Kelsey Hentzen, Medicare Insurance Broker

Answer: Some brokers may charge fees, however, they must discuss payment up front. As a broker, I personally do not charge seniors a fee for services, but everyone is different. I would ask up front before meeting with any broker if you are concerned about fees.

Answer: Typically Medicare Part B will cover nebulizers as part of durable medical equipment. Handheld inhalers are covered under Part D.

Answer: A Medicare Giveback is often given by Medicare Advantage carriers. These specific Medicare Advantage plans work with Medicare and Social Security to reduce your Medicare Part B premium. For example, if the Giveback amount is $60 and your monthly part B premium is $202.90, the carrier picks up the $60 and tells Medicare to reduce the premium so your new monthly part B deduction will be $142.90. If you are already drawing social security, they will automatically update your part B reduction. If you are not drawing social security and pay your bill online, please visit medicare.gov to see your monthly or quarterly statements.

Answer: Original Medicare does not cover smart watches. However, some Medicare Advantage plans will cover fitness trackers. I would check with your plans benefits or a local broker to find out if you plan has this option.

Answer: If you have a disability and have been on Social Security disability for 24 months, you are eligible for Medicare. Social Security supplemental income and Social Security Disability are different. If you or your spouse have previously worked 10 years or 40 quarters, Medicare part A will be at no cost to you. Your Medicare part B has a monthly standard deduction of $202.90 for 2026. I highly recommend connecting with a broker who is familiar with this information to guide you correctly on your next steps.

Answer: IRMA is calculated based on your adjusted gross income 2 years prior. You can find the 2026 Medicare Parts A & B Premiums and Deductibles at www.medicare.gov. If you have questions regarding IRMA, speak to your broker and they can help locate this information for you.

Answer: When you add a Part C Advantage Plan and stay one night in the hospital, you pay a $350 copay instead of the $1,676 deductible. Medicare Part A hospital deductible for 2026 increased to $,1736 per benefit period. A benefit period begins on the day you are admitted to a hospital or skilled nursing facility and ends when you have been out for 60 consecutive days. When you add the advantage plan, it becomes primary and you are no longer responsible for the Medicare Part A deductible. You will pay the $350 a night versus the $1,736 deductible. Now, if you stay 10 days in hospital, you are responsible for a $350 copay days 1-7, costing you $2,450. There are additional carriers that will offer hospital reimbursement plans to help cover advantage plan hospital stays. Talk with your broker about these options.

Answer: Depending on your state, I would look into Medicare Savings Program to help paying your Medicare B premiums. Some Medicare Brokers can help assist with these applications.

Answer: I would first check to ensure your medication is covered by Medicare. With the introduction of the Inflation Reduction Act, this helped Medicare beneficiaries reach the catastrophic coverage phase when they reach the $2,100 maximum. If the medication is expensive then I would consider the Medicare Payment or see if you qualify for a grant or assistance with the medication.

Answer: It is always good to check your prescriptions to see if any of them require prior authorization. This should have been discussed during open enrollment when you switched Part D. I would contact the company you worked with to ask why this wasn't discussed fully when you were switched.

Answer: With Original Medicare, if you have to go into the hospital, your Part A has a $1736 deductible per benefit period. This means, with each hospital admission if you go in again after 60 consecutive days outside a hospital or skilled nursing facility, you might pay it multiple times in a year for different hospital stays. Additionally, part B has a $288 annual deductible and a 20% coinsurance. When you add an advantage plan with your original Medicare, you may pay $350-$450 per hospital stay days 1-7 and $0 copay thereafter. On an advantage plan, you have a max out of pocket so you know in a calendar year, you will not exceed that amount. With original Medicare, your 20% coinsurance has no maximum.

Answer: During Annual Open Enrollment from October 15th to December 7th you can change your Advantage plan. If you are working with a broker, I would suggest reaching out to them to confirm if your specialist is in the network. Short answer is yes, this should have been discussed and reviewed with your broker during Annual Open Enrollment.

Answer: Yes, you are eligible for a special enrollment period if you are on Medicare and lost employer coverage. Be sure to keep any documentation of prior coverage to avoid penalties.

