Jason York, Medicare Insurance Broker

Answer: The Annual Notice of Change or (ANOC). It is very important to read so you can learn what the changes are to your plan.

The plan you are in can change so dramatically that it no longer makes sense for your needs.

Again, I say this a ton but an agent who cares.... will reach out to review that ANOC with you!

Answer: Yes it is covered under a MAPD or Stand alone drug plan.

Know, when it comes to cost that truly depends on the the carrier and what tier they put the drug.

Also some carriers may exclude the name brand ADVAIR completely and only provide the generic or require you to start with the generic medication then advance to the higher tier brand name due to how you respond.

So in short the out of pocket cost will differ slightly carrier to carrier but on average expect $30-$100 for 2026-2027

Answer: A few ways:

1. If you have a trusted agent you can call and ask them to review the summary of benefits or evidence of coverage (for a deep dive) with you.

2. You can call the carrier and ask them.

3. Or if you're savvy about knowing where to look you can review the summary and evidence of coverage yourself, but I prefer my clients to call me to be sure.

Answer: There a dozen or so life events that qualify you for special election period (SEP).

FOR EXAMPLE:

Moving, change in Medicaid or low income subsidies, loss of employer coverage, natural disaster, maybe you never received the correct information from the carrier, etc.

The windows for each differ from 2-8 months.

If you think an event can qualify you for a special enrollment. DO NOT wait to find out!

Answer: Unfortunately no, Social Security does not pay you for both rather will pay you the highest amount of the two into one payment. Example you receive $2,000 Now and your husband received $3,000. You will begin to receive the $3000! Not $5,000 but still an increase!

Answer: Few couple things to note:

1. If Medicare deems the surgery necessary

and

2. if you have indeed paid your annual Part B deductible ($283 for 2026)

Then yes your plan will cover the costs for the surgery!

Answer: No a hospital plan is not required but highly recommended. Hospital plans can cover the wholes that’s Medicare advantage plans have. Yes you can use it twice a year and typically an unlimited number of times. Benefit renewal time is anywhere from 60 days to six months depending on the conpany and plan selected.

Answer: Not verifying that their medications are on the formulary and at the lowest cost. Also verify what Pharmacy is preferred and which ones aren't as that has a lot to do with the pricing.

Answer: You can review the summary of benefits and the evidence of coverage by contacting the Insurance company. Also be sure the agent that is wanting to review with you will go that extra mile to dig into the plan and inform you of any restrictions to the benefits, prior authorizations etc. Ask the important questions if they aren't discussed before hand!

Answer: Id say the word free is objective. Everyone has different needs. A lot of the time a supplement can wind up being cheaper than an advantage after all the copays and out of pocket cost are tallied up.

Answer: Cms sets the original medicare medical deductible each year. However most plans do not have a medical deductible if you were to choose a third party company.

Answer: Some plans offer an over the counter card. That can be used at may drug stores like cvs, walgreens, or walmart etc for over the counter medications or vitamins, bandaids, tynelol, or personal care items etc.

Answer: I would say it's difficult to get an accurate estimate as things may change and medications as well. You can however look at your plans summary of benefits and see what to maximum out of pocket would be along with your drug cost. Max on drug costs is $2000 before you hit the catastrophic phase and then medications become $0. Other wise you can review copays for dr visits, any premiums you may have, copays for medical equipment etc.

Answer: You are eligible for 1 free annual physical each year, anything beyond that will be at a cost. If it's a ppo and it was preformed out of network that may be the reason or if the physical covered a non Medicare covered service.

Answer: Yes, emergency care outside the U.S. in general is covered to a certain $ extent. Each plan may differ.

Answer: The cheapest way to get Medicare coverage is to have qualify for part a through your work history and apply for B assistance through Medicaid or a Medicare assistance program that can lower out of pocket costs. Typically Medicare Advantage plans for just basic care would be your cheapest route.

Answer: By having a trusted agent on your side you are NOT alone! A knowledgeable agent will be able to answer any difficult questions you may have, navigate and explain the different options(Medicare companies/plans) that you have to choose from.

Also by having a trusted agent on your side, I'm there to review changes every year, answer any questions or concerns you may have throughout the year and ultimately ease the burden of knowing what's best for YOU, not the companies.

A great agent is always ahead of the game and informs their client base of any changes, so you can leave the worrying up to me!

Best part is it's FREE!