Joni Kattau, Medicare Insurance Broker

Answer: No, there is nothing you need to do or fill out. There are a couple of considerations you should take into account however. The first is that your husband works for a large employer (more than 20 employees) for his coverage to be considered creditable coverage. The second is if you are both on a high deductible health plan and contributing to an HSA, then you don’t want to be enrolled in Part A because there are tax implications.

Answer: If you are on a Prescription Drug Plan or a Medicare Advantage plan, you should take the opportunity during AEP to review your plan options for the following plan year. Plans change every year as does your health. I equate MedAd and PDP plans to home and auto insurance and should be shopped every year.

Answer: Routine eye care, like your annual exam for your glasses prescription, is not covered. Medicare only covers one pair of glasses after you've had cataract surgery. Otherwise, glasses and/or contacts are not covered by Original Medicare. Many Medicare Advantage plans include vision coverage and an annual allowance for eyewear. If you have a Medigap plan, there are many stand alone vision plans that you can purchase. Some Medigap plans also have a vision discount program as part of their extra benefits.

Answer: Medicare covers medically necessary cataract surgery which includes a basic single vision IOL (intraocular lens). Premium or Multifocal IOL's are not covered by Medicare as they are not considered medically necessary. Additionally, Medicare does not cover laser-assisted or Femto cataract surgery.

Almost all cataract surgeons have different packages for patients to pick from based on their needs and desired outcome after surgery (do you want to wear any glasses after surgery or not.) Anything beyond the basic surgery and IOL is going to be considered Premium and the patient will have to pay out of pocket.

Answer: If you are on Traditional Medicare Part B and a Medigap plan, there are no provider networks. If you are on a Medicare Advantage (Part C) plan, the insurance company that you are signed up with will have a provider directory on their website where you can search for doctors by name or specialty.

If you're looking at plans for 2026 and thinking of changing insurance companies, you can search provider directories as a guest user (no login required) so you can make sure that all of your current providers are in-network with any plan that you are considering switching to.

If you use a broker or agent, we can also help you with this task and make sure that your current providers are in-network with your plan options for 2026.

Answer: As long as your coverage is creditable (at least as good as coverage Medicare offers) and has prescription drug coverage, you can wait to sign up for Medicare Part A & B. Many individuals choose to sign up for Part A right away because it's a $0 premium for most people. However if your employer plan is a HDHP and you're contributing to an HSA, you do now want to enroll in Medicare Part A as it can have tax implications.

Answer: You can visit Medicare.gov to search for Prescription Drug Plans in your zip code. You will need to enter the names and dosages of each or your prescriptions and the website can help you compare costs. You can also schedule a meeting with a benefits center or an independent broker. We will also need your prescriptions and dosages and we can look up your drug costs for 2026.

Answer: The answer depends on your age. If you're retiring before you turn 65 then you will need to determine how you will obtain health coverage until you're eligible for Medicare when you turn 65.

If you're retiring at 65 or older, then you will want to enroll in Medicare Part A and B. Your Initial Enrollment Period (IEP) is seven months and begins 3 months before the month you turn 65, includes your birth month and the three months following your birth month. You will complete your Medicare enrollment through ssa.gov website.

If you want additional coverage beyond the core coverage provided by Medicare and the Federal government, it's recommended to speak with an indepent broker that can help you look at all of your options for additional coverage.

Answer: You will need to appeal your IRMMA with Social Security. It is very common for new retirees/enrollees to appeal their earnings since the IRMMA lookback is 2 years and reportable income often decreases with retirement.

Answer: Most preventive screenings are covered 100% by Medicare Part B. Some age restrictions/requirements apply but most of those are for beneficiaries below the age of 65.

Answer: The answer to your question is in the word you used "push". No one should be trying to push you into anything.

If you're speaking to an independent agent that represents multiple carriers and multiple plans, then our job is to present options to you that best match your needs and let you decide which option you prefer.

If agents are pushing you one way or another then it's likely that they are trying to meet a quota and make a sale.

Answer: If you call the insurance carrier directly, they will only be able to discuss their plans with you and no others. These are known as Captive Agents and they represent one carrier and that carriers plans alone.

Independent Medicare Brokers often represent multiple different carriers with dozens of different plans. Personally I represent 7 different carriers and 63 different plans. This allows me to present my clients multiple carrier and plan options depending on their needs and I'm not restricted to just a couple of plans.

Answer: If the agent is a 'captive' agent, then they are going to push the plans offered by their carrier and possibly plans that help them meet a quota or get a bigger commision.

As an Independent Medicare Broker, I represent 7 carriers that offer dozens of different plans (Medicare Supplement, MA, MAPD, PDP, C-SNP and D-SNP). My job is to review the clients needs and present them options bases on those needs. My guidance is unbiased and my only interest is doing what's best for the client. Clients should never be pressured to pick one type of plan over another.

Answer: Great question and one I hear often. CMS has strict regulations on what is an educational event vs. a sales event. An educational event cannot go over any plan specific details, premiums or deductibles.

The Medicare 101 seminar that I lead is strictly educational in nature, covering the A, B, C's and D's of Medicare and includes topics like Medicare Advantage, Medicare Supplement and Part D Drug coverage; how all these parts work together with Original Medicare and some of the situations where a person may pick one option over another.

Answer: There are a couple of different 'gaps' in traditional Medicare coverage. Medicare A and B does not cover Vision, Dental or Hearing so enrollees either need to purchase separate coverage for these benefits or pay out of pocket for services when they are needed.

Another considerable 'gap' in Medicare Part B coverage is that there is no annual maximum out of pocket limit. When you are covered by Part B, you have a 20% coinsurance for all services and there is no upper limit on how much you'll pay out of pocket per year like most people have with their employer coverage. If you're healthy and don't see the doctor very often, this 20% coinsurance may not seem to be much of a burden; however, if you are diagnosed with cancer or need a life-saving procedure, the 20% coinsurance can quickly climb 10's of 1,000's of dollars and can quickly deplete any savings you have.

These are the main two 'gaps' that I educate my clients on when reviewing Medicare parts A & B.

Answer: It depends on what state you're in. In Texas there is a six month open enrollment period that starts on your Medicare Part B enrollment date. If you are beyond the six month open enrollment window, you are outside of the 'guarantee issue' period and you may need to go through health underwriting (answering medical questions) when trying to switch from a Medicare Advantage plan to a Medigap plan.

Answer: Most Medigap/Medicare Supplement plans offer emergency coverage of medical expenses while traveling outside of the US and US Territories. Likewise, many Medicare Advantage policies also offer Emergency and urgent care coverage outside of the United States.