Karen Moore, Medicare Insurance Broker

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There are a lot of moving parts in Medicare and often times very confusing for people. Seniors deserve to have the care they need as they age and It’s very rewarding to help them find a plan that works for them.

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Through the Inflation Reduction Act in 2025 the maximum out of pocket cost for drug coverage is set at $2000. Once a person reaches $2000 out of pocket costs then their drug prescriptions cost are reduced to $0 for the rest of the year.

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Medicare recipients may prefer to only have a Medicare Part D plan if they have other credible Part B coverage, for example through the VA or Indian Health Services. Comprehensive coverage that includes both Medicare Part B and D coverage will provide more overall coverage for a Medicare recipient.

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Some states allow you to switch between Medicare Supplement plans with a guaranteed issue under the birthday rule (changing plans in your birthday month), however this rule varies from state to state. Some states like WA have a guaranteed issue at any time depending on the Medicare Supplement plan letter.

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If you do not have other credible Part B and Part D coverage past your Initial Medicare Enrollment period (3 months before your 65th birthday month, your 65th birthday month and 3 months after your 65th birthday) according to Medicare standards, then yes you will incur a late enrollment penalty when you do enrollment into Medicare Part B and D.

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There have been cuts to Medicaid and Medicare this year and also many changes to Prescription drug coverage since the implementation of the Inflation Reduction ACT. These changes and they will impact Medicare recipients vary from state to state. This is another reason why you may want to seek the help of a Licensed Medicare Agent to help you understand all of these changes and how they can impact plan benefits.

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You do not have to re enroll into Medicare Part A and B when you turn 65 if you are already enrolled. You will however have another opportunity to enroll into a Medicare Advantage plan as you will be in a ICEP election period. Additionally you can enroll into a Medicare Supplement plan as you will be in a Medigap Open Enrollment period.

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Selecting a Medicare Supplement or Medicare Advantage plan is a very personal choice and greatly depends on a persons lifestyle, their health care needs and what is affordable. Medicare Advantage plans are tied to specific Provider networks. These plans typically have lower monthly plan premiums and function like an umbrella, to include everything that Part A and B cover. Most Medicare Advantage plans include Medicare Part D (drug prescription coverage) and other benefits beyond part A and B, like dental, hearing and vision. Medicare Supplement plans close a portion or all of the remaining 20% that Part A and Part B do not cover.

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Medicare Supplement plans are accepted by doctors nationwide who will accept Medicare Parts A and B as the primary Insurance coverage. Additionally, some Medicare Advantage PPO plans have national Provider networks in all 50 states that you can utilize.

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Medicare Part D covers prescription drugs that aid in helping you quit smoking. Additionally Medicare Advantage plans offer under their Preventative care, which is covered by the plan, Smoking Cessation counseling.

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Working with a Licensed Agent that is knowledgeable can help you navigate and understand all the many parts of Medicare and help you through the enrollment process. There is NO cost, always, for a Medicare Agents help and they can continue to help you even after you have enrolled into a plan.