Melissa Hatten, Medicare Insurance Broker

Answer: Your current insurance is at least as good as Medicare coverage—specifically for prescription drugs (Part D).

That’s it.

Now why does that matter?

Because Medicare is watching the clock.

If you go 63 days or more without creditable drug coverage after you’re eligible for Medicare…

you can get hit with a late enrollment penalty when you finally sign up for a Part D plan.

And that penalty?

It doesn’t go away. It sticks with you.

Answer: The Medicare Give Back Benefit (sometimes called the Part B premium reduction) is when certain Medicare Advantage plans pay part of your Part B premium for you.

Here’s how it works in real life:

You’re still enrolled in Medicare and you’re still responsible for your Part B premium…

but the plan steps in and says, “Hey—we’ll cover a portion of that for you.”

So instead of paying the full standard Part B premium each month, you might see:

A lower deduction from your Social Security check, or

A credit back depending on how you pay

Now let me be clear on something…

It’s not available on every plan.

Only certain Medicare Advantage plans offer this benefit, and the amount can vary.

Some plans might give back:

$30 a month

$75 a month

Sometimes even more

But it’s not always the highest giveback that’s the best plan.

And this is where people mess up…

They chase that “money back” number and ignore:

Doctor networks

Drug coverage

Copays and out-of-pocket costs

So yeah… you might save $80 a month on your premium…

but pay way more when you actually use the plan.

And we’re not doing that.

Melissa version, straight up:

Yes, the Give Back Benefit can put money back in your pocket.

But the goal isn’t just a lower premium…

it’s making sure the plan still works when you actually need care.

Bottom line:

It’s a nice perk—not the whole decision.

Answer: Your window is:

1 month before you move

And up to 2 months after you move

So total… you’ve got about a 3-month window to make a change.

Don’t wait until after you move and everything is chaos.

If you know you’re moving, start looking before—that way your new plan is ready to roll when you get there.

Because here’s what can happen if you don’t:

You could end up out of network, paying more than you should, or scrambling to fix it after the fact.

And I don’t like scrambling for my people.

One more thing…

Make sure you actually update your address with Social Security. That’s what triggers everything and makes your move “official” in the system.

Bottom line:

You’ve got a short window—but if you plan it right, it’s a smooth transition instead of a stressful one.

And this is one of those moments where having someone guide you through it?

Makes all the difference.

Answer: You don’t lose your Medicare because you found love.

That’s not how this works.

You just want to make sure everything still lines up financially and coverage-wise for your new situation.

Bottom line…

Marriage doesn’t take your Medicare away.

But it is a good time to double check your benefits and make sure everything still makes sense for BOTH of you.

Answer: If you have Original Medicare (Part A & B)

→ No, it does NOT cover SilverSneakers or other similar programs.

Medicare does not pay for gym memberships or fitness programs at all.

Now… here’s where it changes.

If you have a Medicare Advantage plan (Part C)

→ A LOT of them DO include SilverSneakers or similar.

And when it’s included, it’s usually at no extra cost to you.

Answer: Let me clear this up, because there’s a lot of misinformation out there.

No—Medicare brokers do NOT charge seniors a fee for their help.

If you sit down with me, call me, text me, ask a hundred questions… you’re not getting a bill. Period.

So how does that work?

We’re paid by the insurance companies, not by you. When you enroll in a plan, the carrier pays the agent a commission that’s already built into the plan. It does not increase your premium, and it’s the same whether you use an agent or go direct.

Now here’s the part people don’t always think about…

If you go online and enroll yourself… or call a 1-800 number…

you’re still paying for that commission—you’re just not getting the guidance that comes with it.

You can do this alone…

or you can have someone walk it with you, answer your questions, fix problems, and make sure you’re actually in the right plan…for the exact same cost.

And I don’t disappear after you enroll.

When something looks off, when a bill doesn’t make sense, when you get one of those “Medicare letters” that makes your head spin… that’s when you call me.

At the end of the day, you’re not paying for a broker…

but you absolutely benefit from having one on your side.

Answer: Here’s the honest answer:

There is no one set tier across all plans… but most of the time, Repatha sits on a higher or specialty tier.

And here’s why that matters.

Repatha is not a cheap, everyday medication. It’s a specialty drug used for serious cholesterol and heart risk issues. Because of that, Part D plans usually place it on:

Tier 3 (non-preferred brand) in some plans

Tier 4 or 5 (specialty tier) in many others

Just because it’s “covered”… does NOT mean it’s cheap.

