Lori McDermott, Medicare Insurance Broker

Answer: Hospital stays are never covered fully. There is a hospital deductible and coinsurance that is applied and required to pay.

Answer: The biggest disadvantage to having a Medicare Advantage are the required prior authorizations and must use a network.

Answer: Original Medicare does not require referrals to see specialists and there is no network. As long as the doctor accepts Medicare you may see them.

Answer: The overhyped benefits you should be wary of are a food benefit. These are only available to people who have medicare and medicaid. Scammers usually lead with these benefits to try to get you to give your medicare number and then they change your plan that doesn't fit your healthcare needs.

Answer: There are many $0 premium plans offered by carriers, however, these plans are funded the same amount as other plans. The difference is when there's no premium, your cost share for deductibles, coinsurance, and copays will be higher.

Answer: Your medicare benefit has no affect on you should you get married. You will not lose coverage. The only thing that could happen is your joint income could trigger a higher cost in Part B premium or go the opposite direction in possibly receiving Extra Help. Check IRMAA surcharges and Medicare Savings Program for eligibility.

Answer: Only in rare cases, such as non-payment of premium, falsifying information or if the carrier goes bankrupt.

Answer: Carriers had decided to exit the market with certain plans because they were not sustainable. For year 2027, CMS is providing a 2.48% increase or over $13 billion in additional Medicare Advantage funding to plans. Medicare should work for the people. This increase should help keep coverage affordable.

Answer: Depending on your prescription plan Medicare Part D, Breztri Prescription is a brand name drug and subject to deductible and coinsurance. For 2026, the Part D deductible is $615.00. On average, Breztri is $50.00, but costs vary depending upon your plan's deductible and formulary (drug list), some carriers may put it on tier 3 or 4. Price varies based on your plan. Call the pharmacy telephone # on the back of your ID card for your plan's specific coverage.

Answer: Medicare does not cover smart watches or fitness trackers. However, some Medicare Advantage plans may include the benefit as a value ad or provide discounts. Check with your carrier for more information.

Answer: Medicare Part B giveback is a dollar amount the carrier designates as a benefit to reduce your Part B premium. You will receive a credit toward your Social Security check each month you are enrolled in the plan.

Answer: Yes, Medicare Advantage plans cover you worldwide using the urgent and emergency care benefit. If traveling internationally, contact your carrier for urgent and emergency locations in the area you're traveling. You may use any facility, but it's best to know in advance where they're located in proximity to your stay.

Answer: Working with a Medicare agent helps you avoid costly mistakes like late penalties or missed Medigap windows, while giving you personalized comparisons across plans that government resources like the Centers for Medicare & Medicaid Services don’t provide. They also guide you through underwriting if needed and offer ongoing support year after year—typically at no cost to you.

Answer: In New York, Medigap can be enrolled into at any time. There's no underwriting and a guaranteed issue. In New York, guaranteed issue Medigap means that insurance companies must sell you a Medicare Supplement plan at any time of year, regardless of your age or health conditions. Unlike most states, NY requires continuous open enrollment, meaning you cannot be denied coverage or charged higher premiums due to pre-existing conditions.