Gary Haft, Medicare Insurance Agent

Answer: Basically, there are some exceptions, but in most cases unless you have Long Term Care Insurance or a Home Care Only policy, you are pretty much on your own.

If you have a three day stay in a hospital for the surgery and then within a few days enter a nursing home, you might get some coverage, but home care under Medicare is kind of rare.

Answer: Logically making Medicare available to younger individuals would vertically end up bankrupting Medicare’s trust funds a lot sooner that the scheduled date of 2033, where if the U.S. Government does not do something fast will cause those receiving SS and/Medicare to be reduced by about 21%-23% and today - no one can afford to lose that much of their Social Security and pay more into Medicare’s I.R.M.A.A.

also know as the Income Related Monthly Adjustment Amount where everyone pays into based on their Modified Adjusted Gross Income (MAGI). We are in for a rude awakening in 2033.

Answer: Medicare requests that you start the enrollment process for Medicare within the three months prior to the month that you turn 65. There is a 7 month enrollment period that starts 3 months before the month you turn 65 and then there is the three months after your birth month. Most everyone starts the process in the three month period before 65.

Answer: Technically - Yes, but remember that you probably will have to answer medical questions to qualify. If you can qualify- you may change your Medicare Supplement any month of the year.

Answer: Seniors are losing Medicare Advantage plans because many of the carriers are losing money on the plans and many plans are being discontinued, especially the better plans. The carriers are offering more plans with less benefits to make up their losses. They are also no longer paying agents commissions on many plans and you must be very careful talking to agents as they will only sell you a plan they will get paid on and if a non-commissionable plan would have been better for you - they won’t tell you that a better plan exists because they are not getting paid on it. Finding a well-established and honest agent will tell you the best plans even if it non-commissionsable.

Answer: Medicare Advantage plans have restrictions and limitations. If you have health issues and need to know you can use your choice of providers - then a Medicare Advantage Plan is not the right choice. If you want freedom to choose your providers & can afford to pay a monthly premium then a Medicare supplement is your best choice.

Answer: No need to change your plan only your residence address. Depending upon the carrier you are with - more than likely - your rate will change based on your zip code in Florida.

If you were thinking of changing your plan in Florida - it would be based on your current age and of course your zip code. The only reason to change is if your premium on a Florida policy is less in premium for the same plan you are currently on, but the concern is you would likely be underwritten and have to answer medical questions to qualify. I am a Medicare Agent for the past 41 years.

Answer: If you are talking about Medicare - keep in mind that Medicare does not cover outside the USA.

If you have a Medicare Supplement - then they will cover up 80% up to a lifetime maximum of $50,000 after you meet a $250 deductible. Also keep in mind - it is really for "emergency" needed care that would be considered a life-threatening emergency. All claims must be in English or at least converted to English before submitting it to your insurance carrier.

Answer: If you are wanting to change your Medicare Advantage Plan and you missed the

Medicare AEP-Annual Enrollment Period - then you have a second chance with the Annual OEP - Open Enrollment Period (Jan 1-Mar 31) that follows the AEP.

Answer: Talk to an experienced and honest Medicare agent by asking friends and relatives for their agent to help. A good Medicare agent might have the CMIP designation which is a Certified Medicare Insurance Planner

Answer: That all depends on your individual situation. If you want freedom of choice to choose any provider - then choosing a Medicare Supplement along with a stand-alone Part D makes sense. Advantage plans do have restrictions.

Answer: Yes - it is overkill with all the marketing literature sent out and much of it is very confusing to most seniors. Many seniors are signed up for a plan and they don’t even know they signed up. Most never authorized and an agent went ahead and enrolled them anyhow. Must be careful not to agree to anything on the phone or by email or text message.

Answer: You can possibly save in your Medicare Supplement by switching to a High Deductible Plan G where your premium is very low, but you would have an Annual Deductible (in 2025) of $2,870. Most clients don’t hit that deductible in most years and therefore saves a considerable amount of premium dollars to pay the deductible.

Answer: The higher the premium the lower the deductible. But it all depends on your current health and whether you are willing to pay the higher premium or whether you want to keep your premium low and if you willing to pay out of pocket until you meet your deductible.

Answer: It is not always easy to differentiate between an experienced agent and a new agent. Sometimes a new agent has learned all there is to know and can answer all your questions but one way to know for sure is when they received their health insurance license. That will tell you how long they have been in business and how long they have had thei “Health” license. Like my self - I have my license for health since 1984 and have worked in the Medicare area since then. That’s 41 years.

