Kris Moen, Medicare Insurance Agent

Answer: You’re not supposed to be struggling like this on Medicare—there are programs that can wipe out a big chunk of those costs. You just have to get enrolled in the right ones.

Answer: You’re not getting taxed for having Medicare—but you did pay into it your whole career, and if your income’s high, they’ll charge you more for it.

Answer: Original Medicare with a supplement is like paying ahead so nothing surprises you.

Advantage is cheaper each month, but you’re playing by the plan’s rules when you use it.

Answer: Medicare will fix your cataract—but if you want the fancy lens so you don’t need readers, that part’s on you.

Answer: Medicare will take care of your eyes if something’s wrong—but if you just need new glasses, you’re usually on your own.

Answer: SNPs are Advantage plans built for folks with more going on—whether that’s income, health conditions, or living situation. When they fit, they can be really good. When they don’t, they feel tight.

Answer: Just because your doctor takes Medicare doesn’t mean they take your Advantage plan—you’ve gotta check the fine print.

Answer: People don’t mess up Medicare by picking the wrong plan—they mess up by picking the cheapest one without realizing how they’ll pay for it later.

Answer: Part A gets you in the hospital—but it doesn’t protect your wallet while you’re there.

You’ll still face:

Deductibles

Daily copays

No spending cap

Answer: You can always switch plans—but you can’t always get back into Medigap without answering some tough health questions.

Answer: Medicare will help you get back on your feet—but it won’t pay to stay there long-term. Medicare covers short-term rehab (up to 100 days max)

Answer: Medicare pays a big chunk—but not all of it. If you don’t have something covering the leftovers, you feel it every time you walk into a specialist’s office.

Answer: Medicare gives you a grace period when you lose work coverage—but the clock starts ticking right away, even if you think you’re covered under COBRA.

Answer: Under 65, Medicare isn’t about age—it’s about disability or serious health conditions. Most folks get there through Social Security disability after a waiting period.

Answer: Medicare will pay for bloodwork when there’s a reason for it—but they’re not big fans of "let’s just test everything and see what happens".

Answer: You’re not stuck—you get a chance to adjust things every year.

But some doors (like Medigap without health questions) don’t stay open forever.

Answer: Signing up for an Advantage plan when they are first eligible is the biggest mistake people can make in my opinion. When choosing a plan, people should be thinking "how will my health be 10 years from now" not "how's my health right now?"

Answer: Don’t try to win the paperwork war every day—just set up a system, check it once a week, and only pay what matches. Everything else goes in the ‘figure it out later’ pile.

Answer: Say you move from North Dakota to Arizona—your current Advantage plan likely won’t work there. Medicare gives you a window to pick something new, and it might be one of the only times you can grab a Medigap plan without jumping through health hoops.

Answer: Advantage is cheaper each month—but you’re agreeing to play by the insurance company’s rules.

If you don’t like rules, or you want zero surprises, it’s probably not your deal.

Answer: IRMAA is just Medicare looking back two years and saying, "You made too much back then, so we’re charging you more now."

The trick is controlling what shows up on that tax return—or fixing it if life changes.

Answer: Medicare will pay to look for problems for free…

but once they find something, now you’re in treatment mode—and that’s where costs can show up.

Answer: Your doctor is always the one calling the shots medically…

but with Advantage plans, there’s a second opinion sitting behind a desk deciding if they’re going to pay for it.

Answer: Medigap is like prepaying your medical bills so nothing surprises you.

Advantage is cheaper each month, but if something big happens, you’ve got skin in the game.

Answer: Hang onto them for a year or two just to make sure everything checks out. If something looks off or gets messy, keep them longer—otherwise you’re safe to clean house.

Answer: With an HMO-POS Medicare Advantage plan, you have a primary care physician, you typically need referrals for specialists, and you're required to stay in network. BUT, you can go out of network for certain services at a higher cost.

With an HMO Medicare Advantage plan, you must stay in your network AND you need referrals and there is no coverage out of network except emergencies. These are generally the lowest cost in regard to premium

A PPO plan gives you freedom to go wherever you choose, however you do see a higher premium cost.

Answer: Original Medicare resets based on time out of the hospital (60 days)

Advantage and Supplement plans reset every plan year

Answer: Medicare Advantage plans (part C) are the primary payor. You still have parts A & B. So in this case, you wouldn't be responsible for the $1,676 part A deductible, you would follow the Part C structure of $350/day for 7 days.

Answer: 1. Make a list of her doctors

Start with a quick list of:

Primary care doctor

Any specialists (cardiologist, endocrinologist, etc.)

Preferred hospitals or clinics

These are the providers you must verify before choosing a plan.

2. Check the plan’s provider directory

Every Medicare Advantage plan has an online doctor search.

