Maci Mishler, Medicare Insurance Broker

Answer: The biggest reward I have is helping guide my clients through this very complicated system! People come to me because they don't understand all of the minute details that can have a huge impact on their quality of coverage and therefore their quality of care.

Answer: Medicare Advantage can have huge disadvantages when it comes to networks. I don't care how attractive the extra benefits may be, because at the the of the day this is health insurance and that is our main focus--making sure you're covered when you need it!

Answer: Some people come to regret a Medicare Advantage plan because they don't realize what some of their care will cost. For example, some things people use every month, like oxygen, can be very expensive and that client would have been better not going with Medicare Advantage.

Answer: My job revolves around what is best for my client. I think the most frustrating part is people not knowing that competent, caring people exist to help them through this process. They don't have to do this alone and if they work with a good broker they don't need to worry!

Answer: The good news is the max out-of-pocket costs was lowered in 2025, but there are still very expensive medications out there. If this is a compound med there is not a ton we can do, but if it's just an expensive name-brand look into manufacturers programs or grants.

Answer: You should understand the difference in network accessibility as well as the difference between prior authorizations and who is making the decisions about whether the insurance will pay or not. Seek out a good broker!!

Answer: People don't understand how individualized Medicare is. My recommendation for coverage is rarely the same, sometimes even for spouses! People don't realize that what works for their neighbor may not work for them AT ALL!

Answer: If they cannot answer questions you have and it seems like they're fumbling and possibly giving you incorrect information that should be a red flag. If I have someone ask me a question I don't know I'll simply tell them I need to look into it and get back to them with the answer. I never lie to clients!

Answer: Medicare Supplements have a premium and some people can't afford them. Those premiums will also go up over time so they need to understand they're paying for their coverage. A lot of people who are new to Medicare may not use their coverage enough to see the benefit to the larger premium, but they need to understand that statistically, they will eventually use that coverage and the premium will be worth it!

Answer: You will need to file for it to be reduced, otherwise it will take 2 years to catch up. IRMAA looks back on your taxes from 2 years prior. So, 2025 will look at 2023 taxes.

Answer: If you are looking at an expensive disease, you will want to look more closely at Medicare Supplement options if you're new to Medicare. But, if you already have an advantage plan you will probably not be able to move to a Medicare Supplement. I recommend finding a good broker in your area to help you navigate.