Niels Heemskerk, Medicare Insurance Agent

Answer: IRMAA is calculated based on your family's income 2 years before the current year. Social Security looks back 2 years every year, in addition, the actual increase may change every year.

Answer: You can file the SSA-44 in the year you are experiencing a life event. It sounds like your income may have changed significantly in 2025 and 2026. Since you are planning to participate in Medicare part B and D in 2026 you can file the form this year.

Answer: The advantage of working with a reputable broker/agent is that they know the market and can help answer all questions. Make sure you find someone that will do a thorough needs analysis. If you are not comfortable with the agent, find another one!

Answer: A lot of my clients that are just about turning 65 believe that Part B is an automatic. They will call a week before they are qualify for Medicare and think all is set. My recommendation is that three months before their effective day they should get Part B set up.

Answer: No need to be sceptical, but they probably did a very good needs analysis and found that you need or want really good dental coverage included in the medical plan and very low premiums.

Answer: To know if your hearing aids are covered there are two ways to do so. The Evidence of Coverage which you can find in the member portal for your plan has that information. The other way which maybe easier is to call the customer (member) service number.

Answer: The one piece of advice I would give is find a reputable insurance agent that can show you all options. Pick the plan that fits your budget and your needs.

Answer: You can enroll in Medicare the 3 months prior to your 65th birthday, your birthday month, and the three months after your birthday month.

Answer: You do not have to re-sign up, but it maybe a good time to review your current plan and see what's available. You have a new Initial enrollment period and can chose any plan without medical questions the 3 months before your 65th birthday, your birthday month, and 3 months after your birthday month. Speak with a reputable insurance agent to help find the right solution for you.

Answer: The options for good coverage are many and somewhat confusing. A reputable insurance agent will do a thorough needs analysis and based that present all the options available so you can make an informed decision.

Niels Heemskerk

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Answer: This is a really good question. There are two roads in your journey to cover the gap in Medicare. You ask about one of those roads, Medicare Advantage, which really combines Part A, B, and ,D and sometimes other benefits like chiropractor, dental, vision, and hearing. The premium is usually very low, but you pay as you use the plan through copays and coinsurance, and there are varying maximum out-of-pocket expenses.

The other road is to purchase a Medicare Supplement and a Prescription plan. The premium is a bit higher, and it can go up when you get older. The big advantage is that you only have to pay a small deductible, and you can go to any doctor or hospital that accepts Medicare.

Someone who has medical issues should look hard at the latter, as long as they have a guaranteed issue enrollment period.

Talking to a reputable insurance agent who can present you with all the options is important. Give me a call!

Niels Heemskerk

Health Markets Insurance Agency

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