Leslie Santos, Medicare Insurance Broker

Answer: • “Medicare Secondary Insurance” is just a general term that means any insurance paying after Medicare — this could include a Medigap plan, employer group coverage, retiree coverage, or even Medicaid

Answer: The best way to compare your current Medicare Supplement (Medigap) plan to a Medicare Advantage (Part C) plan is to look at three main areas: coverage, cost, and flexibility.

1. Coverage:

• A Medigap plan works with Original Medicare, meaning you can see any doctor or specialist nationwide who accepts Medicare — no networks.

• A Medicare Advantage plan often includes extra benefits (like dental, vision, hearing, or gym memberships), but you’ll typically need to use doctors and hospitals within the plan’s network.

2. Costs:

• Medigap plans usually have higher monthly premiums but very low out-of-pocket costs when you get care.

• Medicare Advantage plans tend to have lower premiums but higher copays or coinsurance when you receive services.

3. Flexibility:

• Medigap offers more freedom to travel or see specialists without referrals.

• Medicare Advantage can provide convenience if you prefer having one card and potentially bundled benefits.

Answer: One of the most common misconceptions people have about Medicare is believing that it covers all healthcare costs in full — just like traditional employer insurance. In reality, Medicare only covers about 80% of approved medical expenses under Part B, leaving beneficiaries responsible for the remaining 20% plus deductibles, copays, and services not included (like dental, vision, and hearing).

That’s why it’s so important to explore additional coverage options, such as a Medigap (Supplement) plan or a Medicare Advantage plan, to help fill those gaps and manage out-of-pocket costs.

Many people are surprised to learn this after they’ve already retired, so having the right guidance before enrolling makes a big difference in both coverage and peace of mind

Answer: ✅ If the employer has 20 or more employees:

They can usually delay Medicare Part B (and Part D) without penalty because their employer plan remains primary. However, it’s still smart to enroll in Part A since it’s premium-free for most people and can help cover hospital costs.

⚠️ If the employer has fewer than 20 employees:

They should enroll in Medicare Parts A and B when first eligible. In this case, Medicare becomes the primary payer, and the employer plan is secondary. Delaying Part B could result in late penalties and gaps in coverage

Answer: One of my most successful strategies for building rapport during a remote meeting is to focus on creating a personal connection right from the start. I take a few minutes to chat casually — maybe about the weather in their area, their hobbies, or even how their day has been — before jumping into Medicare details. This helps set a relaxed, conversational tone and shows that I genuinely care about them as a person, not just a policyholder.

I also make sure to maintain strong eye contact through the camera, smile often, and use a warm tone of voice. I keep my background professional and well-lit so they feel comfortable and trust that they’re speaking with someone credible.

The main difference from in-person meetings is that I rely more on vocal tone and facial expressions since I can’t use handshakes or body language as much. I also check in more frequently to ensure they understand everything and feel heard — small verbal affirmations like, “Does that make sense so far?” or “I want to be sure this plan really fits your needs” go a long way in remote settings.

Answer: Well, excellent question. With original Medicare only, you will have to pay 20% of the approved amount for an ambulance, right? Which means that you have to go for the Part B deductible first, which this year, 2025, is $240. It might change for 2026, and those bills could add up year after year. My advice, and your best option, will be to choose a Medicare Advantage plan, which will not only be a smaller charge for the ambulance and sometimes could even be zero, but also includes dental, hearing, and vision coverage that is not included in Medicare alone. I hope that answers your question. And if you have any other questions, please submit it to the side, and I'll be more than happy to answer it. Thank you, have a good day.

Answer: You should contact a medicare insurance broker like me with the list of medications, doctors, hospitals and any other benefits needed who is going to help find the right plan that covers all or most of your meds.

Answer: You can always go back to Original Medicare during enrollment windows, but getting a Medigap plan later may not be as easy or as affordable.

If you try an MA plan for the first time and drop it within 12 months (“trial right”), you can get back into any Medigap without underwriting.

Answer:

In 2025, the donut hole is officially closing,

Now you and your plan together pay until you reach the catastrophic coverage threshold.

Tip to avoid high copays review your plan every year.

During Open Enrollment (Oct 15–Dec 7), check if another Part D or Medicare Advantage plan covers your meds better. Formularies and costs change yearly.

Answer: Yes, it will cover it if your Dr send a medical necessity letter stating that you have any of the medical conditions the medication is labeled for.

Answer: It depends on your needs. If you travel regularly around the us or own properties in different states you should keep your medicare open, purchase a supplement to cover your 20% responsibility; with guaranteed issue the first 6 months after you become elegible for medicare, and a separate part D plan for your prescriptions. Or, a medicare advantage plan which has more coverages. Contact me with any questions.

Answer: The biggest mistake is treating Medicare like a one-size-fits-all program instead of tailoring it to your health needs, prescriptions, and financial situation. Also,

Not Comparing Medicare Advantage vs. Medigap

Missing Enrollment Deadlines

Not Checking Prescription Drug Formularies

Not Re-Evaluating Every Year

Answer: Do not wait, that will create a penalty for life. Keep your employer credible coverage (20 employees or more enrolled) and advise the social security office your decision.

Answer: There is no difference. We can offer virtually the same service whether in person or virtually. Is up to you and who you feel most comfortable with.

Answer: Pharmacy Discount Cards (GoodRx, SingleCare, etc.)

• These are not insurance but can sometimes give you a lower cash price than your Medicare Part D copay.

• If you use a discount card instead of your Part D plan, that purchase:

•Might save you money out of pocket.

•Will not count toward your Medicare plan’s deductible, coverage gap (“donut hole”), or out-of-pocket maximum.

Answer: You only have 6 month after you are elegible for medicare to enroll in a medigap plan or supplement.

Answer: You are now on the ICEP initial coverage election period where you have 3 month before your birthday month and 3 months after to claim your Part A and B and enroll in an advantage plan or a supplement.

Answer: The most common is the Part B one when you turn 65 and do not claim your benefits on time, that will trigger a penalty for life

Answer: You should create a medicare.gov account for each of them and contact a medicare broker to help you sort thru the plans options available in hour county.

Answer: Absolutely, as soon as they turn 65 you must go to the nearest social security office to apply for the Part A and B or they will get penalized for life.

Answer: Yes, in most plans that medication is covered and depending on your LIS level is the copayment you will be responsible for.

Answer: There are many changes coming for 2026 one of the biggest being that you now have to qualify for the benefits in the flex card (when offered by the plan).

Answer: Yes, fraud is the major driver of benefits being cut and you should be concerned because that directly affects your copayments and deductibles.

Answer: Medicare health insurance brokers work with all the companies who have plans in your area, as opposed as others that only represent one company and can only present you the plans of the company they work for. You should always look into ALL the options available to make your selection.