Joshua Ruiz, Medicare Insurance Broker

Answer: "What I love most about being a Medicare agent is the impact I get to make every day. For many people, Medicare is overwhelming and confusing, and I take pride in being someone they can trust to guide them through the process. Helping clients find the right coverage not only saves them money, but also gives them peace of mind about their health and financial future. It's incredibly rewarding to know that I'm making a real difference in people’s lives, especially during such an important transition."

Answer: Yes, you can have just Medicare Part A (hospital insurance) and Part B (medical insurance), but it does not provide the full coverage most people need.

Original Medicare (A & B) covers about 80% of approved medical costs, which means you’re responsible for the remaining 20%—with no cap on out-of-pocket costs. It also doesn’t include things like prescription drug coverage (Part D), dental, vision, or hearing.

To help fill those gaps, most people choose one of the following:

Medicare Supplement + Part D: Covers the 20% and helps reduce unexpected medical costs.

Medicare Advantage (Part C): All-in-one plans that include A, B, often D, and extras like dental or vision.

So while A & B alone is technically “enough” to get by, it can leave you financially vulnerable. Most beneficiaries find better protection by adding coverage.

Answer: The recent intensification of audits and scrutiny of Medicare Advantage (MA) plans by the Centers for Medicare & Medicaid Services (CMS) is poised to significantly impact nursing home coverage, particularly concerning prior authorization practices and patient care decisions.

Answer: No, you cannot use your Original Medicare card if you're enrolled in a Medicare Advantage plan.

When You’re on a Medicare Advantage Plan (Part C):

Your Medicare Advantage plan takes the place of Original Medicare for your medical and hospital coverage.

You must show your Medicare Advantage card when receiving care, not your red, white, and blue Medicare card.

Original Medicare will not pay for your services while you're enrolled in a Medicare Advantage plan.

If a Provider Doesn’t Accept Your Advantage Plan:

You cannot use your Original Medicare benefits to bypass the Advantage plan’s network or billing rules.

You would either need to:

Pay out of pocket, or Find a provider who is in-network or accepts your Advantage plan, or

Switch plans during an eligible enrollment period (like the Annual Enrollment Period or Special Enrollment Period if applicable).

Bottom line: If you have Medicare Advantage, that plan is your primary coverage. Your red, white, and blue card no longer applies unless you disenroll from the Advantage plan and return to Original Medicare.

Answer: Yes. Once the policy is issued it will pay secondary to any claims paid by medicare. If you enrolled in Plan G during your Medigap Open Enrollment Period (the 6 months after enrolling in Part B at 65+), no pre-existing condition limitations apply—your surgery would be covered.

Answer: If a senior is turning 65 and still working, they may be able to delay Medicare — but it depends on their situation:

Are they covered by employer insurance?

Yes, and the employer has 20+ employees:

They can delay Part B (and Part D) without penalty. Part A is usually free, so many enroll in Part A only.

Yes, but the employer has fewer than 20 employees:

Medicare becomes primary, and they should enroll in both Part A and B to avoid gaps in coverage and penalties.

No employer coverage or self-employed with marketplace plan:

They should enroll in Medicare to avoid late penalties and coverage gaps.

Answer: Medicare encourages beneficiaries to report fraud or billing mistakes — and you’re protected when doing so in good faith. You won’t get in trouble for reporting something suspicious, even if it turns out to be a mistake.

Call 1-800-633-4227

If you prefer, you can report without giving your name — though giving your info may help them investigate more thoroughly.

Answer: Not filling the gaps in coverage when first eligible for Medicare. Drug even if on no medication is important to have from the beginning to avoid penalties! Another mistake is people not having the proper guidance on comparing Medicare Advantage to Original Medicare.

Answer: Yes I believe so. With technology and AI coming in strong along with a more tech savvy group of medicare beneficiaries, we will see more tech involved.

Answer: Many people see it like a foreign language. But at its core, it’s simply health insurance—just like group or individual coverage. That’s where we come in. We help simplify the confusion, providing clear guidance so individuals understand their options and feel confident choosing the plan that’s best for them.

Answer: Just because a drug is brand-name and lacks a generic doesn’t guarantee coverage. Always verify with your specific Part D plan — and know you have options to request exceptions or change plans.

Answer: Why Some Agents Push Medicare Advantage Plans:

Higher Commissions:

Medicare Advantage (Part C) plans often pay agents higher upfront commissions than Medigap (Supplement) plans — especially in the first year.

No Medical Underwriting:

Advantage plans are guaranteed issue during certain periods, while Medigap may require medical underwriting if you're outside your Open Enrollment. So agents may lean toward what’s easier to get approved.

Bundled Coverage:

Advantage plans often include Part D drug coverage, dental, vision, and extras — so they’re an “all-in-one” pitch that’s easier to explain and sell.

Lack of Training or Licensing:

Some agents aren’t certified or contracted to sell Medigap, so they steer clients to the plans they’re authorized to offer.

Be cautious — but not cynical.

A good agent should educate you on both options:

Medicare Advantage: Lower monthly premiums, but networks, copays, and prior authorization.

Medigap + Part D: Higher monthly cost, but more freedom, fewer out-of-pocket surprises, and no referrals.

If you're not hearing a comparison of both, ask questions or consider getting a second opinion.