Answer: The Donut Hole is already gone for 2025. This means that once you hit retail cost of drugs at $2,000, then your drugs are all free until the end of the calendar year. The $2,000 is the maximum cost of drugs on all 2025 drug plans.

Answer: Very Simple. According to the AMA - AMerican Medicare Assn, doctors are permitted to leave any advantage plan with 30 days notice to the carrier in any month of the year, but you as a policyholder are stuck with the plan for the full calendar year. That is the rule. I believe that should not be allowed by the AMA has fought to protect the doctors.

Answer: Understand that a Medicare Advantage Plan has a network of providers they expect you to use whereas Original Medicare and a Medicare Supplement allows you to go to any doctor or hospital or medical facility in the USA as long as they work with Medicare. There are many restrictions on a Medicare Advantage Plan and you have to follow their rules and stay within their network of providers. With Original Medicare and having a Medicare Supplement - you have freedom of choice to see anyone of your choosing.

Answer: Original Medicare has no liability to pay any claims if you are on a Medicare Advantage Plan. Medicare pays a flat rate to the Medicare Advantage Plan carrier to manage your care and the carrier is responsible for paying your providers NOT MEDICARE itself.

Answer: Medicare for many years did not allow for Acupuncture to be covered, but I now believe that many of the Medicare Advantage Plans may be covering acupuncture, but you MUST confirm with the advantage plan you wish to enroll in before you actually enroll.

Answer: Since the changes to the 2025 Part D program now has a $2,000 cap on the cost of drugs as long as your drug is on the formulary list for the Part D plan you are on or will have chosen, then the $2,000 cap applies to you and that drug as well as all your prescriptions. The drug must remain on the formulary list of covered drugs in order to have that $2,000 per calendar year cap.

So - if your drug costs $6,000 per month and the cap is $2,000 for the calendar year, then your maximum cost is $2,000 for the entire year or at least the balance of this calendar year. The insurance carrier is responsible for 60% of the overage above the $2,000 cap. I hope this answers your question.

Answer: If you are retiring next year - are you turning 65 or are you already 65+. What you need to do will determine whether you are already on Medicare Part A & B and whether your current insurance is better than what is offered by a Medicare Supplement or is a Medicare Supplement better.

Answer: Working with a Medicare Agent near you just makes the relationship a little stronger as you now know the agent and it is a little more personal. But working with an agent remotely is not a bad thing if it is a referral from another client. That client has already worked with the agent and has a trust in that agent. I prefer to meet with clients locally if at all possible as it builds a better relationship between client and agent.

Answer: In order to prevent fraud - make sure you check all your claims and bills against the Medicare Summary Notices you receive and make sure the doctor or provider has not entered any additional services that you did not receive.

Answer: A Medicare broker is on who represents several insurance companies that sell Medicare Plans.

A Medicare Agent is someone who works for Medicare directly.

Answer: Your contract with your Medicare Advantage Plan is set up for a "Calendar Year" and therefore you cannot leave that plan until the next enrollment period effective date (January).

Simply speaking - When you sign up for a calendar year plan, you are basically stuck with the plan for that calendar year.

The Annual Enrollment Period (AEP) October 15th thru December 7th each year with a start date of January 1st of the following year.

Answer: IRMAA Never does away. There will always be IRMAA. If your income is less than $106,000 (for 2025) as a single person or $212,000 for a married couple (filing jointly) then you would pay the base rate of $185.00/mo. It is suggested to notify Social Security if it drops below the above figures.

Answer: You can see your current doctors on a Medicare Advantage Plan if they are listed in their Provider directory and obviously must be currently on their provider network. Otherwise you will need to look for new doctors/providers within the Provider Network of that Medicare Advantage Plan. Each Advantage Plan has a different directory.

Answer: The only way you can do that is if you have been on a Medicare Advantage Plan for 12 months or less and this includes all Medicare Advantage Plans combined for those twelve (12) months. Once you hit the 13th month, you can no longer move from a Medicare Advantage Plan to a Medicare Supplement without answering the Medical Questions.

Answer: Usually Medicare Part A covers you very well. If you enter a hospital for an overnight stay and you do not have a Medicare Supplement, you would have to pay a deductible of $1,676 whether you are in for one overnight stay or up to 60 days. If you have a Medicare Supplement, then between Medicare and your supplement you are fully covered and that deductible would be paid by your Medicare Supplemental plan. You are covered up to 150 hospital days thru Medicare and your supplement, but your supplement covers you for an additional 365 days.

