Jacquie Wolf, Medicare Insurance Broker

Answer: Assuming you are eligible for Medicare Parts A & B and are enrolled, yes! Your coverage will be effective January 1st.

Answer: Moving to a new state will require at least one change. If you have an Advantage Plan or a standalone Prescription Drug Plan you will have to select a plan offered in your area.

In NY, if you have a MediGap (Supplement) Plan you can compare what you have with what is newly available to you and consider a change if it benefits you.

Answer: You will likely be auto enrolled into Medicare Parts A & B if you are collecting SS benefits.

Medicaid eligibility determinants will change after you turn 65. If you remain eligible, having both Medicare and Medicaid is the sweet spot for medical coverage.

You are receiving so many notices because there is a financial incentive for any Medicare plan to have you as a member. It's 90% advertising and they have access to public records including your age.

Consulting an independent Broker should get you info about all of your options!

Answer: Advantage plans offer a lot of benefits at a lower cost. Hype isn't really what's happening. It's more like bait and switch. There are plans that are designed for folks who are eligible for both Medicare and Medicaid that can offer substantial benefits and no cost medical treatment at $0 premium. Marketing tosses those plan benefits out to lure you in and when you don't qualify they steer you towards an option you do qualify for.

The primary thing to look for is network. Are your providers in the plans network? That will matter most. Medicare requires Star ratings which will give you some idea of the quality of the plan, based on a multitude of factors including your satisfaction with getting the treatment you need.

Answer: It is definitely not that easy. There are many things to consider including your health needs and prescriptions. Consulting a licensed Medicare Broker will connect you with someone familiar with all the options who can help you choose the plan that fits your needs and budget. It doesn't cost you anything extra to work with a Broker! We are paid a commission based on your enrollment.

Answer: Yes, if the drug is not in their formulary (list of covered drugs) they do not have to cover it.

However, they must include at least 2 medications that exist to deal with whatever the prescription is for. You have 2 options:

1) discuss alternatives with your doctor and check the formulary to see if they are are covered.

2) ask your prescribing doctor to request a "formulary exception" which, if granted, will include that drug for you.

It will probably not be cheap though!

Answer: Hi

Once you are Medicare eligible you can use your HSA to pay your premiums!

There are many other obscure exceptions and rules but that you can do!

Answer: If you are already certain that you will need Long Term Care, it is too late to purchase coverage. Speak with an Estate Planning attorney about a Medicaid Trust that can protect your assets and still enable you to qualify for Medicaid. Medicaid does currently provide coverage for LTC.

Answer: If your provider suggests that it's not covered by Medicare, they are likely correct. Medicare does not cover cosmetic, experimental, or treatments not approved for the issue they are being used to treat.

Be prepared to pay the bill, or discuss your other options with your provider.

Answer: IRMAA, the Income Related Monthly Adjustment Amount, is assessed based on your MAGI, Modified Adjusted Gross Income, 2 years prior to the year we are in. For 2026, they will be referencing your 2024 tax return. There is a chart available that will show you the income brackets and assessment for individuals and couples.

Answer: When you turn 65 you have an extra opportunity to change your choice of coverage. You do not have to sign up again or make a change if you are happy with what you have!

Answer: Consult a professional to find out if you are required and eligible to enroll in Medicare.

There are different circumstances depending on your employment, income, and retirement benefits. Know which rules will apply to YOU.

Answer: Premiums are the monthly cost for whichever plan you choose.

Deductibles are the amount you have to pay before the plan you enroll in begins to pay. Not all plans have deductibles and not all deductibles apply to all services.

Copays are the dollar amounts you have to pay your providers.

Coinsurance is the percentage you have to pay your providers. This is one or the other, not both.

Examining your needs and budget is the best way to make a choice!

Answer: It is best to have your medical provider initiate the appeal because they will have to demonstrate the medical need for the service. Many appeals are granted once the medical need is established but certain procedures, like cosmetic or experimental treatments will often be denied.

Answer: I would say that confirming medications being covered and providers being In-Network among different carriers is the hardest part. Fortunately, there are tools available to make it easier.

Answer: Nothing is Free, but there are many $0 premium plans available that might be a good fit for you. It all depends on your needs and budget.

Answer: Simple, it costs you nothing and you are working with a person trained in Medicare and the details of the plans in your State. Working with a Broker gives you access to many different carriers!