Justin Scheiner, Medicare Insurance Agent

Answer: IRMAA is determined by Social Security based on your income from two years ago, so you are only responsible for it if your income was above Medicare’s set limits. For 2026, it generally applies if your 2024 income was over $109,000 filing individually or $218,000 filing jointly.

Answer: The biggest mistake is choosing a Part D plan based only on the monthly premium instead of checking how their specific medications are covered. A plan that looks cheap upfront can end up costing much more if their drugs are in a higher tier, require prior authorization, or are not covered well at their preferred pharmacy. The best plan is the one that fits their actual prescriptions, pharmacy, and total yearly cost, not just the lowest premium.

Answer: Insurance companies can offer many Medicare Advantage plans with a $0 monthly premium because Medicare pays the insurance company a set amount each month to manage your care. The plan may also control costs through provider networks, prior authorizations, and negotiated rates with doctors, hospitals, and drug companies. So while the premium may be $0, members can still have copays, deductibles, and out-of-pocket costs when they use care.

Answer: Yes, you can usually cancel Medicare Part B if you move abroad, and you would do that through Social Security. Just keep in mind that Medicare generally provides very limited coverage outside the U.S., and if you drop Part B and want it again later, you may face a late-enrollment penalty or have to wait for a future enrollment period.

Answer: If you are moving to a new state, the big Medicare checklist is making sure when your current Medicare Advantage or Part D plan ends, what new plans are available in your new area, whether your doctors and pharmacies are in network, and when your Special Enrollment Period starts and ends so you do not have a gap in coverage. If you have a Supplement, also check whether the premium will change after the move.

Answer: “Creditable coverage” usually means other prescription drug coverage that is expected to pay at least as much as standard Medicare Part D coverage. It matters when someone is delaying Part D because if they go 63 days or more without Medicare drug coverage or other creditable drug coverage, they can face a late enrollment penalty when they enroll later.

Answer: I think hospital indemnity plans can make sense for some people on Medicare Advantage, especially if they want extra protection against inpatient copays and like having more predictable costs. That said, they are not a replacement for good core coverage, so I usually look at whether the Advantage plan already has reasonable hospital cost-sharing before adding another premium.

Answer: Most plans mail the Annual Notice of Change (ANOC) in the fall, typically by the end of September, so you have time to review changes before the Annual Election Period starts. If you don’t see it by early October, call the number on your member ID card and they can resend it or point you to a digital copy.

Answer: If the shutdown drags on and Congress doesn’t extend the authority, providers could start losing reimbursement for certain telehealth services, leading to more ABNs, more denied claims, and a real “do we keep offering this?” squeeze—especially for smaller practices. For beneficiaries, that can translate into fewer telehealth options, unexpected out-of-pocket bills, and delayed care (particularly for rural and homebound patients) as offices pull back to avoid financial risk.

Answer: Paying for a high-end Medicare Supplement can be worth it if you value predictable costs, see doctors frequently, or want maximum freedom to see any Medicare provider with almost no bills beyond your premium and Part B deductible. It’s closer to “overkill” if you’re very healthy, rarely use care, and could comfortably handle higher deductibles or occasional bills in exchange for lower premiums (for example, Plan N or High-Deductible G)

Answer: Medicare Advantage plans come in several types, including HMOs, PPOs, PFFS plans, and Special Needs Plans (SNPs). HMOs generally require staying in-network, while PPOs allow more flexibility with out-of-network providers. PFFS and SNP plans offer more specialized structures, with SNPs designed for people with specific health or financial needs.

Answer: You can sign up for Medicare during your Initial Enrollment Period, which starts three months before the month you turn 65 and lasts for seven months total. It’s best to enroll early so your coverage starts the first day of your birthday month.

Answer: Telemedicine has enhanced personalized healthcare by making it easier for patients to connect with providers remotely, allowing for more frequent, convenient, and tailored care that fits individual health needs and lifestyles. It also enables real-time monitoring and faster adjustments to treatment plans.

Answer: If you delayed Medicare past 65 because you had employer coverage, you’ll want to sign up during a Special Enrollment Period once that coverage ends so you avoid penalties. The first step is to enroll in Part B through Social Security, and then you can add a supplement or Advantage plan that fits your needs.

Answer: Medicare covers a “Welcome to Medicare” visit (within the first 12 months of Part B) and a yearly Annual Wellness Visit (AWV) at no cost. These are not the same as a traditional head-to-toe “physical exam.”

Annual Wellness Visit (AWV): Focuses on reviewing your health history, medications, preventive screenings, and making a care plan. Medicare pays for this 100%.

Traditional physical exam: Includes things like a full body exam, routine bloodwork, or addressing new medical problems. Medicare does not cover this as a “free physical,” so doctors may bill you.

If your doctor billed you, it likely means they performed or coded the visit as a full physical exam rather than the Annual Wellness Visit.

Answer: Yes, Medicare can help pay for certain wearable medical devices, like insulin pumps or seizure monitors, if they’re considered medically necessary for managing a chronic condition. These devices are usually covered under Medicare Part B as durable medical equipment (DME), as long as they’re prescribed by a doctor and meet Medicare’s guidelines.

Answer: What I enjoy most about working with Medicare clients is the opportunity to simplify a complex system and provide peace of mind during an important transition in their lives. It’s incredibly rewarding to earn their trust and help them feel confident about their healthcare choices.

Answer: For most seniors, especially those aged 65 to 75, Medicare Supplement Plan G offers the best overall value due to its strong coverage and cost predictability—covering nearly all out-of-pocket expenses except the small annual Part B deductible. While Plan F provides even more comprehensive coverage by also covering that deductible, it’s only available to individuals who became eligible for Medicare before January 1, 2020; those beneficiaries are “grandfathered in” and can keep or switch to Plan F, which may still be ideal if the premium is reasonable. For anyone new to Medicare after that date, Plan G is typically the most robust and cost-effective option.

Answer: Yes, many of Medicare’s technology systems are outdated, making processes like enrollment, claims, and provider coordination unnecessarily complex. Modernizing these systems could greatly improve efficiency, user experience, and accessibility for beneficiaries and providers alike.

Answer: Medicare mail is designed to overwhelm you — and confuse you into bad decisions. As your broker, I cut through the noise. If it’s not from Social Security, shred it. I personally deliver your real documents, ID cards, and updates, so you stay informed, protected, and in control.

Answer: If you missed your initial Medicare enrollment due to a medical emergency, you may be able to request Equitable Relief, which can allow for backdated coverage in certain cases. You’ll need to provide documentation and contact Social Security to formally request it.

Answer: The biggest disadvantage of Medicare Advantage plans is their restrictive provider networks, which limit access to healthcare providers and specialists outside the network, often leading to higher out-of-pocket costs for out-of-network care.

Answer: Original Medicare combined with a Part D prescription drug plan offers flexibility, nationwide access, and consistent coverage, making it an excellent choice for frequent travelers. Unlike Medicare Advantage plans, which are often geographically limited and depend on specific provider networks, Original Medicare with Part D ensures you can access care and prescriptions anywhere in the United States without restrictions.

Answer: The biggest mistake I see seniors make when enrolling in Medicare is listening to friends. Everyone’s situation is different — what worked for your neighbor or coworker might not be right for you. Medicare isn’t one-size-fits-all, and making decisions without personalized guidance can lead to unexpected costs or gaps in coverage.