Answer: No - If you are on Medicare Disability prior to age 65, then you have another chance at a guaranteed issue of a Medicare Supplement at age 65. Those on Medicare Disability realize the cost of a Medicare Supplement is very expensive and most people will take out a Medicare Advantage Plan (as long as you have both Medicare Parts A & B) where it is more affordable but not necessarily the best choice for insurance.

Answer: It all depends on your working status. If you are still working, even in a tight budget, if you take your Social Security early at age 62, you will get approximately 25%-30% less and for the rest of your life with the lower amount AND you will have to pay back money if you earn over the threshold working prior to your full retirement age (FRA). Once you make it to your FRA, then you can earn as much as you want. If you delay to age 70, for each full year above your FRA (Let's assume your FRA is 67), then you will get an additional 8% per year for three years, that's 24% more income. It is up to you. I personally waited to age 70 to get 32% more as my FRA was age 66.

Answer: Normally you are automatically on Medicare Part A (Hospital Insurance) as of the first day of the month of your 65th birthday, even though you have not applied for it. Do you have to apply for Medicare Part B? No - not while you are still working, whether you are on your employers group health plan or an individual health plan. If your group has 20 or less employees on the group plan, then Medicare is Primary and you may be required to enroll in Medicare in order to have coverage. If the group is larger than 20 employees (21 or more) then Medicare is secondary to your group plan and your plan pays first and Medicare pays second. I don't recommend that anyone enroll in Medicare if they are still working unless they are required to. Besides, if you are on the group plan and NOT enrolled in Medicare, you do not have to pay the Medicare Part B fee.

Answer: Sorry to say - NO, as far as I know. Why would there be any tax benefits for paying Medicare premiums, whether you are a retiree or if under 65 on disability.

Answer: I do not believe that Medicare will ever be privatized. If that were to happen, then we would have to go to National Health Care like Canada or England and other countries, but something like that really can't happen in the USA because it would mean that everyone on America would have to be on the same plan and that includes the U.S. government employees including the President and Vice-President and all those in the Congress and the House and the Senate and you know that they have the best insurance in the world and we Americans are paying for their insurance, so why would they agree to lowering their benefits?

Answer: Medicare itself does not cover, Dental, Vision or Hearing. BUT, Medicare Advantage Plans - many of them cover some of these extra benefits, but you must use their facilities, meaning you must use their dental facilities and their hearing vendors as well as their vision vendors. If you have a dentist that you wish to maintain and he or she is not on the dental provider list of the Medicare Advantage Plan, then you have to decide if you are willing to change dentists. If Medicare Supplements were to add these benefits to their plans, they would have to increase their premiums to cover some of those benefits or make them an option to add them otherwise if they are included at a higher premium, many that don't need or wish to have those benefits would end up paying for them for everyone else.

Answer: Medicare agents go through certifications each year or two to be able to learn the products available so they can help you choose a plan to meet your needs. The only thing I find in the 41 years I have been working with seniors on Medicare Plans is that many agents are out to sell you a plan that makes them the most money. Most younger agents starting out in the business might do that so they can build up their business. If you speak with an experienced agent who has been in the business a long time, will tend to be more straight with you and really show you plans to fit you and your budget and not concerned as much at the commission they will receive as long as they get paid from the carrier. --Gary Haft,

Answer: Medigap or Medicare Supplements do not have provider networks and therefore you can see any provider of your choice. Medicare Advantage Plans all have provider networks. HMO Plans you must use only "In-Network" providers and PPO's allow you to go out of network, but you must ask that provider if they will accept the "terms, Conditions & Fees" associated with your Medicare Advantage Plan. Out of network providers are not mandated to care for you and could ask you to pay out of pocket.. Most of the time if they are not on the plans network, they will not necessarily work with you.

Answer: No one can avoid IRMAA, unless your MAGI is on or below the basic income. For 2025, if your household income is below $212,000 for a married couple or $106,000 for a single person, then you pay the standard base rate of $185/mo. Any income above these figures, you will pay a higher amount.

Answer: Your Medicare Supplement will work anywhere in the world, but it us usually for an emergency situation. If you are just not feeling well and it is not life threatening, you are likely not going to get the claim paid. Remember that you have a $250 deductible to meet before your Supplement would pay, therefore if you are not feeling well and you go see a doctor, and your cost is less than $250, then it is all out of your pocket. It is always recommended that when traveling outside the USA - to consider taking out international insurance that covers your health and medical expenses. Just be aware that these plans do have limitations and restrictions.

