Jason Hark, MBA, CMIP, Medicare Insurance Broker

Answer: Yes, that is correct, with one exception. The exception is that the covered prescriptions must be in the formulary. Hope this helps!

Answer: The biggest mistake seniors make when enrolling in Medicare is missing their initial enrollment window and not signing up on time. This can lead to late enrollment penalties that last for life and costly gaps in coverage when they need care most. Using an experienced broker can help you navigate the process correctly and make sure you enroll on time to avoid these serious problems.

Answer: If your income goes down after you retire, you can ask Medicare to lower your Part B premium by reporting your new income. You do this by filling out a form called the “Extra Help” or “Income-Related Monthly Adjustment Amount (IRMAA) appeal.” This can help make your monthly costs cheaper based on what you earn now.

Answer: Yes, the 2025 changes to Medicare Part D will help if you take expensive specialty medications. Starting in 2025, there will be a $2,000 limit on how much you have to pay out of pocket for covered drugs each year. After you reach that limit, your plan will pay 100% of the costs for the rest of the year, which can save you a lot of money.

Answer: Yep, if you lose your employer health coverage, you get what's called a Special Enrollment Period to sign up for Medicare without any penalties. That period usually lasts about eight months, startin’ the month after your coverage ends, so you’ve got plenty of time to get on board with Part A and Part B. It’s real important to sign up on time so you don’t end up with any gaps in coverage or extra fees later on.

Answer: They can save you money because they often have lower monthly costs and extra benefits like vision or dental. But sometimes you might pay more if you go to doctors outside their network or need extra care.

Answer: Discount cards can help lower your medicine costs, but the money you save with them doesn’t count toward your Medicare drug plan’s yearly out-of-pocket limit. In 2025, your Medicare Advantage drug plan will cap what you pay out of pocket at $2,000, but using discount cards won’t help you reach that cap faster.

Answer: Great question! Medicare Part A (hospital insurance) is usually free because most people or their spouses paid Medicare taxes while working for at least 10 years.

Medicare Part B (doctor visits, outpatient care, and other services) isn’t free because it covers things that aren’t paid for by those taxes. So, everyone who has Part B pays a monthly premium to help cover those costs. We explain it as a forever tax, unless your income is below a certain threshold.

Answer: Medicare covers a Welcome to Medicare preventive visit (a one-time physical in your first 12 months on Medicare) and an Annual Wellness Visit every year—but these are not the same as a full physical exam. Some doctors might bill you for extra tests or services beyond what Medicare covers during these visits.

With a Medicare Advantage plan, your doctor has to follow the plan’s rules, and sometimes there are copays or charges depending on your plan and what services you get. It’s a good idea to ask your doctor or your plan exactly what’s covered before your visit.

Answer: Yes, if you just moved to a new state, you may need to update your Medicare coverage, and you may qualify for a Special Enrollment Period (SEP).

Answer: One of the most important questions you might not have thought to ask is:

"Will my Medicare plan still meet my needs if my health changes?"

Answer: Yes, as well, most Medicare Advantage plans also cover nutrition counseling for high cholesterol. They have to cover at least what Original Medicare does, but you may need to use a doctor in the plan’s network and get a referral first. Always check with your plan to be sure what’s covered and if there are any extra rules.

Answer: Most of our clients do not leave the Advantage Plans, For those that do, they leave because they can’t always see the doctors they want and may have to get approval for care. The plans can also change every year, and sometimes cost more than expected.

Answer: The biggest downside to Medicare Advantage plans is that you gotta stick to their list of doctors and hospitals. If your doctor ain’t in their network, you might have to pay more — or it might not be covered at all.

Answer: The ability to remove the stress from my clients, on the phone, you can hear the tension leave their voice, in person, they are like a whole new person at the end of the appointment. Nothing beats the idea of actually helping someone!