Answer: Original Medicare A covers hospital coverage, however there is a $1,676 deductible every time you go to the hospital. Additionally, Medicare B covers doctors and specialists. There is a $257 deductible in 2025 as well as a 20% coinsurance. So if you have a $100,000 medical bill, you are responsible for 20%. Medicare Advantage plans include copays for services, plus has a max out of pocket, similar to group insurance. This keep your cost low and knowing your expenses for services up front. Medicare Advantage plans also typically include extra benefits such as dental, vision and hearing. They can have gym memberships and over the counter money to spend depending on the plans service area. It is a great option to add to your original Medicare for great coverage.

Answer: Part C Advantage Plans and Part D prescription drug plans change every year. It is always good to have someone look at it every year.

Answer: Check your prescriptions on your ANOC. You can also have a Medicare broker look over the changes to your plan and prescriptions for 2026.

Answer: Medicare does not cover Long Term Care. However, there are a couple options to explore if you are interested in Long Term Care coverage. There is insurance you can buy additionally to help, or you can look at adding to an annuity. My recommendation is to see if your Medicare broker can connect you with a retirement specialist to help.

Answer: You can log into your social security account and there is a button to replace your Medicare Card. If you do not have an account, call the Social Security office.

Answer: Yes, in most scenarios, you will need to answer health qualifying questions if you switch Medigap plans.

Answer: I would suggest having someone review your current Medicare Advantage plan from October 15th to December 7th. A broker can look at all plans in your area and ensure your favorite hospital will be in network for 2026.

Answer: If you are unable to provide creditable coverage when you move to Medicare, it is possible you would be subjected to a lifetime penalty. The penalty depends on how long you have gone without health coverage.

Answer: This is a great question. It is always good to have your Part D looked at especially if you are on a new medication. Each year, your prescription coverage can change. You should receive and ANOC (Annual Notice of Change) from the carrier you selected for your part D. This has information on prescription drug changes for the next year.

Answer: The earlier you take your social security the lower the amount you will receive. Taking social security depends on your current situation. Are you still working? What is your tax bracket? Often times you can ask your Medicare Agent if they know anyone willing to do a retirement assessment. This is very helpful when you are at retirement age.

Answer: Yes, Medicare covers emergency care only outside of the United States. It is always a good idea to check your current benefits to ask about coverage before leaving the country.

Answer: This answer depends on a few things. First, if you choose to stay with your current employer's insurance, you want to ensure it is creditable coverage from your current employer. Your HR department should be able to provide that information to you. Secondly, it is a good idea to compare your current employers benefits with Medicare. Often times, Medicare can save you money every year by comparing max out of pocket, deductibles and copays.

Answer: Many advantage plans offer 24/7 telehealth or nurse line. If you are are original Medicare, part B covers telehealth but subjected to a 20% coinsurance and an annual deductible of $257 for 2025.

Answer: I would look at the part D deductibles. Some plans do not have a prescription deductible. Either way, your max out of pocket for the year does not exceed $2,000 for 2025. You'll want to find out which tier drug your prescription is, and then you can look at the carrier's formularies. Additionally, you can go to medicare.gov and enter your prescription and see which option works best in your zip code.

Answer: No you can keep your same Medicare plan, however, it is always good option to meet with a broker to ensure you are on the best plan.

Answer: You can attempt to fill out a form called the SSA-44, otherwise known as Medicare Income-Related Monthly Adjustment Amount-Life-Changing Event." IRMA is based on your adjusted gross income two years prior. You can also talk with a retirement specialist to see if they could assist.

Answer: I would highly suggest talking with a broker that understands your needs. With advantage plans, its good to add a hospital and cancer plan to cover most everything you might need.

Answer: You can enroll in Medicare 3 months before your birth month. If your birthday is June 9th, your Medicare will become effective June 1st. If your birthday is the first of the month (6/1), it will become effective the month before. You have your birth month and three months after to enroll in Medicare. Your initial enrollment period is 7 months.

Answer: Medicare does cover some medical out of the country. I would highly suggest taking out additional travel insurance while you are on vacation.

