Michael McGarrigle, Medicare Insurance Broker

Answer: Here is a link to Medicare Part B Premiums and the Income-Related Monthly Adjustment Amount. https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles

The base rate for Part B in 2026 is 202.90 per month.

The Centers for Medicare & Medicaid Services (CMS) calculates the premium each year using projections prepared by Medicare actuaries. By law:

Beneficiary premiums are intended to cover about 25% of the projected cost of the Part B program.

The federal government pays the remaining 75% through general tax revenues.

CMS estimates:

Physician and outpatient costs

Preventive services

Lab work

Durable medical equipment

Inflation in healthcare

Expected enrollment

New benefits authorized by Congress

Reserve requirements for the Part B Trust Fund

After those projections are complete, the standard monthly premium is announced, usually in the fall.

Why Some People Pay More (IRMAA)

Higher-income beneficiaries pay an additional surcharge called the Income-Related Monthly Adjustment Amount (IRMAA).

IRMAA is determined by:

Your Modified Adjusted Gross Income (MAGI) from two years earlier

For example, 2027 premiums will generally be based on your 2025 tax return.

The IRS provides this income information to the Social Security Administration.

SSA determines whether an IRMAA applies.

IRMAA applies to:

Part B

Part D

The additional money helps offset a larger share of Medicare costs for higher-income beneficiaries.

Based on the Medicare Trustees' current projections, the standard Part B premium for 2027 is expected to increase from $202.90 to about $209.50 per month. The official amount won't be announced by Medicare until late October or early November, so this is our best planning estimate—not the final number.

Answer: I recommend meeting with a trusted Medicare advisor after October 1 to review the Medicare plan changes for 2027. That's when the new Medicare Advantage and Part D plans, premiums, formularies, provider networks, and benefits become available, giving you time to compare your current coverage with your options for the coming year before Annual Enrollment begins on October 15.

Keep in mind that some important Medicare information isn't released until later in the Annual Enrollment Period. For example, the standard Medicare Part B premium and deductible, as well as the Income-Related Monthly Adjustment Amount (IRMAA) brackets and surcharges for higher-income beneficiaries, are typically announced later in the fall. Those changes can affect your total Medicare costs, so it's worth reviewing your coverage again once those figures are released.

Unfortunately, every Annual Enrollment Period I hear from people who were misled by agents using prohibited Medicare sales practices, such as making unsolicited phone calls or showing up at someone's home without a prior invitation. Be cautious of anyone who pressures you into making a change before reviewing your doctors, prescriptions, and healthcare needs.

Take the time to work with someone you know and trust—someone who will educate you about your options and help you choose the coverage that best fits your needs, not just try to make a sale.

Answer: Your situation is a bit complicated, and I would strongly recommend sitting down with a trusted Medicare advisor who can review all of the details of your specific circumstances.

One of the first questions I would ask is whether your employer has 20 or more employees. The answer to that question is very important because it affects your Medicare options and whether you were required to enroll in Part B.

The difficult part is that if you are already enrolled in premium-free Medicare Part A, you may not be able to disenroll from Part A, and that generally means you can no longer make tax-deductible contributions to an HSA. Depending on your situation, there may still be options worth exploring with Social Security, but I wouldn't make any changes until you've had someone review your entire situation.

This is one of those situations where a little planning before enrolling in Medicare can make a big difference. An experienced Medicare advisor can help you understand your options and avoid unintended consequences.

Answer: One situation that really stands out involved a client who was unexpectedly laid off the day before the first of the month. Because of the timing, they lost their employer health coverage immediately but hadn't had the opportunity to enroll in Medicare Part B beforehand. They were understandably very anxious and weren't sure what to do next.

I reassured them that we would work through the process together. We gathered all of the necessary paperwork for both the client and their spouse, made sure everything was completed correctly, and submitted it as quickly as possible. I also helped them evaluate their Medicare options and enroll in a Medicare Supplement plan along with a Part D prescription drug plan that fit their healthcare needs and budget.

In the end, everything came together successfully, and they avoided what could have been a very stressful gap in coverage. Moments like this remind me that my job is about much more than selling Medicare Supplements and other Medicare Plans. It's about helping people through confusing and stressful situations, educating them about their options, and giving them confidence that they're making the right decisions.

Answer: Medicare will pay for counseling to help you quit smoking—up to eight sessions per year through Part B. If medication is needed, many Part D plans also cover prescription quit-smoking drugs.

Answer: Concierge medicine is separate from Medicare. You pay a membership fee for better access—longer visits, same-day appointments, direct communication—and Medicare does not cover that fee.

Here’s how concierge works with Medicare:

Original Medicare (especially with a supplement):

This is where concierge usually works best. If the doctor accepts Medicare, they bill Medicare for covered services, and your supplement applies as normal.

Most of my clients who use concierge care are on Original Medicare with a High Deductible Plan G—it keeps premiums lower while still giving strong protection for bigger expenses.

Medicare Advantage plans:

This can be more difficult. These plans use networks, and many concierge doctors are out-of-network or don’t participate. That means you could be paying the membership fee and out-of-pocket for care.

If the doctor opts out of Medicare:

Medicare won’t pay at all—you’re fully private pay.

Bottom line:

Concierge care can complement Medicare, but it usually works much better with Original Medicare (often paired with a High Deductible Plan G) than with Medicare Advantage.

Call our office if you still have questions or concerns about Medicare.

