Jason Wisniewski, Medicare Insurance Broker

Answer: If you're already on Medicare you can change your plan at least once every year during the Annual Enrollment Period (AEP) from Oct.15-Dec. 31 each year. Your new plan starts January 1st if you make a change during this time.

If you are enrolled in a Medicare Advantage plan you can change your plan at least 2 times per year. Once during the Annual Enrollment (AEP) from Oct.15-Dec 31st each year, with a January 1st effective for your new plan if you make a change during the AEP and another chance from January 1st to March 31st, this is known as the Medicare Advantage Open Enrollment Period (OEP). During this period you can change plans and your new plan will start the 1st of the following month (for example if you change plans in January, your new plan starts in February, etc)

In addition to the AEP & OEP which occur annually, you may also qualify for a Special Enrollment Period (SEP) outside of these time frames which would allow you to make additional changes. Some examples of an SEP include:

Moving to a new service area (changing county or state)

Qualifying for Extra Help (LIS or Medicaid)

Qualifying for a State Pharmacy Assistance Program (SPAP)

Loss of Employer Group coverage

Moving into a Nursing Home

And many other scenarios

Answer: If you don't have any other "Creditable coverage", yes you will absolutely be penalized. And the penalty is a lifetime penalty so if you don't have any other "creditable coverage" it's not a good idea to delay enrollment. "Creditable coverage" is the key. If you work for an employer with more than 20 employees that is considered "credible coverage" and you will not be penalized for delaying your Medicare enrollment but you will have to prove that you had this coverage before you eventually do enroll in Medicare later on ( for example you plan on retiring at 67).

If you have no other coverage, only use VA coverage or you somehow stay on an Obamacare plan past 65 or your employer has less than 20 employees and doesn't meet creditable coverage standards then you will be penalized when you join Medicare outside of the 7 month window you have to enroll.

In short, don't play games with this and make sure you get advice from a professional Medicare broker when handling this.

Answer: Some Medicare Advantage plans already cover wearable tracking devices like the Fitbit & Garmin. Original Medicare does not.

Answer: Original Medicare has no options.

Medicare Advantage plans contract woth companies like MD Live, Teladoc, etc depending on the plan.

Answer: Home modifications are covered by certain Medicare Advantage plans. Original Medicare does not.

Answer: Telehealth is only covered by Medicare Advantage plans in 2026. Original Medicare will not cover it in 2026. So you will need to enroll in a Medicare Advantage plan if you want Telehealth

Answer: With Nursing home coverage you shouldn't rely on any type of Medicare plan be it Medicare Advantage, Medicare Supplement or Original Medicare for long term custodial care but if you're talking about short term stays for Rehab you will get up to 100 days covered on any plan. You should either look at Long term care insurance or if youre nelow poverty level you could apply for Medicaid.

The benefit of a Medicare Advantage plan is that they will cover those short term stays without any prior hospital stay whereas Original Medicare or Original Medicare plus Medicae Supplement requires a 3 day prior Inpatient Hospital stay before they cover it.

With Medicare Advantage plans they do require Nursing facilities to submit clinical information before extending stays which sometimes Nursing home staff are lazy to do. If your plan denies an extended stay is 90 percent of the time because the staff at the Nursing home hasnt given them the clinical information to support the request for extended stay. If you have a broker your broker can help you file an appeal and also put pressure on the Nursinh home staff to submit the required clinical information to get your stay extended

I did that for my father in law successfully and have done it for several other clients as well

More broadly even Original Medicare as well as Medicare Advantage plans will be cracking down on Nursing homes for submitting too little clinical information and will require them to start providing more detailed diagnosis

Answer: If you only have A and B you will have unlimited out of pocket expenses because there is no out of pocket maximum with Original Medicare. You also have no prescription drug coverage, no dental coverage, no vision coverage and no coverage for hearing benefits

You won't even be able to get an annual physical exam because Original Medicare only covers a physical once in your lifetime

It is far better to get a Medicare Advantage plan (often for $0 additional premium) that includes your preferred doctors if you cant afford a Medigap policy

Answer: Typically I find Advantage plans to have better drug coverage than stand alone plans. But to recommend the right one I would need to know where you live since plans are filed by County and State and I'd need the specific names of your medications and doctors to know which plan is the best fit

Feel free to reach out for personalized help

Answer: Once you join a Medicare Advantage plan you no longer need to worry about any of the Part A or part B deductibles anymore.

You're in a much better place now though because the Medicare Advantage co-pays include all the doctor charges whereas Original Medicare Part A does not.

For example a 3 day hospital stay under Original Medicare would be:

$1,676 deductible plus 20% co-insurance for physician services. So if the procedure was $50,000 you would pay $10,000 (20 percent) for the procedure plus $1676 for Part A deductible facility charges.

With Medicare Advantage there are $0 co-pay for physician services while you are an Inpatient at the hospital so you just pay the $350 co-pay per day for the facility.

In my example you would only pay $1,050 instead of $10,000 under Original Medicare.

Hope this clears things up and shows you the value of your Medicare Advantage plan.

Answer: For me, it is pretty easy, obviously, given that they know I am a Medicare Health Insurance broker with 18 years of experience. If you are just trying to help your parents prepare for Medicare, it is best to let them know there are plenty of ways to get information from the comfort of their home or in their local community. It is important to understand timelines as it is an important part of their retirement planning, and it is also important to understand how and when to apply to avoid costly penalties and unnecessary and easily avoidable mistakes. Working with a broker simplifies these tasks, costs nothing (we are paid by the insurance companies, not clients), and we will advise through the entire process and maintain a lifetime client relationship afterwards.

We at JW Senior Insurance offer virtual appointments via Zoom or the option to discuss over the phone or through email. Whatever works best for them. We also offer an easy-to-use Medicare Survey.

Feel free to get in touch.