Hannah Skinner, Medicare Insurance Agent

Answer: Although Medicare does cover an abundance of services, there is not a guarantee that Medicare will cover everything that your employer coverage does. It would be wise to do a side by side comparison of your current plan versus Medicare plans. Meeting with a Medicare agent to discuss your options can make comparing plans less overwhelming.

Answer: I love getting to work with seniors to help them get the coverage they need and deserve. Medicare can be very confusing and everchanging, so it's nice to have someone on your side that can keep up with these things for you. I love being that person for my clients.

Answer: Yes, you can change your Medigap plan at any time of the year. You must be able to health qualify to change unless you live in a state that has rules that say differently. Although, you can change at any time, you typically get your yearly rate increase on your policy's renewal date. This can be a good time to review your plan because you have the most accurate rate information.

Answer: Medigap plans are great for people who travel a lot because they do not have networks. You might face higher costs by going with an Advantage plan with networks if you are trying to receive treatment out of the service area. It is never a bad idea to meet with an agent and review your Medigap plan. You could be paying too much for it and could get the same coverage for much less.

Answer: If your employer coverage is creditable towards Medicare (meaning your employer has 20 or more employees) then you should be able to defer Part B. When you are ready to take Part B when you retire, you will need to prove that you have creditable coverage, or you will receive a late enrollment penalty.

Answer: There is a common misconception that Medicare covers long term care or nursing home care. Unfortunately, Medicare does not cover long term care or a stay at a nursing home. I would recommend a long or short term care policy to cover this expense.

Answer: A PPO allows you to go out of the network if you choose to, but you will likely have a higher cost than if you were to go in network. An HMO typically does not allow you to get care outside of the network except in the case of an emergency. HMOs can be more restrictive especially because doctors can leave the network in the middle of the year. Your doctor leaving the network does not give you an opportunity to change your plan.

Answer: If you are over 65 and have previously deferred your Part B then you will want to apply for Part B to start when your employer coverage ends. When applying you will need to have your employer benefits person fill out an employer benefits verification form to prove that you had creditable coverage since you turned 65. If you are under 65, then you will want to look at other coverage options until you turn 65.

Answer: Medicare Part A covers inpatient hospital stays, skilled nursing facility stays, and hospice among other things. There is a $1676 deductible that resets every 60 days. This means you could have this deductible up to 6 times a year which could total over $10,000 in a year. There is also a limited amount of days that Medicare will cover in the hospital/skilled nursing facility. I would recommend looking at some type of secondary coverage to avoid this large out of pocket cost such as a Medigap plan, Medicare Advantage plan, or a Hospital Indemnity plan.

Answer: The cheapest Medicare plan is not always the best. For example, Medicare Advantage plans can have a $0 premium, but your out of pocket expenses could total upwards of $10,000 a year. Whereas Medigap plans have a premium that is typically between $50-$300/month. Medigap plans, however, have little to no out of pocket costs in comparison to Medicare Advantage.

Your friend might be referring to Medigap plans. Medigap plans are federally standardized, so a plan letter (for example Plan N) has to have the same coverage no matter which company is offering it. If Company A is offering Plan N for $100, but Company B is offering Plan N for $200, you might be inclined to go with Company A since they are offering the same coverage for a lower price.

Answer: Losing creditable employer coverage does give you a Special Election Period. You have 8 months from the day you lose coverage to enroll in Part B. You have 63 days from the day you lose coverage to enroll in a Part D or Medicare Advantage plan.

Answer: I would start by having them watch some videos explaining the topic. There are many great YouTube channels that explain the ins and outs of Medicare. Setting up a 3-way call with an insurance agent can also be a great way to comfortably discuss Medicare. Medicare can be a very confusing topic, so it can be helpful to have a professional to guide your parents through it.

Answer: There are many steps you can take to avoid Medicare fraud. Keep your Medicare card/number in a safe place out of the public eye. Only share this number with medical providers or an insurance agent who YOU have contacted. Never give your Medicare number to anyone who contacts you first. Insurance agents will require this information to help you make changes to your plan, but you can schedule an appointment with an agent who you trust.

In most cases Medicare fraud affects the medical providers and insurance carriers more than the insured, but it is always good to be diligent in keeping your information safe.

Answer: It helps to start with some "homework". Watching videos, reading the "Medicare and Me" handbook, and doing research online is a great way to prep your learning experience. It is really important to understand the basics of Medicare before jumping into learning about secondary plans like Medigap or Advantage. What do Part A, B, C, and D cover? What are the copays and deductibles associated with these parts? Once you have that foundation, it makes it so much easier to add on to it.

Answer: The donut hole has been replaced with a maximum out of pocket. For 2025, this Maximum out of pocket is $2000 for the year. This means that as long as your medications are covered under a plan's formulary, you will never pay more than $2000 for those medications in one year. This change has resulted in some plans raising their premiums and changing their formularies.

Answer: You can switch to Original Medicare during the Annual Election Period, but you have to answer health questions unless you are in your Initial Enrollment Period. The only exceptions are New York, Massachusetts, and Connecticut where open enrollment is allowed year round.

Answer: Palliative care and hospice care are extremely similar, but hospice refers specifically to people who have a prognosis of 6 or less months to live. Palliative care can be provided at any point of an illness.

Medicare covers palliative care when it is medically necessary. Typically it will be covered both in- and outside of hospice care.

Answer: Providers will typically send your Annual Notice of Change within 60 days of the Annual Election Period. Look for it in the mail between August and October 1st.

Answer: Medigap policies are guaranteed renewable. This means that your plan has to renew your policy every year as long as your pay your premiums even if you are filing a lot of costly claims.

There have been Medigap carrier become insolvent and pull out of the market, however, you are protected in this situation. If this happened to you, you would have guaranteed issue rights to get another plan with no underwriting. The guaranteed issue plan is a Plan G or Plan F depending on when you became eligible for Medicare.

Answer: Medicare supplements or "Medigap" plans are secondary to Medicare. Medicare Advantage plans are considered an "alternative" to Medicare.

Answer: Yes, Medicare does cover asthma and other breathing conditions. Any medications or nebulizers will be covered under Part D. Any durable medical equipment (such as oxygen tank) will be covered under Part B.

Answer: Medigap Plan N is the most cost-effective for seniors that do not frequent the doctor's office more than 15-20 times a year. Medigap Plan G is the best value for seniors that tend to have more than 20 visits to a provider per year. This is because Plan N has up to a $20 copay at the doctor's office, but it offers a lower premium. Plan G has a higher premium, but it covers all copays after you meet your Part B deductible.

Answer: You can qualify for Medicare under age 65 if you have End-Stage Renal Disease, or have received Social Security Disability benefits for at least two years. To see if you qualify for Social Security Disability Income, please refer to www.ssa.gov.

Answer: If you are retiring and would like to take Medicare, you will need to go to www.ssa.gov to apply for Medicare Part B. In order to avoid the late enrollment penalty, you will need to get your employer benefits/HR person to fill out an employee benefits verification form (CMS-L564) and submit it with your Part B application.