Jon Morton, Medicare Insurance Broker

Answer: Today's question is how much will the monthly premium for Part B Medicare be here in 2026? And what drives those changes?

So for most people, it's going up to $20 to $90 per month, which is about a 10% increase for those individuals earning $109,000 per year and more. They're going to be looking at a higher monthly premium, and then even a higher one at $500,000 or more in annual income.

So again, for most people, it's $20 to $90 per month. And what drives those changes mainly are increased health care costs and utilization.

Answer: Hi, so today's question is: are Medicare agents paid by specific insurance companies to sign up clients to their plans only? That's a great question. And yes, if they are exclusive, they are also known as captive agents, meaning they only work for one specific company. I'm an independent agent, so in my case, I can offer many different carriers, so that you have a choice of who you are signing up with. It's based on what works best for you, not necessarily what works best for the agent. It's really based on what works best for you. I'd love to work with you, so give me a call.

Answer: So today's question is, I'm caring for my dad who has Alzheimer's and lots of medications, and I keep getting bills I don't understand. Any tips for not drowning in paperwork?

Well, first of all, I want to say I'm sorry to hear that you're going through this situation. It's very challenging. I've been through this myself with relatives, and I can say there are a number of resources from the Alzheimer's Association and other groups. Having an agent like myself, I basically have a number of resources and ideas that I can share with you. For example, setting up things as much as possible, as much as legally possible, can help automate the process. So you're not dealing with the paperwork all the time.

There's a lot of very simple ways to do that. So if you want to reach out, I'd be more than glad to help you with this challenging time.

Answer: Today's question is, can I get dental and vision with Medicare? Yes, dental and vision coverage are included in most Medicare Advantage plans. And if you just have regular original Medicare, you can also get standalone dental plans and standalone vision plans. Or if you have original Medicare and a supplement, you can also get standalone plans.

Answer: So today's question is, what was my most successful strategy for building rapport with the beneficiary during a remote meeting? And how does this approach differ from my in-person engaging techniques?

Well, when you're working with people online, it can be a little different, as you can see just watching this video, because you're not directly across from someone. Sometimes it looks like you're looking away if you look down or something. If it's being done by Zoom or Microsoft Teams or different types of GoTo meetings and so forth, it's not exactly the same as meeting in person.

That being said, a lot of people like to speak by phone as well. So how does that differ? Well, I'm not sure. Overall, it does differ in that it's in a different format. It's a different medium. However, the big thing is that I listen to what matters to different people, because everybody has a different situation. What matters to one person could be something totally different than what matters to the next beneficiary that I speak to.

So I want to make sure that whoever I'm speaking to, I get to know what their story is and what matters to them. Before I can make any kind of recommendations and things of that nature. So glad to hear from you, and keep those questions coming!

Answer: So today's question is, I'm about to leave the hospital from surgery. Will Medicare cover a home health aide? Well, it's kind of not a simple question. So basically, it can be up to eight hours in a day, up to 28 hours in a week, so very part-time. And the person who has to be covered by skilled care. So the home health aide can't be the only aide. And they don't take care of things like food delivery and things of that nature either. So it's not exactly a simple answer, but certainly yes. So you can have some coverage from Medicare for a home health aide after surgery. So learn a lot more about it. Reach out, I'd be glad to help share and help you understand all the details.

Answer: Hi, so today's question is about maximum out-of-pocket limits for Medicare and what that means for you. Well, original Medicare from the government, part A and B, does not have maximum out-of-pocket limits. That means that you have a monthly premium for your part B, and then you have the different costs with co-pays and coinsurance. And there's no maximum on how much that could be.

Okay, so if somebody is in a catastrophic situation, let's say they have a $100,000 medical bill and then coinsurance is 20%, that would be $20,000. There is no limit to protection from having to pay that entire $20,000. Whereas Medicare Advantage plans, for example, they do actually have a limit, and it can range the most. It can be as high as $90,000 to $50,000 per year. Some are less, like $6,000 or $6,500, something like that. So they do have limits, and Medicare supplement, or what's called a Medigap plan, they don't need limits because they cover so much.

