Michael Kim, Medicare Insurance Agent

Answer: When you are looking at Medicare Advantage (MA) plans, the 1-to-5-star rating system from the Centers for Medicare & Medicaid Services (CMS) is essentially a scorecard for how well a plan actually delivers on its promises. While it might look like a standard internet review system, it is built on hard data collected from medical records, member surveys, and administrative audits. Here is exactly how those stars translate to the care you receive.

Better Health Outcomes. Independent health studies show that enrollees in 4- and 5-star plans generally experience better medical outcomes. For example, members in higher-rated plans are less likely to be readmitted to the hospital within 90 days of an illness because their outpatient follow-up care is managed more tightly. More "Perks" and Lower Costs. The system incentivizes insurance companies to do well. Plans that achieve 4 or 5 stars receive a financial "Quality Bonus Payment" from Medicare. By law, the insurance companies cannot just pocket this extra money—they must reinvest it back into the plan. They use these bonuses to offer lower premiums, reduced copays, or richer supplemental benefits like dental, vision, hearing, and fitness allowances. Customer Service and Access. If a plan has 4 or 5 stars, it usually means their network of doctors is reasonably stable, and they are faster at approving prior authorizations. Low-star plans (1 or 2 stars) often have higher rates of member complaints regarding claims being denied or long delays in getting care approved.

Answer: The best way to find out is to talk to me. I'm a Medicare Insurance Broker, and I will help you understand why or why not a Medigap aka Medicare Supplement Plan might be right for you. The best time to get a Medicare Supplement Plan is when you first get your Medicare Card.

Answer: Yes, you'll need to enroll into another Medicare Advantage Plan in the state you moved to. Depending on which state you moved to, I would be willing to help you enroll.

Answer: That's why getting a Medicare Advantage Plan is more focused on prevention. On the Medicare Advantage Plan you can get a gym membership without any monthly premiums as long as the gym is in the network.

Answer: If she only has Medicare, than she would have to pay 20%, as Medicare only covers 80%. And Medicare only does not cover prescriptions, dental, hearing, or vision.

That's why you should get a Medicare Advantage Plan that will cover all this. Plus most Medicare Advantage plans have a $0 monthly premiums. Call me today and I will help you, I don't charge for my services as I get paid by the carriers.

Answer: No. If you travel alot Medigap aka Medicare Supplement Plans are designed for Travel. But if you want to save money, I can offer you a Medicare PPO plan without any monthly premiums. Call me and I will help.

Answer: Medicare Insurance Brokers like myself don't charge for our services. So feel free to contact me, and I will help you.

Answer: It's based on your level of income, maybe you made more money than your friends.

* IRMAA stands for Income-Related Monthly Adjustment Amount, affecting Medicare Part B and D premiums.

* It is designed to ensure higher-income beneficiaries pay more for their coverage.

* The calculation is based on your modified adjusted gross income (MAGI) from two years prior.

* The Social Security Administration (SSA) uses tax returns to determine your MAGI.

* There are specific income thresholds that trigger different IRMAA levels.

You can appeal the IRMAA determination if you experience a significant life change affecting your income.

Answer: 1. The "Insolvency" Timeline

The HI Trust Fund, which pays for inpatient hospital stays, hospice, and skilled nursing, is facing a growing gap between income and expenditures.

Depletion Year: 2033 (3 years earlier than the 2024 projection).

Post-Depletion Scenario: If the fund is depleted, Medicare will only be able to pay approximately 89% of scheduled benefits using incoming payroll taxes.

The Cause of the Shift: The 2025 report cited higher-than-expected spending in 2024 and an upward revision of future costs for hospital and hospice services as the main reasons for the shortened timeline.

Answer: You should apply for state Medicaid for those who are below poverty level. This along with your Medicare and Medicaid, I would be able to enroll you into a Duel Complete Plan, just for people like yourself. All your copays on Medications and Medical services would be covered by the state.

Answer: The Medicare Advantage Plan does cover cancer screenings, and you can get one every year at no cost to you. It's called a preventive screening.

Answer: The 3-Midnight Rule (Skilled Nursing Facility Coverage)

This is a long-standing requirement for Original Medicare. It states that for Medicare to cover a stay in a Skilled Nursing Facility (SNF), you must first have a medically necessary inpatient hospital stay of at least three consecutive days (three midnights).

Answer: If you have been disabled for more than 24 months you will be able to sign up for Medicare.

After you get Medicare Part A and Part B, call me and I will help you enroll into a Medicare Advantage Plan.

Answer: I would have Medicare Advantage Plans available in rural areas. I don't think this will happen unless carriers starts to sell in these areas, but not enough people to be profitable for the carriers.

So that's why in these places, only Medicare Supplement Plans are available.

Answer: Technology will always help people to learn more about their options with Medicare but Medicare Brokers will always be needed to give the human touch with questions most Medicare received seniors have.

The technology will aid Medicare Insurance Brokers to do our jobs more efficiently and effectively.