Steps:

Go to the insurance company’s website (Aetna, UnitedHealthcare, BCBS, etc.).

Click “Find a Doctor” or “Provider Directory.”

Search by the doctor’s name.

If the doctor appears, they are in-network for that specific plan.

⚠️ Important: A doctor might accept one company’s plan but not another.

3. Call the doctor’s office (best confirmation)

Ask the front desk something like:

“Do you accept [Plan Name] Medicare Advantage for next year?”

Doctors’ offices track which plans they participate in and can confirm quickly.

4. Double-check with the insurance plan

Call the plan’s member services or broker and ask:

“Is Dr. ___ in network for this specific plan for 2026?”

You want confirmation from the insurer and the doctor because directories can sometimes be outdated.

Friends’ plans can be great for them but terrible for someone else depending on doctors and medications.

Answer: Hands down a plan G Medicare Supplement plan is the way to go. It's the most comprehensive plan out there. From a cost perspective, it's more than an advantage plan however most everything is covered with the exception of your Part B deductible. Pairing a Plan G with Prescription Drug Plan that suits your needs is the most comprehensive coverage you can get.

Answer: Original Medicare works anywhere, but moving can affect your drug plan, Medicare Advantage plan, and sometimes your Medigap rates. You’ll likely qualify for a Special Enrollment Period to choose new coverage. Let’s take a look together so you don’t lose any benefits.

Answer: If you have diabetes or kidney disease, Medicare Part B covers:

3 hours of one-on-one nutrition counseling your first year

2 hours of follow-up counseling each year after

Additional hours if your doctor says it’s medically necessary

Cost to you:

-Medicare pays 100%

- No deductible

- No coinsurance

(as long as the provider accepts Medicare)

Answer: What I enjoy most about being a Medicare agent is helping people feel relieved instead of overwhelmed. Medicare can be confusing, the rules change every year, and it’s easy to make a decision that affects your health and wallet without even realizing it. I love being the person who can sit down, simplify everything, and give you honest guidance you can trust.

For me, the best part is when someone says:

“Thank you — I actually understand this now.”

Or when I hear:

“I feel so much better knowing I’m on the right plan.”

This work is personal. It’s not just enrolling someone in a plan — it’s helping them protect their health, their budget, and their peace of mind. I get to build real relationships, often with families I’ve known for years, and that’s something I’m truly grateful for.

At the end of the day, what I like most is simple:

I get to help people during one of the most important transitions of their life, and I get to make it easier.

Answer: If you missed open enrollment, you still may have options. If you’re on a Medicare Advantage plan, you can switch January through March. Otherwise, certain life events—like moving, losing employer coverage, qualifying for Medicaid, or finding a 5-star plan—can open special windows. Let’s review your situation and see what you qualify for.

Answer: Over the last few years, hospitals and insurance companies have been required to post more of their prices online. This is called healthcare price transparency, and it’s meant to help you understand what care might cost before you receive it.

But here’s what most people discover very quickly:

the numbers are confusing, inconsistent, and often don’t match what Medicare will actually pay.

That’s where I come in.

What Price Transparency Means for You

You now have access to:

-Procedure estimates from different hospitals

-Pricing differences between clinics

-Some insight into how insurance negotiates rates

This can be helpful — but it often raises even more questions.

How I Help You Navigate It:

My job is to take that messy pricing information and translate it into something useful and easy to understand.

I help you see:

-What Medicare will actually approve

-What your plan will pay

-What your share of the cost would be

-How prices change depending on the type of Medicare plan you choose

-Instead of guessing or worrying, you get a clear picture of your real costs.

Many people think that more pricing information would make choosing a plan easier.

But the truth is, it’s made guidance even more important.

Clients tell me:

“I looked up the prices online, but I still have no idea what I’d actually pay.”

Because of this, I’m able to build stronger relationships and give you more personalized explanations based on your doctors, medications, and budget.

Answer: Medicare was built in 1965, when:

-People lived shorter lives

-Chronic conditions were less common

-Long-term care wasn’t a national crisis

-Most care happened in hospitals, not at home

-Today’s seniors have very different needs, and Medicare hasn’t fully caught up.

So, to answer the question... yes, it's about time!!

Answer: As you turn 65, first make sure you’re enrolled in Parts A & B. Then decide whether Medigap or Medicare Advantage fits you best. Review your medications, check that your doctors take the plan, and choose a drug plan that keeps your costs down.

Answer: “If my health changes suddenly, how will my coverage protect me next year — not just today?”

Most people focus on:

-premiums

-networks

-drug copays

-dental or vision perks

but they forget the #1 risk with Medicare:

-Your health can change overnight,

-but your ability to change plans does not.

