Gregory Gudis, Medicare Insurance Broker

Answer: First off, congratulations on reaching an important milestone. The best thing you can do is start early so you don’t miss your enrollment window. You have a seven-month period to sign up that starts three months before your 65th birthday month and ends three months after.

If you’re already collecting Social Security, you’ll be enrolled automatically in Medicare Parts A and B. If not, you’ll need to sign up through Social Security. From there, decide whether you want a Medicare Advantage plan or Original Medicare with a Medigap policy and a Part D drug plan.

Everyone’s situation is different, so it’s worth having a short conversation to make sure your coverage matches your health needs and budget. A little planning now saves a lot of headaches later.

Answer: There isn’t one that’s better for everyone. It really depends on your needs, lifestyle, and budget. Medicare Advantage plans usually have lower monthly premiums, but you’ll pay more as you go with copays and network limits. They often include extras like dental, vision, and gym benefits, but you have to stay within the plan’s network.

Medigap has a higher monthly premium but very few out-of-pocket costs. You can see any doctor in the country who accepts Medicare, which gives you more freedom, especially if you travel or live in more than one state.

If you want lower premiums and are comfortable with a network, Advantage might fit. If you prefer predictable costs and full flexibility, Medigap is usually the better choice.

Answer: That’s a great question. It’s important to know that Medicare doesn’t cover long-term custodial care, like help with bathing, dressing, or eating. It only covers short-term skilled nursing care after a hospital stay.

To plan ahead, start by learning what’s covered and what isn’t. Look into long-term care insurance or hybrid life policies with care benefits while you’re still healthy enough to qualify. Medicaid can help with nursing home costs, but there are strict income and asset rules, so early planning with a professional is key.

Finally, build possible care costs into your retirement plan so you’re not caught off guard later. The earlier you plan, the more control you’ll have over your care and your finances.

Answer: This will always be more of a personal preference on how you like to do business. Both nearby agents and remote agents can typically offer the same products and guide you the same, a local agent can meet you in person and typically knows the local market a little better than someone selling all over the country. As an agent I moved from the Philadelphia metro area to the Phoenix metro and while I continue to service my customers back east and add more, I have become more in tune with my current market and visit folks to review their needs when they request. I think this brings a more personal experience for probably one of the most important needs in retirement, your health insurance.

Answer: When choosing an insurance agent doing some thorough research is crucial to ensure you find a trusted professional. First and foremost, check with your state's Insurance Department to confirm the individual is properly licensed. Many states can be found here including my home state of Arizona.

The next step would be to review their professional credentials, if any. For example, I am a Certified Financial Planner and advertise myself as one. You can look up those credentials and any past disciplinary actions.

After that you can certainly do some research looking individuals up online but of course not everything on the internet (good or bad) is true. After confirming the above and knowing their licenses are up to date you will at some point have to trust your instincts and decide if this person is right for you when gathering information to make your insurance decisions.

Answer: Without knowing your plan and whether it is Medicare with a Supplement or Medicare Advantage, this is a difficult question to answer. While Original Medicare does not usually require prior authorization (usually meaning they still can), Medicare Advantage plans would be more likely to.

Answer: The changes to Part D in 2025, especially the addition of a $2,000 out-of-pocket limit, will greatly assist those who require costly specialty drugs. This change ensures that once individuals hit this maximum out of pocket, they will no longer be responsible for any further payments for covered medications for the remainder of the year.

Answer: Medicare doesn't pay for a short-term stay in assisted living since assistance with personal care tasks isn't considered medically necessary. However, Medicare does pay for medically necessary short-term care in a nursing home

Answer: This can be done on the Medicare website but I absolutely recommend speaking with an agent who does this everyday. Getting your Part D plan correct could save so much money and a mistake could be really costly.

Answer: Medicare Part A is the hospital insurance part of Original Medicare but it is not a comprehensive solution. The addition of Part B and Part C or Medigap would give the beneficiary a more complete plan.

Answer: Every person is different and depending on your individual needs one cannot necessarily be said to be better than the other. I have found Original Medicare with a Supplement and Part D plan makes people very confident with no network, referrals and usually no or low copays. On the other hand Medicare Advantage tends to be cheaper up front, has more added benefits outside of what Medicare covers and is usually more similar to what folks had when working. That said it is always worth having your situation evaluated by an Insurance Broker before making a decision.

Answer: After being on Disability for 2 years you are automatically enrolled in Medicare even if you have not reached 65 yet.

Answer: Most people think they will have poor coverage when on Medicare vs what they had when working. As plans have continued to add benefits and there are caps on out of pocket for Part D, plans tend to be much better than work coverage.

Answer: Talk to an Insurance Broker to find out all of your options. Don't go directly to one company. Your needs are going to vary from others and you need a plan that fits those needs.