Answer: Contact a lawyer and ask the lawyer to make you "Power Of Attorney", then you would be able to make all the healthcare decisions for your elderly parent.

Answer: I don't know what plan your on. Are you on a Medicare Supplement Plan or a Medicare Advantage Plan?

Because Medicare Advantage Plans don't have any monthly premiums, but if your on a Medicare Supplement Plan, you will have a monthly premium and the cost will continued to increase every year. So call me and I can find out and help.

Answer: Just make sure you are truthful and make sure you fill out every question to the best of your abilities.

You can apply for Medicare by just calling the social security office.

Answer: It is covered by a Medicare Advantage Plans? In most states the Medicare Advantage plans are $0 Monthly Premiums and cover both Medical and Prescriptions along with ancillary benefits like Dental, Hearing, and Vision.

Answer: It depends on the treatment. What kind of questions is this, you will have to be way more specific when it comes to treatment.

Answer: Getting Medicare will not affect your income. Only Medicare Part B, will come out of your social security benefits.

Answer: I do believe Medicare Advantage Plans do. By calling me and going over the Medicare Advantage Plans I would be able to check in the state and city where you live.

Answer: Helping seniors and those with Medicare get complete coverage. This brings me joy that they will have affordable health coverage.

Answer: A broker like myself is appointed with most major carriers and a Medicare Agent is only with one. He or she can only offer that carrier no other.

Answer: No. Most Medicare Advantage Plan carriers will have have alternative plans if this ever happens. And if the carrier is no longer available in the area I would just offer you another carrier as I am a Medicare Insurance Broker appointed with most major carriers in your area. I'm licensed in 24 different states.

Answer: If that is something your Primary Care Physician is asking you do, then it was most likely be covered. But everything is based on your Primary Care doctor.

Answer: Medicare Supplemental Plan G. Has the most coverage and it is the most popular, please call me and I will be more than happy to explain it with you.

Answer: When you first receive Medicare. Or Oct. 15 - Dec. 7th which is Annual Election Period when you can change your Medicare Advantage Plans if your not happy with it.

Answer: Medicare alone will not cover that. Your dad would have to get a Medicare Advantage Plan, most offer chiropractic services which I can help your dad enroll with.

Answer: Talk with a Medicare Broker like myself. This is reduce your stress and I would be able to answer the questions you have and also help with enrolling your mother into the best plan for her.

Answer: In short, it won't. With advance tech, and A.I. a lower workforce would do more and be more efficient. The workforce in the future will smarter and have alot of tools to help upcoming Medicare enrollees.

Answer: Oct. 15th - Dec. 7Th. Only if you don't like your current plan. If you do like it, you don't have to do anything as it will automatically renew itself.

Answer: Might be more benefits for insurers. It would only be a good thing, and carrier could increase existing benefits to higher amounts.

Answer: Medicare Advantage Plans have diabetic shoes, diabetes meters, diabetic supplies, healthy habits and much more.

Answer: You can get a Medicare Advantage Plan. These plans do not have any monthly premiums, and covers both medical and prescriptions. Also include ancillary benefits like vision, hearing, dental, free gym membership and much more.

Answer: You can't get both. You will get which ever is more, so if your late husband's SS benefits are more then you will get his.

Answer: You can ask your Primary Care Physician for generic medications, if your medications even has generic. For those who can't take generics maybe because it doesn't work for them you can also try calling the manufactures to make a deal with them to get your medications at a lower price directly from the manufacturers.

Most of the time it's as simple as just going to the "primary" pharmacy instead of the standard. Find out with your carrier who the primary pharmacy is as each carrier has a different primary pharmacy you should use to get the lowest prices.

Answer: Virtual visits

Talk to a health care provider from your computer, tablet or smartphone

What is a virtual visit? It may be a term you’re hearing more often. That’s because the use of virtual visits, also known as telehealth, has expanded recently, offering people more ways to connect with a health care provider from home or work. During a virtual visit, you use digital technologies, like your smartphone, tablet or computer, to talk with a provider. You can get treatment options and even prescriptions for medications, if needed.

UnitedHealthcare offers members options for virtual visits with local providers or by using UnitedHealthcare’s preferred national providers

Answer: This will be covered by a Medicare Advantage Plan. Most Medicare Advantage Plans have a $0 monthly premium that covers your concerns and many more benefits.

Contact me and I will go over some plans in your area, if I am licensed in your state.

Answer: Most Medicare Advantage Plans have $0 monthly premiums. But Medicare Supplement Plans have monthly premiums, it all depends on your needs.

So you'll have to speak to a Medicare Broker like myself so we can determine which plan works for you.

Answer: It gives you the tools to be able to finally quit smoking. Plus you'll have care givers who will work with you to reach your goals to stop smoking so you won't have to do it alone.

Answer: If they sound like they are from India, it's a scam! If they only offer you one carrier, I would not go with that agent.

Answer: It's up to you. If your benefits keep decreasing and it doesn't make sense anymore, then it might be time to change. On the other hand if your plan works for you then, you don't have to change keep it as long as you can.

