Jeffrey Adams, Medicare Insurance Agent

Answer: No, every individual has their own Medicare account. Your marital status is not involved in the process.

Answer: It isn't easy to figure out because there are so many variables. If your company has under 20 employees, you must get Part B when you are first eligible, as Medicare will be your primary payor. If your employer has over 20 employees, you can postpone Part B and not pay the monthly premium, as long as you have creditable coverage from your employer or your working spouses employer. There is no penalty and you will get a special election opportunity when you lose your coverage to enroll in Part B.

Additionally, Part B currently costs $202.90 so at times it can be more cost effective and better coverage to go with Medicare. A comparison of your coverages and costs would answer that question more effectively.

Answer: Yes, if you are on Original Medicare or if you have a Medicare Supplement plan G or N, you must meet thte deductible of $283 in 2026 before your Physicail Therapy would be covered. On Original Medicare, you would then pay 20%. On a Supplement, it would be covered 100% after the deductible. On a Medicare Advantage plan, copays for Physical Therapy will vary by plan, but range from $25-$50 per visit

Answer: Your best bet in that situation is a Medicare Advantage plan if there is one in your area. There are many plans with monthly premiums of $0 over and above your Part B cost - which will typically increase every year as well. The Advantage plan will have copays that you only pay when you actually use the benefit, so if there is a $0 premium, you will have no cost unless you see a doctor.

Answer: It is ok to meet with multiple brokers. It is important to make sure that the brokers are independent and offer multiple plans in your area. If they only represent one plan, or one type of plan, you may not get the advice that is best for you. You may only hear about the one product that they offer and it may or may not be the best fit for you.

Answer: No, as long as your wife is still working and the coverage is considered creditable by Medicare, you will not have a penalty when you enroll in Part B

Answer: Medicare does cover the cost of blood thinners. If you are receiving IV injections in a provider office, they would be covered under Part B and you would pay 20%. If they are prescribed by your physician and you take them at home, they would be covered under Part D. Your cost would be determined by the Tier of the medication, the plan deductible and the plan copay.

Answer: The plus to Original Medicare for frequent travelers is only if you are going to be in one place for an extended period and have physycian relationships in that area. No need to worry about networks. If you simply travel a lot, a Medicare Advantage plan offers emergency room and urgent care worldwide. Although if travelling internationally, I'd recommend a policy that will help you get home as an added supplement

Answer: Medicare agents are paid by the insurance company for enrollments made to that company. Some agents are "captive", meaning they can only enroll you in one company plan. It is best to ask an agent at the start of your conversation to see what plans they represent.

Answer: For the first 20 days in Skilled Nursing, Medicare covers the cost 100%, as long as you have spent 3 days as an inpatient in the hospital before admission. If you have a Medicare Advantage plan, the 3 days requirement is usually waived.

After day 20, you pay a daily copay of $217 per day until day 100, which is the maximum Medicare covers. If you have a Medicare Supplement plan, it will usually cover that cost. A Medicare Advantage plan usually has a copay nearly the same, which you will pay until you hit your plans maximum out of pocket.

If you are still in Skilled Nursing beyond 100 days, you are responsible for the full cost of the care unless you have some type of Long Term Care Insurance.

Answer: You can change your plan every year from October 15 until December 7 for a January 1 effective date. If you are on a Medicare Advantage plan as of January 1, you can make 1 change from January 1 until March 31, to be effective the first day of the next month.

You can also make changes if you qualify for a Special Election Period, such as certain illnesses, qualifying for Medicaid, address change and others.