Answer: Yes, Medicare covers hospice. There are certain criteria to meet in order to be eligible for hospice.

Answer: Medicare Advantage plan availability are based upon zip code. If you move to a rural, its possible you might have fewer options. However, make sure to check your doctors hospitals in the network.

Answer: Yes, you can be penalized if you do not enroll in Medicare when you turn 65. However, if you are on group/work insurance, you may not need to apply for Medicare. Its always a good idea to check with your current employer that you have credible coverage. If you are on Marketplace Insurance or have 20 or fewer employee's, you will need to enroll in Medicare.

Answer: Medicare can be overwhelming. My advice is to attend multiple seminars if they are offered in your area. Additionally, make sure you are working with a broker so they can shop all the plans in your area. Most brokers can help you apply for Medicare part A and B and help you shop plans.

Answer: You can apply for extra help Medicare Part D by going to www.ssa.gov. There you will see an option for "Medicare." Then select "Apply for Part D extra help." The process is very quick and easy. If you need assistance, I would love to be of service.

Answer: Extra protection is always good to have. I would look at your max out of pocket for your health insurance plan and get coverage for the amount of the health insurance plans max out of pocket.

Answer: The short answer is no, Medicare does not fully cover the costs of nursing home care, particularly long-term care. Medicare generally covers skilled nursing facility (SNF) care for a limited time, primarily for post-hospitalization rehabilitation needs. However, there are options for long-term care and we discuss these options in our office with clients.

Answer: If you are ready to enroll in Medicare A and B, you are able to enroll in Medicare without taking your Social Security benefits. However, you will receive a quarterly bill in the mail for your Medicare part B premium. You can call social security to make monthly payments instead of quarterly if that works better for you.

Answer: Medigap Plan C covers bloodwork up to 3 pints. You should be able to call your carrier's customer service number on the back of the card and ensure you are covered. If you are on an advantage plan, some plans cover at $0 and some charge a co-pay depending on the carrier.

Answer: No matter which Medicare Supplement plan you enroll in the coverage is the same. If you choose a plan G, it is the same coverage with every carrier. What to look for when enrolling in a Medicare Supplement plan is (1) monthly premium (2) financial rating of the company (3) and how long they have been in business. Make sure whoever you speak to can look at multiple carriers.

Answer: This is a great question! If you are in your first 12 months of your Medicare Part A effective date, you can switch from a Medicare Supplement to a Medicare Advantage and vise versa for those initial 12 months. After the 12 months, you may try and switch to a Medicare Supplement during Annual Open Enrollment, however, you may have to health qualify. Keep in mind, as you age, the monthly premiums may also increase. Its best to try and make a decision in those first 12 months. Additionally, there are other qualifying events for moving to a Medicare Supplement plan, such as moving out of the service plan area.

Answer: One of the biggest misconceptions about Medicare is that its too expensive. The best way to understand the costs associated with Medicare is to sit down with a licensed broker and review all your options.

Answer: There are many routes to educating clients new to Medicare. I have clients that either meet one on one and go through our Medicare Guide Packet, or they can attend any of one of our Free Educational Medicare Seminars. I truly believe its best to find a broker who can shop all the plans in your area to find the best option for their clients.

Answer: I personally enjoy celebrating life wins with my clients. Turning 65, retiring, birthdays, new grand babies, and vacations. I think of my clients as second parents and I enjoy helping them through the Medicare process.

Answer: Most Medicare Advantage plans offer $0 monthly premiums and $0 primary care visits. This also depends on your zip code or service area. You'll want to consider copays and benefits of each plan to ensure it is the right one that fits your individual needs. Some advantage plans may have health deductibles or prescription deductibles. You'll want to ensure whoever you are working with goes over the summary of benefits of the plan.

Answer: This answer depends on if you plan to continue to work. If you are working, I would consider doing a side by side comparison of your group insurance and Medicare. If you are retired or no longer working, the first step would be to apply for Medicare A and B. Then find a local unbiased broker who can shop all the plans in your area and offer a comparison between a supplement and an advantage plan.