Mary Manos-Mitchem, Medicare Insurance Broker

Answer: A Medicare agent can work for just one insurance company, while a Medicare broker works with multiple companies, so they can actually compare plans and recommend what fits you instead of what they’re required to sell.

Answer: If you’re turning 65 next month and you don’t have your Medicare card yet, the first step is to enroll in Medicare Part A and Part B through Social Security — you can do it online at SSA.gov/medicare. Once your card arrives (usually in about 2–3 weeks), we’ll go over your doctors and prescriptions to choose the plan that actually fits your needs. The key is to get enrolled now so you avoid delays or gaps in coverage.

Answer: The most important Medicare question isn’t “How much is the premium?” It’s “What does this plan cost me if my health changes?” Because your plan should protect you on your worst day, not just your best.

Answer: I help people make sense of Medicare—without the pressure or confusion.

Plain language. Real guidance. Support that doesn’t stop after enrollment.

Honestly, I love being the person who cuts through the confusion. Medicare is intentionally complicated. I make it simple and make sure people aren’t overpaying. Once you help a few people feel genuinely taken care of, it’s hard to do anything else.

Answer: If you switch from one Medigap (Supplemental) plan to another, you’ll usually have to answer health questions and may be denied or charged more based on your health. However, if you’re in your Medigap Open Enrollment Period or have certain guaranteed issue rights — such as losing other coverage or trying an Advantage plan for the first time — you can change plans without answering health questions.

Answer: If you have Original Medicare, you’ll pay for hearing aids yourself.

If you have a Medicare Advantage plan, check your plan’s benefits — you may have partial or full coverage.

Answer: You can change your Medicare Advantage plan from October 15 to December 7 each year — your new plan starts January 1. If you already have a Medicare Advantage plan, you can also change it once between January 1 and March 31. Outside these times, you can only switch plans if you qualify for a Special Enrollment Period, such as when you move, lose other insurance, or become eligible for Medicaid or Extra Help.

Answer: Discount cards (like GoodRx) can sometimes make your medicine cheaper, but they don’t work with your Medicare Drug Plan.

• If you use a discount card, that purchase won’t count toward your Medicare plan costs.

• You can’t use both your Medicare plan and a discount card for the same drug at the same time.

• Some people use discount cards for drugs their plan doesn’t cover, and that’s okay — it just doesn’t count toward your plan spending.

Simple rule:

Use whichever gives you the lower price — just remember that discount card purchases don’t count toward your Medicare costs.

Answer: Medicare says things are okay for now during the government shutdown. But if it lasts too long and Congress doesn’t fix things:

*Video doctor visits (telehealth) might stop being paid for.

*Doctors might not get their money on time.

*Patients might have to pay more or skip care.

*Health programs that help people could run out of money.

So, for now it’s fine — but if the shutdown keeps going, it could start to cause real problems for doctors and patients.

Answer: If Medicare or your plan says “no” to covering something you need — like a procedure or medication — don’t worry. You actually have the right to appeal and ask them to take another look.

Here’s how it works:

Start by reading the denial letter

You’ll get a notice — it might be called a “Notice of Denial of Medicare Coverage” or an “Explanation of Benefits.”

That letter will tell you why they said no, how to appeal, and when you need to do it by. Make sure you keep it handy — it’s your roadmap.

You usually have up to 120 days from the date on that letter to file your appeal. Some drug plans have shorter timelines, so the sooner you start, the better.

There are five levels of appeals, but most people only need the first one or two

• First level: Redetermination

You ask the company that handled your claim to take another look. Just fill out the form that came with your denial letter, or write a short note explaining why you think it should be covered.

• Second level: Reconsideration

If they still say no, you can ask an independent reviewer — not connected to your plan — to review your case.

If you keep appealing, there are higher levels (like hearings with a judge and reviews by the Medicare Appeals Council), but most issues get resolved earlier.

Include a note or letter from your doctor explaining why the service or medication is medically necessary for you. That really helps. And always keep copies of everything you send or receive — it’ll make things much easier later.

You don’t have to do this alone! You can contact your local State Health Insurance Assistance Program (SHIP) — they have trained counselors who can walk you through the process for free.

You can find your local SHIP at the shiphelp website.

Answer: Medicare can be overwhelming, with various components like Part A, B, C, D, Medigap, deductibles, copays, networks, and formularies. An agent simplifies this complex system by providing clear explanations.

They compare Medicare Advantage and Part D prescription drug plans, ensuring you get the best value for your money. They compare costs, networks, and drug coverage to avoid overpaying.

The best part? You don’t pay the agent directly. They’re compensated by the insurance companies if you enroll through them. Your premium remains the same regardless of whether you sign up yourself or through an agent.

Additionally, agents help you find compatible doctors and medications. They check if your doctors are in-network and if your medications are on the formulary, which can save you significant headaches.

Ongoing support is another benefit. If you encounter billing issues, claim denials, or want to switch plans during Annual Enrollment (October 15 to December 7), your agent can assist you. This means you don’t have to deal with Medicare or the insurance company alone.

Answer: You don’t have to pay both the Part A deductible and the Advantage plan copay.

Since you’re enrolled in a Medicare Advantage plan, you’re bound by the plan’s rules.

This means you’d owe $350 per day for the first 7 days of your hospitalization (with a maximum of $2,450 if you stayed 7 days).

If you’re discharged sooner (for instance, after 3 days), you’d only pay $1,050 in total (3 × $350).