Corey Romero, Medicare Insurance Broker

Answer: Start with what actually matters to them. Not what sounds good in a commercial, not what their neighbor has, and definitely not what was pitched at a "free" dinner seminar.

You want to look at three main things:

1. Doctors and hospitals they want to keep.

2. Prescription drugs they take.

3. Budget: including both monthly premiums and total out-of-pocket costs when they actually use the plan.

From there, the best way to compare plans is by using real tools, not guesswork. Medicare.gov has a plan finder that can help, but honestly, it is only as good as the info you put in. Our tools are a lot more in-depth and easier to compare.

If you're not familiar with how Medicare works, it can get confusing fast. Comparing Supplements to Advantage plans, figuring out provider networks, and trying to read between the lines of what is actually covered can wear anyone out. Even people who do this every day get overwhelmed, so we get it.

When I helped my own mom, the key was starting with her doctors and medications, then working backward to find what fit. We didn’t just sort by lowest cost and hope for the best.

The best approach is to work with someone who knows the system and is willing to take the time to get it right. And if you are doing it yourself, do not rush. Look at multiple options.

Medicare mistakes are expensive and long-term. Fixing them later is a lot harder than doing it right the first time, so ask questions and ask them early.

Answer: Unfortunately, yes. And I say that from personal experience.

Someone in my own family had fake charges show up from a bogus company billing Medicare for medical supplies they never needed and never received. It looked official, and unless you’re really paying attention, it’s easy to miss stuff like that.

Fraud is a big business, and seniors are prime targets, especially when their personal info gets out there. We’re talking shady companies billing Medicare for mobility devices, braces, tests... you name it. And most of the time, the person being billed has no idea it’s even happening.

So yeah, it’s a big problem for everyone. It’s easy to think “Medicare’s paying, not me,” but fraud drives up costs for everyone.

The best thing you can do is look over the Medicare summary notices or plan EOBs regularly. If something looks off, say something. You can report it, and in many cases, it gets cleaned up pretty quickly if you catch it early.

Answer: Yeah, probably. Because, to be completely blunt, if you don’t help, there’s a good chance they’re going to end up in a plan that doesn’t fit or costs way more than it should.

I just helped my own mom with it this year, and even with all the experience I have, it still took some digging to get everything lined up the right way. We had to go over her doctors, prescriptions, what she wanted to keep, what she didn’t care about - it’s not as simple as just picking the one with the lowest premium.

If you’re not familiar with how Medicare works, it’s easy to get overwhelmed. The commercials, the mail... It’s nonstop. And unfortunately, most of it’s designed to push people into plans that may or may not work for them. Sometimes the heavy sales tactics work in a way that our parents end up paying a high price to learn a lesson the hard way.

So yeah, be involved. Help them ask the right questions, or at least make sure they’re working with someone who will. Research what you can, speak to someone who is highly referred, and when something feels off - trust your gut.

Medicare isn’t hard if you’ve got good guidance, but it can be a mess if you go in blind.

Answer: Kind of, but not in the way you might hope.

Medicare only covers one thing at the chiropractor: manual manipulation of the spine to correct a spinal subluxation. That’s it. No X-rays, no massage therapy, no acupuncture, and definitely no general maintenance visits. Just that one service, and only if it’s medically necessary and properly documented.

So if you’re going in just for back pain, stiffness, or to “stay aligned,” Medicare’s not covering that. And unfortunately, plenty of people find that out the hard way when the bill shows up.

If it’s covered and you have Original Medicare, you’ll typically pay 20% of the Medicare-approved amount, and it counts toward your Part B deductible. If you have a Medicare Supplement (Medigap) policy, it may cover some or all of that 20%, depending on which plan you have. So in many cases, you’d end up paying little to nothing out of pocket for the visit, as long as it meets Medicare’s criteria.

Some Medicare Advantage plans may offer additional chiropractic benefits, but just to be clear, that’s the insurance company adding it and not Medicare itself. If it’s not covered by Original Medicare, the Advantage plan is the one footing the bill, not the federal program. This is where you’ll often hear mixed answers, since people tend to confuse the two.