Answer: Medicare DOES NOT cover hearing aids. If you are on a Medicare Advantage Plan, many of these plans cover a portion of the cost of a hearing aid. therefore if you want a good set of hearing aids, you will likely need to pay out of pocket. If you are a Veteran, the VA does provide a free paid of hearing aids but it may be determined by your disability.

Answer: I am not sure of your question - but Medicare is looking for the lowest possible cost and therefore looking at the Medicare Advantage Plans overall - it seems the costs have increased substantially, and they are finding that there are more claims that are possibly not medically necessary causing the Medicare Advantage Plan to possibly cost Medicare more on their side than the Medicare Supplement and Original Medicare. Understand that Medicare pays a flat amount of money to each carrier for each enrolled member to a Medicare Advantage Plan and if your expenses exceed that amount, the carrier loses money and therefore many times looks for another way to charge Medicare for that excess. The amount Medicare pays to the carrier for that enrolled member depends on the health of that member.

Answer: IRMAA is the Income Related Monthly Adjustment Amount and this changes each year and is based on your Modified Adjusted Gross Income for the last filed tax return which in many cases is the tax return from two years prior. Therefore for 2025, the tax return used is the 2023 tax return or if you have already filed your 2024 tax return, that may be used. Your income may be more than your friends and therefore you will pay more.

Answer: To ask what are all the plans available to them and the cost of the monthly premium for each plan so they can choose an affordable plan. There are many carriers that offer the plans and the question is really, "Which Carrier is the right one?" The right carrier is not always the least expensive one. But the question is how long has the carrier been in the Medicare Supplemental market to know how experienced they are.

Answer: AI is so new that I am not totally sure what Medicare will cover, but if Medicare approves of the claim submitted by your provider, then obviously Medicare will cover their portion and if you have a Medicare Supplement, then your supplement will pay its portion of the claim. Medicare pays 80% of what they approve and your supplement would pay 20% of the Medicare approved amount.

Answer: I ask prospects to come to my office if they are within a reasonable proximity to my office and sometimes if I am able - I can meet them at their home and I show them all their options and explain how these options work and we can then be able to choose the right plan to fit their needs and budget. It gets a little complicated at the start, but when I am finished, you will be able to understand it all.

Answer: Medicare does not cover any medical expenses outside the USA. When you are on a cruise ship you are technically outside the USA. If you have a Medicare Supplement, it covers benefits outside the USA up to $50,000 lifetime benefits after you meet a $250 deductible. This deductible is separate from your Medicare Part B deductible of $257 (for 2025). Once you use up that $50,000, it is gone forever. Keep in mind that all claims outsider the USA must come to the insurance carrier in ENGLISH and you will be submitting the claim directly to your carrier.

Answer: Simple - if you enrolled in Medicare late meaning after your Initial Enrollment Period (IEP), which would be within the 7-month enrollment when you are approaching age 65. The 7-month period is the three months before your month you turn 65, the month you turn 65 and the 3 months after you turn 65. If you miss this 7-month period when enrolling in Medicare, then you will be penalized for the rest of your life.

Answer: You must tell the doctor when you make the appointment for the annual physical that this appointment should be submitted as your Free annual physical. You see doctors don't get paid the same as if it was a regular visit.

Answer: Since I am in the business, I read all the articles on Medicare, which you too can do, but I get much of my information directly from the Insurance Carriers and some information directly from Medicare. I find that 98% of Medicare Supplement clients never change their policies. As for Medicare Advantage Plans, they seem to change each year to some degree and that means clients/policyholders need to really talk to their agent or a new agent about comparing their current Medicare Advantage Plan to a new plan during the Annual Enrollment Period between October 15th and December 7th each year. There are usually some changes in the Medical Benefits and many times there could be changes to their Drug Formulary and that means you need to check to see if your current prescriptions are still covered on their formulary list. You also wish to make sure your doctors/providers are still on your plan as well as they are permitted to leave the plan any month of the year with 30 days notice to the carrier, but you cannot do that. -- Gary Haft

Answer: It is actually true. The $2,000 drug cap is actually based on the total retail cost of the drugs. All drugs must be on the plans formulary list in order to count towards that $2,000 cap

Answer: HSA SAVINGS ARE PERMITRED TO BE USED AFTER RETIREMENT FOR MEDICAL EXPENSES AND I BELIEVE CAN BE USE TO PAY FOR MEDICARE PLAN PREMIUMS - BEING PAID FOR A MEDICARE SUPPLEMENT PREMIUM. I DON’T THINK YOU CAN PAY YOUR MEDICARE PART B PREMIUMS (IRMAA FEES) WITH HSA MONIES.