Cyle Gillman, Medicare Insurance Broker

Answer: Moving to a rural area could change the Medicare Advantage plans that are available in that geographic plan area. In order for a carrier to offer a Medicare Advatange Plan in an area there must be a certain number of doctors in that area willing to participate in that plans network.

Therefore, moving from a more populated area to a rural area, you may notice fewer plan options.

It's always best to do a search on Medicare.gov, call 1-800-Medicare, or reach out to a licensed broker to determine what plans would be available based on the area you are looking at moving to.

Answer: Yes, this is different. This is a Special Enrollment Period allowing a beneficiary to make a one time change from the current Medicare Advantage, Medicare Advantage with Prescription Drug Coverage, or Stand Along Part D plan, outside the Annual Enrollment Period to a plan that has a 5 start rating from CMS.

Answer: There are a number different ways that a medicare beneficiary can check to see whether her doctors will accept a Medicare Advantage Plan.

Searches can be done on Medicare.gov, by calling 1-800-Medicare, by talking to SHIP counselor are all ways. Calling the doctors she works with to find out what Medicare Advantage Plans they accept as in-network as well, or working with a licensed Broker; someone that is able to place individuals in the best plan for their situation.

The biggest thing to remember is that just because a friend likes a plan, doesn't mean it's right for your, or your mother's situation. Working with a professional that can look at all aspects and explain the key differences between what your mother currently has and what she is considering is going to be key.

Answer: No, Medicare doesn't cover nursing home care. Medicare will cover a portion of your care up to 100 days, after a qualifying hospital stay. The progress of your situation will be monitored during that time period.

You will want to do additional planning for nursing home care, in the form of short and long term care plans, as well as understand the basics of when your care would be covered under Medicaid in the event of a long term care event.

Answer: The short answer is yes, the information should be safe, but ask the agent you are working with questions that make you feel comfortable sharing more. The conversation shouldn't be one sided, you have the right to ask questions about how they will be using your information.

The more information you are willing to give an agent, the better solution the agent can find for you. Every agent should be gettin a signed Scope of Appointment from you before an appointment as well. That said, basic information your zip code alone will give an agent the opportunity to tell you the plans that are available in your area and discuss the basics of the plan.

If you want information tailored to you specifically, then more information is helpful. Your date of birth and your Medicare Beneficiary ID number, the name of any doctors you see, the hospitals that you would choose to have a procedure done and the prescriptions you are taking will be necessary.

If the agent is asking financial information, it may be to screen if you may be eligible for any extra benefits you may not be aware of. If they start asking you for information regarding specifics of your savings and retirement accounts, they may be looking to start a conversation about retirement and income planning; which should be discussed in a separate appointment from the appointment where you are discussing or choosing a medicare plan.

Answer: In 2025 the donut hole as it was known went away. They introduced a maximum out of pocket expense for covered prescriptions of $2000.00 and a Prescription Payment Plan, which allows you to spread the cost of your medications over the year.

This amount did increase for 2026 to $2100.00 for covered prescriptions. As long as your medication is covered on your providers formulary your expenses won’t exceed this amount.

Answer: Extra benefits are going to depend on the type of plan you have and your carrier. Medicare supplement and advantage have numerous different options. While “extras” are great benefits to explore, your agent should be working with you first to verify your medications and providers are covered and in-network with your plan.

Once you’ve verified plans that cover your specific situation, you’ll then want to see what extra benefits those plans will provide.

Answer: Medicare Advantage plans can be changed during Annual Enrollment, One time during Open Enrollment and one time for Special enrollment periods.

Annual Enrollment runs from October 15 - December 7 of each year.

Open Enrollment runs from January 1 - March 31 of each year. You may make one change; this is allowed because occasionally a beneficiary faces a “surprise”, Dr leaves their network, medications aren’t covered etc.

Special Enrollment periods can include moving outside of your coverage area, diagnosis of chronic conditions, being institutionalized, etc.

Answer: Essentially it’s not a matter of whether you’re paying or not, it’s how you’re paying.

Supplement plans come with monthly premiums, but depending on the plan you have, your additional costs throughout the year are very easy to predict.

With advantage plans, most don’t have an additional premium, but you pay as you see doctors, get treatment, are hospitalized, etc.

Most of the time, it comes down to how you want to pay for your coverage and what you’re most comfortable with.

Second to that, you’ll want to verify you have coverage for the medications you’re taking, by reviewing your plans formulary; whether you’re using an advantage or standalone part d plan.

Unless an advantage plan has a part B giveback, or you qualify for other assistance in paying for part B, you’re not going to avoid that monthly premiums; so essentially no coverage is free.

Answer: Depending on what has changed with your health, you may be eligible to switch your plan through a Special Enrollment Period (SEP). A SEP allows mid year changes under certain circumstances, to ensure that your plan still meets your needs if those needs have changed considerably since you signed up for it.

Answer: Medicare deductibles do change annually. If you are referencing Medicare Part A and Part B (Original Medicare) This is what those deductibles have looked like since 2020.

2020 A $1,408 B $198

2021 A $1,484 B $203

2022 A $1,556 B $233

2023 A $1,600 B $226

2024 A $1,632 B $240

2025 A $1,676 B $257

If you have a Medigap or Supplement plan one or both of these deductibles may be covered.

If you have a Medicare Advantage plan, your deductible will be set by that carrier and can vary from plan to plan.