Dustin Haffner, Medicare Insurance Broker

Answer: Medicare Supplement plans can deny coverage in some situations depending on when you apply.

If you are in your Medicare Supplement Open Enrollment period or have a guaranteed issue right, you generally cannot be denied due to health conditions.

However, outside of those situations, most companies in Oklahoma use medical underwriting, which means they can ask health questions and potentially deny coverage based on certain health conditions.

Answer: Medicare can cover multiple preventive screenings, even around the same time, but each test has its own eligibility and timing rules (like once a year or every few years), so they all have to be “due” to be covered; many are $0 under Part B if done as true preventive services with a provider who accepts Medicare, but if anything is billed as diagnostic or combined with treatment, you could owe copays or deductibles, and your Annual Wellness Visit mainly plans these screenings rather than doing them all at once—so it’s smart to confirm with your doctor’s office that each test is preventive, due, and fully covered before scheduling

Answer: Medicare Part B covers screening mammograms once every 12 months for women age 40 and older, and one baseline mammogram for women ages 35–39.

Colonoscopy screenings are covered every 10 years for people at average risk, or every 24 months if the person is at high risk for colorectal cancer.

For prostate cancer screening, Medicare covers a PSA blood test once every 12 months for men age 50 and older, and a digital rectal exam once every 12 months (the exam usually has a 20% coinsurance).

Answer: No — you do NOT have to re-enroll in Medicare Part A or Part B.

If you already have:

Part A (Hospital)

Part B (Medical)

They automatically continue when you turn 65.

Answer: It’s mentioned in the Medicare & You handbook… but it’s not emphasized the way it should be. Most people are focused on:

• Part A

• Part B

• Drug plans

• Medicare Advantage commercials

Medigap timing gets lost.

Insurance companies don’t advertise underwriting rules

Companies selling Medicare Supplement policies have no incentive to shout:

“After 6 months, we can deny you.”

They focus marketing on:

• “Freedom to choose doctors”

• “No networks”

• “Predictable costs”

The underwriting fine print isn’t the headline.

Agents don’t always explain long-term consequences

Some agents:

• Focus on getting someone enrolled

• Don’t explain future switching limitations

• Or assume clients won’t change later

Once someone chooses Medicare Advantage at 65 and later wants to move to Medigap, underwriting becomes a shock.

Answer: Healthcare’s biggest digital shift will be meeting patients where they already are—mainly through simple, text-based communication instead of clunky portals.

AI will quietly handle intake, triage, and follow-ups so patients get faster, clearer answers without waiting weeks or playing phone tag.

Care will move from occasional office visits to ongoing, between-visit engagement, especially for chronic conditions.

Answer: Make sure you’re in the right enrollment window

• Oct 15 – Dec 7 (Annual Enrollment):

You can switch from Original Medicare to Medicare Advantage

Coverage starts Jan 1

• Jan 1 – Mar 31:

Only if you’re already on Medicare Advantage

• Special Enrollment:

If you moved, lost coverage, etc.

Pick a plan

• Check:

o Your doctors are in-network

o Your prescriptions are covered

o Costs & extra benefits (dental, vision, hearing)

Enroll

o licensed Medicare agent

o Online at Medicare.gov

o By calling 1-800-MEDICARE

o Through the plan

Answer: Yes — Medicare does cover continuous glucose monitors for people with diabetes if certain eligibility criteria are met. Example would be checking you blood sugar 4 or more times a day. So you can use a compatible smartphone to view and track data, but Medicare may require you to have a stand-alone receiver device in addition to the smartphone to meet coverage rules.

Answer: HMO (Health Maintenance Organization) You use doctors and hospitals in-network, you usually need a primary care doctor, referrals required for specialists, out-of-network care = generally not covered (except emergencies)

PPO (Preferred Provider Organization) No primary care doctor required, no referrals needed

HMO-POS (HMO with Point of Service) Functions like an HMO most of the time but allows limited out-of-network care with approval

PFFS (Private Fee-for-Service)No fixed network and providers must agree to the plan’s payment terms each time with no referrals required

SNPs (Special Needs Plans) Tailored benefits, Care coordination, lower costs for eligible members however you must qualify to enroll.

MSA (Medical Savings Account plans) High-deductible Medicare Advantage plan that comes with a medical savings account funded by Medicare with no network restrictions

Answer: Medicare Advantage plans are not free. “$0 premium” is real—but incomplete meaning you must pay the Medicare part B premium.. Total cost depends on how much care you use. The risk shows up later, not monthly.

Answer: Instead of: “What’s the best plan this year?” Ask yourself: “How much uncertainty can I tolerate in a bad health year?”

Peace of mind in Medicare = predictability, not perfection.

Answer: Friends, neighbors, and Facebook beat expertise.

You explain Medicare for a living. But: “My neighbor loves his plan”

“My cousin said this works great” “I read online that…”

Next Fear of being “sold” assume there’s a catch, Worry you’re steering them.

Answer: What will this cost me in a bad year—not a good one? Total MOOP

The most important Medicare question isn’t about:

Premiums

Dental

Vision

$0 plans

It’s about future you!

Answer: All Medigap plans are secondary to Medicare -

but not all secondary insurance is Medigap.

“secondary insurance” describes how a plan pays, not what kind of plan it is.

Here are some examples of secondary insurance:

Employer or retiree health coverage

Union plans

VA benefits

Tricare

Medicaid

Answer: Medigap is only for rich people” → Not true; it’s about risk tolerance, not wealth

“You can switch to Medigap anytime” - false due to underwriting

“Medicare covers long-term care” - it does not

“All Medicare Advantage plans are the same” → false

Answer: Yes—IRA and 401(k) withdrawals can increase your Medicare costs.

If your income crosses certain thresholds, Medicare adds IRMAA (Income-Related Monthly Adjustment Amount) to:

Part B premiums

Part D premiums

So be sure to speak with a specialist.

Answer: Medical expenses are deductible only to the extent they exceed 7.5% of your Adjusted Gross Income (AGI).

Quick self-check

Ask yourself:

Did I total all Medicare premiums I paid?

Did I check my SSA-1099 carefully?

Did I contribute to an HSA after Medicare started?

Did I track copays and prescriptions?

These all are worth exploring with a tax advisor

Answer: Because Medicare is way more confusing than it looks, and a good agent can save you time, money, and stress.

Medicare is not one-size-fits-all

Original Medicare, Medigap, Part D, Medicare Advantage… each has different rules, costs, and trade-offs. An agent helps match your doctors, meds, budget, and lifestyle to the right setup instead of guessing.

They help you avoid expensive mistakes

Choosing the wrong plan can mean:

Doctors suddenly being out of network

Medications not being covered

Surprise bills

Late enrollment penalties that last forever

Agents know the traps and help you dodge them.

Most Medicare agents are paid by insurance companies, not by you.

They advocate for you after enrollment

This one’s huge and often overlooked.

A good agent helps when:

A claim is denied

A drug gets dropped from the formulary

Your doctors change

Your plan changes benefits next year