. Medicare supplement plans can be changed all year round, but not everybody can qualify to do so. You have to health qualify and go through underwriting, so every company is going to have a set list of questions that you have to pass and prescriptions that you can't take in order to qualify for their policy. Every policy covers the exact same if you choose the right plan letter, so a Plan G is a Plan G is a Plan G. They just charge different premiums. But not everybody is able to change. Now, there are some states that have specific rules that allow you to be guaranteed issue into a policy based on your anniversary or your birthday date, but not every state has those rules. So, it's important to compare all the options and all the prices when you're signing up for the first time. I'd love to help.

Answer: Medicare Part B covers outpatient mental health services, including intensive outpatient programs and partial hospitalization programs, if medically necessary and provided in a Medicare certified facility.

Answer: Medicare does not cover long term care. If you are transitioned from skilled nursing to long term care, you would need to use outside insurance or self pay.

Answer: Unfortunately, this is something Medicare doesn't cover. Medicare does not cover medical marijuana for any type of condition.

Answer: No, there is no way around Medicare not covering a hearing aid. You would need to purchase separate insurance outside of Medicare, or you can get that coverage through a Medicare Advantage plan.

Answer: The most common Medicare enrollment period is in the fall. The Annual Enrollment Period(AEP) is from October 15-December 7, where you can join or switch a Medicare Advantage or prescription drug plan. You can also make a change to your Medicare Advantage plan during the Open Enrollment Period(OEP) from January 1-March 31. There is no enrollment period for Medicare Supplement plans, so those can be changed any time of year.

Answer: Medicare does not cover routine dental and vision. You would need to get purchase coverage outside of Medicare, or seek these benefits through a Medicare Advantage plan.

Answer: Medicare does cover durable medical equipment. You would need approval from your doctor and is typically covered at 80%

Answer: No, you can not enroll in a medigap plan with no underwriting during the annual enrollment period. You can enroll any time of year, but you will always be subject to underwriting unless you qualify for a guarantee issue right.

Answer: Medicare Advantage plans are not free. Some plans have a premium and some have no premium. Either way they are funded by tax dollars, so you have been paying into it your whole working life.

Answer: If you are not drawing social security and automatically enrolled in Medicare, you will need to enroll in part A and part B. You can apply online at SSA.gov