Bottom line: If chiropractic care is a big part of your routine, plan ahead. Medicare coverage for it is very limited in most cases.

Answer: Honest answer: Medicare doesn’t really cover that the way most people hope it does.

If you need help at home with everyday stuff like bathing, getting dressed, cooking, or just someone to be there so you’re not alone, that’s considered custodial care, and Medicare isn’t going to pay for it. Doesn’t matter how much you need it or how long you’ve paid into the system.

Now, if a doctor orders skilled medical care at home like a nurse, physical therapy, or wound care then Medicare might cover that short-term. But it has to meet very specific rules, and even then, it’s limited.

Some Medicare Advantage plans throw in a few hours of in-home support as an “extra benefit,” but it’s usually not something you'd want to rely on for full-time support.

So yeah, this one’s frustrating. People assume Medicare will help more with this kind of thing, but if you need ongoing in-home care, you’re usually looking at long-term care insurance, Medicaid (if you qualify), or paying out of pocket. There are also short-term care policies that can work in a way that is very beneficial to these circumstances for those who are unable to get a long-term care policy later in life.

Not a fun answer, but that's just the way it is and you’re better off knowing that upfront than finding out the hard way.

Answer: Honestly? Longer than you or I want them to..

Here's the deal, there’s no clean answer here. Sometimes it’s a couple weeks. Sometimes it’s months. It depends on what you’re appealing, how good the paperwork is, and whether the right person at the right office decides to actually do their job that day.

Drug plan appeals usually move faster, especially if it’s time-sensitive. But if you’re appealing something like an IRMAA surcharge or a denied claim, you might be waiting a while and calling more than once to make sure it didn’t get lost in a black hole. Which, by the way, is not that uncommon.

It’s one of the most frustrating parts of Medicare. We do everything we can to get it right the first time and follow up, but the timeline? That part’s out of our hands.

Answer: Yes, some Medicare Advantage carriers are definitely better than others.

But "better" really depends on what matters most to you. Some have low copays but few doctors in their network. Others cover a wide range of providers but are a nightmare when it comes to customer service or don't cover your specific medications. Some make it hard to get things approved or change up your meds halfway through the year, which no one enjoys dealing with.

The key is knowing how the plan actually works in your area and not just what the brochure says or what worked for your neighbor. What looks great on paper might be a mess once you try to use it.

No one plan or carrier is a great fit for everyone. That’s why we take the time to match people with plans that fit them and their situations. We’ve seen the good, the bad, and the ones that look good until the fine print kicks in.

Answer: Not necessarily. Just turning 65 doesn’t automatically mean you qualify for Medicare.

You need to be a U.S. citizen or a legal resident who’s lived here at least five years. On top of that, you or your spouse need to have worked and paid into Medicare taxes for about 10 years (or 40 eligible quarters) to get Part A without paying a premium.

If you haven’t met that work requirement, you can still get Medicare, but you might have to pay for Part A out of pocket along with the premium for Part B.

So no, it’s not just about age. There are a few other things that have to line up.

Answer: Yes, the cost of Medicare can be different for everyone.

Some people pay the standard premiums while others end up paying quite a bit more, depending on their income and the type of coverage they choose.

If your income was higher a couple years ago, you might get hit with IRMAA, which means you’ll pay more for Part B and Part D.

Then it depends on whether you go with a Medicare Supplement or a Medicare Advantage plan, and what kind of drug coverage you pick. How often you go to the doctor or use certain medications can also affect what you actually spend each month. No one plan is a perfect fit for everyone and this is extremely important to know since everyone has differing opinions on this topic.

So while Medicare has a few “standardized” costs, what you end up paying out of pocket is based on your specific situation and should be treated as a unique case for every single person.

Answer: IRMAA is always (NOT) a fun surprise and many folks don’t see it coming. It stands for Income-Related Monthly Adjustment Amount, but really, it just means Medicare is charging you more because you “made too much” two years ago. Yay, right?

