Jeffrey Brucculeri, Medicare Insurance Agent

Answer: Yes, you can certainly meet with an agent at any time to get information. However, when it comes to completing a compliant presentation and application, they would have to be present, unless you have power of attorney. If you have POA, then you can go through the process and sign the applications for them, and they don't have to be present. I run into this situation quite often.

Answer: The question I get most often is "How and when should I enroll?" That is the important first step, and it is very confusing to most people. Beyond that, the most important question you should asking is "How do I decide whether to enroll in Part A and Part B, or delaying Part B?" It depends on whether you have employer coverage or not, whether you intend to keep your insurance through work, and how much that premium is compared to the Medicare Part B premium. If you do not have employer coverage, then you would definitely want to enroll in both Part A and B.

Answer: It really boils down to their needs and how they want to manage their medical expenses. With an advantage plan, many carriers offer $0 premium plans, so if the client is relatively healthy, they may decide they would like to keep their money in their own pocket and pay copays along the way if they need any medical services. With a Medigap or supplement plan, the client will pay a premium each month but may have a deductible or copays (depending on what plan they pick). A Medigap plan might be beneficial for someone who has many health issues and needs a lot of care. The monthly premium instead of copays, might help them plan their budget easier for the year.

Answer: It sets a limit to how much a Medicare beneficiary will have to spend, out-of-pocket, in a year on their medications. Once all of their Part D deductible is met and all of their copays or coinsurance adds up to $2100 (in 2026), then they are in catastrophic coverage and pay $0 the rest of the year.

Answer: I wouldn't refer to any of the details or benefits of an HMO as "disadvantages." However, some of the differences between an HMO and a PPO might be that with an HMO you cannot "electively" decide to see a provider who is out of network. If you go out of network, you will be responsible for the costs. Some HMOs will allow an out of network visit in special circumstances on a case-by-case basis. With some HMOs you may need a referral from your PCP to see a specialist. This is not the case with all HMOs; however, the specialists may require a referral and not the insurance company. Also, with an HMO, you will be covered even while traveling outside your area in the case of an emergency. If you need to go to an urgent care center or emergency room, your HMO will cover you at the same copay as if you were going to a local facility in your home area.

Answer: Decide first if you plan to keep an employer plan after you turn 65, or not. If so, you will need to only enroll in Part A. If you don't have an employer plan, you should enroll in both Part A and Part B. You enroll by either logging into your Social Security account at ssa.gov, or you would need to visit a local Social Security office.

Answer: I can't speak to this directly because I don't know how you enrolled (over the phone or in-person), nor with whom you enrolled. However, I can tell you this, in order to remain compliant with Medicare, it is the agent's responsibility to go through the entire summary of benefits with you and point out all of the copays and benefit amounts for each item. Then, the agent should ask if you have any questions and whether you understand the plan benefits as outlined. It is your responsibility to follow along; ask for clarification on any point you don't understand and acknowledge the fact that you understand and would like to enroll in that particular plan.

Answer: Yes, Medicare advantage plans differ by state, but not supplement plans. Supplement plans are standardized nationally and the only difference from a Supplement Plan G from one insurance carrier to another might be the premium. Requirements are the same, regardless of the state.

Answer: This is a bit complicated because it depends on what "window" you're referring to. If you've turned 65 and missed your window to enroll in Medicare Part B, which is three months before your birth month through three months after that month (a seven-month window), you will have to wait until the next Part B General Enrollment Period (GEP). The GEP is January 1 - March 31. If you enroll during these three months, your Part B will go into effect the 1st of the next month. You may also have to pay a late penalty each month, based on how long you went without Part B. If you are asking about missing your "window" to enroll in an advantage plan, you'll have to wait until the next Annual Enrollment Period (Oct. 15-Dec. 7).

Answer: Agents must go through training every year in order to certify with Medicare and the local insurance carriers. These agents become very knowledgeable advisors who are able to assist Medicare beneficiaries. The annual training and the bi-annual continuing education, make someone like me an expert when it comes to Medicare and the plans available in our area. Plus, if you have an issue, your local agent is there to assist you; not someone sitting in a phone room in another country.

Answer: Yes, some plans do cover acupuncture. Medicare allows for acupuncture to be covered for a certain number of visits, but only for chronic low back pain. Each plan has different benefits regarding acupuncture, so it's best to check the summary of benefits or the evidence of coverage before choosing a plan, if you know you would like acupuncture treatments.