So when it comes to maximum out-of-pocket limits for Medicare, this is an important thing to know because what you end up paying in the long run may not be the same as what you pay in the short term.

Answer: So today's question is, "I'm gonna be 65 in a few months, but I'm still working. Do I need to sign up for Medicare right away?" The short answer is probably not, as long as your employer has 20 or more employees. Chances are that you have what's called creditable coverage. So as long as you have that, you do not have to sign up for Medicare. Once that coverage is gone, whether you leave the employer or the coverage ends for a reason, then you have an eight-month window. I'd love to help, so reach out today.

Answer: I love the ability to help people with something that seems complex and overwhelming to them. Being able to put their mind at ease and ensure they are set up to succeed is a great feeling and knowing that people with less stress helps everyone in the long run is exciting too.

Answer: If you have an agent who assisted you in signing up, call them first. I appreciate hearing from my beneficiaries (clients) as it gives me the first opportunity to help them and so that I can be aware of anything that I can potentially help with. Worst case, I refer them to the right place, whether it is the carrier or CMS. Your agent should be your starting point.

Answer: Regardless of the type of medication, the key thing to look at is whether it is covered on a given plan, whether that is Advantage or standalone Part D. In some cases, the Advantage is adequate to cover the need. However, if a drug is an injectable administered at the doctor's office, it could be covered by Part B instead of as a drug under Part D. If it is a super expensive drug, the premium for a Supplement plan could be lower or much lower than the Part B co-insurance for that drug.

Answer: I get paid a commission from the insurance company that a beneficiary chooses for their coverage. This could be for Advantage, Medigap (supplement) or other ancillary products. I base every recommendation on a simple question: Is this plan the most suitable for this person based on their individual wants and needs? Beneficiaries (also known as members or clients) are not transactional customers in this profession. I will most likely be communicating with them for several years, and I believe that by doing the right thing all the time, many of them will refer others to me.

Answer: Your Medicare deductible resets at the beginning of each year since it is an annual deductible. Once it is satisfied, it is good for the remainder of the calendar year. On January 1st, the clock starts over again.

Answer: Each year, co-pays and premiums reset on January 1st. Numerous reasons, including cost of care, utilization, government regulations or policy changes or even type of plan can affect both the co-pays and premiums. For example, changing from an Advantage plan to a Medigap (also called Medicare Supplement) plan will change both of these quite a bit. Higher utilization increases costs, and these can be shared by all members.

Answer: To me, the word retirement is antiquated. I prefer the idea of "Time re-allocation". At any time during one's life, having meaningful social connections is of critical importance to mental health. Often times, people form connections with co-workers and/or other people they meet through their work. When you re-allocate your time from a job/career to other activities, it is important to continue to have meaningful human connections. There are numerous opportunities to volunteer, as well as attending the local senior center, getting involved in civic organizations, or even physical activity groups.

Answer: This is a fairly broad question. If you are currently signed up for Medicare, effective January 1st, then yes. If you change plans in January, then you will have to wait until February 1st in order to use your benefits. If you already have Part A and you are just now signing up for part B, or Advantage or Medigap, you will also have to wait until February 1st.

Answer: First, you say that you need the wheelchair. One of the first steps in the process of getting durable medical equipment is determining if it is medically necessary based on a condition that significantly limits mobility. This would be through a doctor's evaluation and prescription. Next, are you able to safely operate the chair yourself or have someone constantly available to do so? If so, you can choose a Medicare approved supplier, and if necessary, they will apply for authorization. After meeting the requirements, Medicare will cover 80% of the approved amount, after deductible has been met, unless you have a Medigap (also known as Medicare Supplement) plan, which will also cover the 20% co-insurance.

Answer: With a Medicare Advantage (Part C) plan, you do not pay the standard Original Medicare Part A inpatient hospital deductible. Instead, you pay based on the Advantage plan's structure. Rather than the full deductible, which is currently $1736, you would pay the $350 (per your example) times the number of days, up to 7. If your stay is 4 or less days, the Advantage plan would be less expensive in this example.