Answer: I think because they are confused and lazy, have no idea what to do. So they do nothing instead of finding out what to do, what plan they think would be a coverage for them.

Answer: That would depend on Medicare, but so far I don't think so. But anything could happen but I don't think tiered premium would ever be a thing.

Answer: That's not true. Life insurance is something you will have to think about and talk to your agent about.

Answer: If that surgery is requested by your doctor then, yes. Everything has to go through your PCP, and has to be approved by your Medical Group.

Answer: If you chose a Medicare Advantage Plan. Just having Medicare alone would not be enough to cover your medications, so having a plan like a Medicare Advantage Plan would give peace of mind.

Answer: With a Medicare Advantage Plan if you have a chronic condition like diabetes the cost are minimal. Their are Chronic Plans that are specifically designed for your chronic condition so like I said the cost would be minimal to you.

Answer: Maybe to see if your parents are aware of all the benefits out there for people who have Medicare? Maybe they might not be on the best plan for there needs? If not, I could go over the best options for them, and suggest better options.

Answer: They offer plans like Chronic condition working with people that have disabilities who have Medicaid and Medicare. These plans were specifically designed for disabled bodied people in mind.

Answer: No. You would have to enroll into a Medicare Advantage Plans that have Dental, Vision, and hearing benefits.

Answer: Only is states that don't have the Birthday rules. Where you can just change your supplemental plans in the month of your birthday.

Answer: Part B covers doctor visits, tests, outpatient services, preventive care, and medical equipment and supplies.

Answer: Yes. Just like being on land or any where else. But it might be better to have a Medicare Supplement Plan or a Medicare Advantage Plan.

Answer: That there are networks of doctors you will have to deal with. Meaning you have a network of doctors and specialist to choose from. So sometimes clients want a particular doctor or specialist and they might not be in the network.

In that case they can also choose a PPO plan but they will pay a higher cost for the copays for the doctors not being in the network.

So the other options is to go with a Supplement Plans, but not all qualify.

Answer: They think it's a senior living center. No it's a long term care meaning after you had surgery you are going into a long term care to get healed and get better. You will come out eventually, you will not live there indefinitely.

Answer: That depends on the person. Most cataract surgery is simple and the cost is covered by most Medicare Advantage Plans.

Answer: Yes. Because Medicare Advantage Plans do not have monthly premiums, they cover medical, prescriptions, dental, hearing, vision, and other benefits.

Answer: Yes. You would need to call Social Security to schedule a call to sign up for your SS benefits along with your Medicare Part A and Part B.

Answer: No. You would have to pay out of pocket, but the good thing is you have enroll into a Medicare Advantage Plan that does cover hearing aids and most Medicare Advantage Plans have a $0 Monthly Premium.

Answer: Call Social Security office and let them know. Or just walk in with proof like you income tax papers, or anything else showing a drop in your income.

Answer: That depends on if your going to continue to work, and if you have insurance through your company then no you will not be penalized. But if you do turn 65 and you have no insurance coverage then yes you will be penalized, but you have 6 months three months prior, 3 months after your birthday.

Answer: It is worth it for those who have many health issues who need to be able to see specialist without having to in a network, or paying copays.

Or for the person who travels alot and wants the flexibility to be able to see doctors in all 50 states without being in a network.

So it all depends on the person and their personal needs and wants.

Answer: Because now, if you have Tier 3 drugs that your taking you won't have anymore coverage gaps. So if you have 2 or more Tier 3 drugs, you won't have to meet the coverage gap when the retail price of your drugs reach 5,080, then you would have t o pay 25% for the cost of your Tier 3 drugs until the retail price of your drugs reached 8,000 and some change to reach the catastrophic coverage, at that point you would pay $0 cost for the rest of the year for your Tier 3 drugs. But not as of 2025 the threshold is only 2,000 and the coverage gap has been eliminated for 2025. Which saves people who have 2 or more Tier 3 drugs alot of money.

Answer: Medicare Advantage Plans don't cover your hospital stays or surgeries. These are just fails and misleading.

Answer: You might want to have a Medicare Supplement Plan along with a Stand Alone Part D plan so you don't have any limitations. Meaning you can go anywhere see any doctors as long as they accept Medicare. You will have to pay a monthly premium for your Medicare Supplement Plan along with your Stand Alone Part D Drug Plan. Which I can go over that with you based on your age, gender, county, and state.

Answer: Just yesterday a client of mine thought just because he enrolled into Medicare Part A and Part B that he had everything and he no longer had a penalty charge. I explained to him that he had to enroll into a plan like a Medicare Advantage Plan that covered a prescription drugs to not get a penalty charge. So he really did thank me for that and now he is one of my clients under my Book of My Business.

Answer: They listen to their family members or neighbors instead of talking to an insurance broker. Insurance brokers like me don't charge for my services and I am contracted with most mayor carriers so why not talk to a Medicare Insurance Broker like myself?