Answer: Unfortunately, it is legal in most states — including North Dakota — for Medigap companies to deny applications based on health unless you’re in a protected enrollment window.

This feels frustrating because people have paid into Medicare for decades, but Medigap insurance is private insurance, not part of Medicare itself.

Answer: No — Medicare does not fully cover long-term nursing home care.

This is one of the biggest misconceptions people have about Medicare.

Medicare only covers short-term skilled care, and only under specific conditions.

Answer: Let’s list all your medications and compare plans side-by-side so we can see not just the monthly premium, but the actual total costs you’d pay for your prescriptions next year.

Answer: You can change your Medicare Advantage plan each year during AEP in the fall, again from January through March if you’re already on a plan, or anytime you qualify for a special enrollment period due to life changes.

Answer: Medicare Advantage plans are not truly “free.”

They’re often marketed that way because many plans have a $0 monthly premium, but you still pay in other ways:

What “$0 Premium” Actually Means:

-You still pay your Medicare Part B premium (usually deducted from Social Security).

-You pay copays for doctor visits, tests, and hospital stays.

-You pay for services as you use them — it’s pay-as-you-go instead of paying a large monthly premium.

Why They Can Offer $0 Premiums:

-The federal government pays the Medicare Advantage company a set amount each month to manage your care.

-That funding lets many plans reduce or eliminate the plan premium, but the costs show up elsewhere.

What You as the Client Should Understand:

-Your costs are not zero — they’re just structured differently.

-You trade lower premiums for higher out-of-pocket costs when you need care.

-Every plan has an annual out-of-pocket maximum, which Original Medicare doesn’t.

Answer: You can either get Dental and Vision coverage as part of a Medicare Advantage plan, or if you choose to purchase a Medicare Supplement plan you can purchase separate Dental and Vision coverage through your agent.

Answer: Yes — Medicare covers the shingles (Shingrix) vaccine at no cost to you.

As of 2023, Part D and Medicare Advantage plans must cover it with a $0 copay, as long as you get it from a pharmacy or provider in your plan’s network.

Answer: Make sure the plan covers your doctors, your medications, and your hospitals — because the right plan isn’t the cheapest one, it’s the one that fits your actual care.

Answer: A legitimate Medicare agent will:

Be licensed in your state (you can verify on your state insurance department’s website).

Provide their National Producer Number (NPN) when asked.

Give required disclosures and never pressure you to sign up immediately.

Offer multiple plan options — not just one company.

Never ask for your Social Security number or bank info before you choose a plan.

Follow Medicare’s rules, including getting permission before calling or meeting.

Answer: Yes — most medical equipment like wheelchairs, walkers, and hospital beds require special approval called “prior authorization.”

A few key points:

You must get the equipment from a Medicare-approved supplier.

Your doctor must provide a written order stating it’s medically necessary.

Some items (like power wheelchairs) require Medicare to approve the request before you get it.

You’ll typically pay 20% of the cost under Part B after your deductible.

Answer: Filing bankruptcy does not take away your Medicare coverage. You will still keep Parts A and B, and you can still enroll in Medicare Advantage or Part D plans.

What bankruptcy can affect:

Medicare Advantage or Part D premiums — if you were behind on payments, a plan could disenroll you, but you can usually join another plan during the next enrollment period.

Medigap plans — if you already have one, you keep it. If you try to buy a new one after bankruptcy, the company may use underwriting and could deny you.

Medical bills going forward — Medicare will continue covering care the same as before; bankruptcy only clears past qualifying debts.

Bottom line: Your Medicare stays intact, and you still have plan options — just be mindful of premium payments and Medigap underwriting rules if you switch.

Answer: Medicare doesn’t give discounts for low use because it’s an insurance program, not a pay-as-you-go system. Everyone pays the same because:

Risk is shared across all beneficiaries, so people who are healthy help balance costs for those who need more care.

Medicare must stay affordable and predictable, so premiums aren’t based on individual health or usage.

Federal law prevents health-based pricing, unlike some private insurance.

Answer: Medicare spending has shifted significantly toward Medicare Advantage — the private-plan alternative to traditional Medicare. Enrollment in Advantage plans now covers over half of Medicare beneficiaries, and federal spending per person in Medicare Advantage is higher than in traditional Medicare, contributing to a growing share of overall Medicare costs and drawing more public dollars into private plan payments.

Answer: If you’re approved for Social Security Disability Insurance (SSDI), Medicare usually starts after 24 months. Social Security handles your disability payments, and Medicare provides your health coverage—they work together but cover different needs.

Answer: Working with a Medicare agent helps you avoid mistakes, compare plans easily, save money, and get personalized guidance from someone who understands local options and rules—at no cost to you.