Most plans do cover it—about 95% of them—but they almost always come with rules attached like:

Prior authorization (your doctor has to justify it)

Step therapy (you may have to try other meds first)

And here’s the part people don’t realize…

One plan might have Repatha sitting on a Tier 3 with a manageable copay…

Another plan might put it on a specialty tier where you’re paying a percentage—and that can feel expensive.

Even though many people end up around $50/month, that’s plan-specific, not guaranteed.

Answer: It’s not that help isn’t out there…

It’s that you have to know which lane to stay in with Medicare.

This is exactly why I look at:

– Your drug list

– Your pharmacy

– Your plan

– AND your income eligibility for programs

Because the goal isn’t just getting the medication…

It’s getting it at a price that doesn’t stress you out every month.

And that right there? That’s where having someone guide you makes all the difference.

Let’s talk real, because this is where people get tripped up.

Yes… there are savings options for Breztri—but Medicare plays by a different set of rules.

Here’s how it actually works:

First, the part people don’t like to hear…

Most manufacturer coupons do NOT work with Medicare.

Those “$0 copay cards” you see advertised? They’re usually for people with commercial insurance, not Medicare.

Now—don’t panic—because you still have options.

Second, Medicare itself may already be your biggest savings tool

A lot of Part D plans cover Breztri, and many people pay around $50 or less a month depending on their plan.

But—and this is important—it varies by plan. One plan might cover it great… another might not.

Third, there ARE assistance programs specifically for Medicare patients

AZ&Me Prescription Savings Program is one of them.

Answer: Let me keep this real and simple, because this one confuses a lot of people.

Some hospitals don’t take certain Medicare Advantage plans for cancer treatment because those plans work with networks. And cancer care is expensive and very specialized.

Here’s what’s really going on:

First, Medicare Advantage plans have contracts with specific hospitals and doctors. If a hospital or cancer center isn’t in that network, they can choose not to accept that plan. It’s not personal—it’s business.

Second, a lot of top cancer centers want more flexibility than Advantage plans allow. These plans often require referrals, prior authorizations, and have set payment rates. Some hospitals don’t want delays when it comes to serious treatments like chemo, radiation, or surgery—they want to move fast.

Third, reimbursement can be an issue. If a hospital feels like the plan isn’t paying enough for the level of care they provide, they may decide not to participate at all.

Now let me say this part clearly—this does NOT mean Medicare Advantage is bad. It just means you have to check your doctors and facilities before you enroll.

This is exactly why I sit down with my clients and ask:

“If something serious happens, where do you want to go for treatment?”

Because the truth is…

It’s not just about your monthly premium.

It’s about access when you actually need it.

That’s the difference between picking a plan… and picking the right plan.

Answer: Working with a Medicare agent just makes life easier. Period.

You don’t have to figure all this out by yourself

Medicare is A LOT. Plans, rules, letters, deadlines… it’s enough to make your head spin. I break it down so it actually makes sense.

...They do the shopping for you!

You tell me your doctors, your meds, your budget… and I go to work. I compare the plans so you’re not sitting there guessing and hoping you picked right.

....It doesn’t cost you a dime

Yep… FREE help. You’re already paying for your coverage—might as well have someone making sure you’re in the right plan.

....You get a real person… not a random 1-800 number

No call centers. No repeating your story five times. You call, text, or message me—and I’ve got you.

.....I’m not going anywhere after you enroll

This is the part people don’t think about. Things come up. Bills look weird. Mail gets confusing. That’s when you need someone—and I’m right here.

....Peace of mind just hits different

Knowing someone actually cares, knows your situation, and is looking out for you… that matters.

At the end of the day, this is your health, your money, your peace.

Why do it alone when you don’t have to?

Answer: Great question! Enrolling in a Part D prescription drug plan is easier than you might think—and you’ve got a few solid options to choose from 😊

1. Work with a trusted local agent (my personal favorite 😉)

A local agent can walk you through your options, compare plans, and make sure your medications are covered—without the stress. Plus, you’ll have someone you can call all year long, not just during enrollment.

2. Visit Medicare.gov

If you like doing things on your own, the Medicare website has tools to compare plans, check drug coverage, and enroll directly online at your convenience.

3. Call the insurance carrier’s 1-800 number

You can enroll by calling a plan directly. A representative will guide you through their specific options and help get you signed up over the phone.

No matter which route you choose, the goal is the same: finding a plan that fits your medications, your budget, and your peace of mind. 💙