Medicare looks at your income from two years back - so in 2025, they’re using your 2023 tax return. If your income was over a certain amount, you’ll pay extra for Part B and Part D. And no, it’s not always a small bump - it can be a few hundred bucks more per month depending on your income level.

You’ll get a letter from Social Security if IRMAA applies. The timing of that letter? Let’s just say it's government issued and doesn’t always conveniently show up BEFORE you’ve already picked your plans and thought you had your costs locked in.

If you’re not working with someone who brings this up ahead of time, that Social Security letter is not a fun one to open. That’s why it helps to trust your advisor who’s actually looking ahead - not just plugging in plan info or letting you go at it alone.

The good news? If your income has gone down if you just retired, sold a business, or lost a spouse - you can appeal it using form SSA-44 to get those premiums adjusted.

If your 2023 income was over $103,000 (single) or $206,000 (married filing jointly), it’s worth looking into. If not, you’re probably good. Either way, the key is catching it before you’re stuck wondering why your Medicare bill just jumped.

Answer: If your same prescriptions from the same pharmacy on the same drug plan suddenly cost more this year, you’re not crazy. Part D plans reset every January, and even if you didn’t switch plans during Annual Enrollment Period (October 15 - December 7), your plan may have changed on you!

The drug list, or formulary, may have shifted, bumping your med to a higher tier with a higher copay or dropping it from coverage altogether. They send those notices out in easy to overlook mailings and e-mail notifications that are generally ignored by many people who are happy with their coverage. That is, until those changes take effect.

And we can’t forget about the pharmacy game. If your go-to mom and pop shop isn’t considered a “preferred” pharmacy anymore, you’ll end up paying more just for sticking with what’s familiar. The big boys are playing hard ball and sometimes our local pharmacies end up paying the price or are forced to pass that on to you.

Bottom line: plans change, prices go up, and most people don’t find out until they’re standing at the pharmacy counter in January.

Don't wait to review these changes after you receive the shocking bill. Stay on top of changes or work with someone who will help review your options as part of your client relationship.

Answer: Sure! Here’s a recent one that sticks with me:

I had a someone call in who was transitioning from employer coverage to Medicare, but she was still working part-time and had COBRA offered to her. The HR department gave her some half-baked advice and basically told her to take COBRA and “figure out Medicare later.” Problem is, that can screw up your Medicare Part B enrollment and lead to a lifetime penalty or delayed coverage start.

When she reached out to me, she had no idea that COBRA doesn’t count as creditable coverage for delaying Medicare enrollment. If she followed their advice, she would’ve ended up paying more forever and had a gap in her health insurance.

I walked her through exactly how to enroll in Part B on time avoiding those penalties and helped her choose a supplement that kept her doctors and medications covered without all the network drama that she had faced on her group plan.

Her exact words after we finished: “Why didn’t anyone tell me this earlier?”

My answer? “Because they don’t get paid to.”

The unfortunate truth is that HR employee likely didn’t have bad intentions but was simply going off of the limited knowledge that they had so it is a great example of why it’s so important to work with someone who really knows the intricacies of Medicare enrollment.

This is what we a great agent will do. We cut through the noise and get people the right coverage the first time. No guessing. No confusion. Just the truth.

Answer: The biggest mistake I see seniors make when enrolling in Medicare? Pretty simple. They listen to commercials with retired athletes or actors instead of getting real advice from someone they actually trust.

They pick a plan because it says “$0 premium” or “extra benefits,” but don’t realize what they’re giving up until it’s too late like higher out-of-pocket costs, network restrictions, or a drug plan that doesn’t even cover their meds.

Medicare isn’t hard when you’ve got someone who sees you as a person, not a policy number or commission check. It feels like a pain because it’s designed that way so you’ll make a fast decision and never look back.

The key? Honest, no-pressure guidance from someone who knows the system and gives a damn. Not the people on TV reading a script about a “great” Medicare plan he probably doesn’t even use because, let’s be real, they’re either not on Medicare or have a low-cost group plan.

Start with a conversation, not a commercial.