Answer: Yes—Medicare does cover many cancer screenings under Part B, and most are $0 cost as long as the provider accepts Medicare.

This includes things like mammograms, colonoscopies, Pap smears, PSA tests, and even lung cancer screenings (if you meet the guidelines).

One thing to watch for: if a screening turns into a diagnostic procedure (like removing a polyp), there may be some out-of-pocket costs.

That’s where having the right plan setup really matters.

If anyone wants help reviewing their coverage or making sure they’re fully protected, feel free to reach out.

Answer: Hi, my name is Mike McGarrigle. I'm a Medicare agent here based in Florida. And this is Lindsay. She is who you will talk to. She's the face of this agency and she's a licensed agent as well. And if you call in, make sure you say hi to Lindsay.

I just want to answer this question for you. It's if you are enrolled in a chronic special needs program and you're unable to verify your doctor doesn't verify within 60 days. Is there a special election period to be able to enroll in another Medicare Advantage plan?

And the answer to that is yes, there is a special enrollment period. The beneficiary can enroll in another Medicare Advantage plan with or without Medicare Part D, or they can return to original Medicare with or without Medicare Part D. That special election period generally lasts at least two months after the disenrollment. So you must act quickly to be able to fill any gaps in coverage.

Thanks, and I look forward to the next question.

Answer: It’s important because Medicare isn’t a one-time decision—it’s something you’ll be dealing with year after year.

An agent might do a great job getting you enrolled, but what really matters is how they show up over time. Reviews from long-term clients tell you that the agent is still there when rates go up, when plans change, or when something doesn’t make sense.

Anyone can help you sign up. Not everyone is there a few years later when you actually need help.

That’s why I always say—look for reviews from people who have worked with the agent over time. It tells you you’re not just getting help today, you’re getting someone in your corner long term.

Answer: No—you don’t pay anything extra to work with a local Medicare agent.

The insurance companies pay agents, whether you go through an agent or enroll directly yourself. So you’re getting guidance, help comparing plans, and ongoing support at no additional cost.

That’s why I always tell people—take advantage of it. It’s a lot easier to have someone walk you through your options and be there if questions come up later.

Answer: Not necessarily—you made the best decision you could with the information you had at the time.

Medigap is still one of the best options for people who travel a lot. It gives you the freedom to see doctors pretty much anywhere without worrying about networks, and that’s a big deal.

What’s changed for a lot of people is the cost. Premiums have gone up, and after a few years it can start to feel like a lot.

So the real question isn’t “did I make a mistake,” it’s “does this still fit my situation today?”

If you’re still traveling and value that flexibility, it may still be the right plan. If things have slowed down or your priorities have changed, it might be worth taking a look at other options.

That’s something we do all the time—just a simple review to see if what you have still makes sense or if there’s a better way to go.

Answer: You can apply to change your Medicare Supplement plan at any time during the year—but that doesn’t always mean you’ll be approved.

In most cases, switching plans requires answering health questions (underwriting). If you’re in good health, it can be a great way to lower your premium or improve your coverage. But if you have certain conditions, you could be declined.

There are some situations where you can switch without underwriting—like when you first turn 65, lose other coverage, or qualify for certain guaranteed issue rights—but those are specific windows.

This is one of those areas where timing really matters, so it’s worth reviewing your options before making a move to see what’s actually available to you.

Answer: Most people think Medicare is only for those 65 and older, but there are a few situations where someone can qualify earlier.

The most common is if someone has been receiving Social Security Disability Insurance (SSDI) for 24 months—they’re automatically enrolled in Medicare after that waiting period.

There are also a couple of medical conditions that qualify someone sooner. People diagnosed with End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease) can qualify for Medicare without waiting the full 24 months.

Each situation is a little different, especially when it comes to timing and how coverage starts, so it’s something we usually walk through on a case-by-case basis to make sure everything lines up correctly.

Answer: Seniors aren’t usually losing Medicare Advantage plans by choice—it’s more that the plans themselves are changing.

Each year, insurance companies review their plans based on costs and usage. When healthcare gets more expensive or a plan isn’t working financially, they may reduce benefits, change networks, or in some cases stop offering that plan in certain areas.

So from the client’s perspective, it can feel like the plan just went away.

We’re also seeing more changes year to year than we used to, which is why it’s so important to review your coverage regularly.

The good news is, there are almost always other options available. It just takes a quick review to make sure you’re still in a plan that fits your doctors, medications, and budget.

That’s something we help clients with every day—so they’re not caught off guard when these changes happen.

Answer: One of the biggest questions people don’t think to ask is: “How will this plan work for me if my health changes?”

A lot of decisions get made based on what things look like today—but Medicare is something you live with long term. Doctor access, specialist flexibility, out-of-pocket exposure, and your ability to make changes later all matter more over time than just the monthly premium.

That’s something we walk through with our clients every day. We’re not just looking at what works right now—we want to make sure your plan still works if your situation changes.

If you’re not sure, that’s exactly what we’re here for. We’ll go through it with you and help you think through the “what ifs” so you can feel confident in your decision.

Answer: At a minimum, I recommend reviewing your plan once a year—usually during the Annual Enrollment Period.

That said, if you’re actively in therapy or your treatment changes, it’s worth taking another look sooner. Networks, coverage rules, and authorizations can change, and you want to make sure your providers and services are still covered the way you expect.

Also, if you have a qualifying chronic condition, there may be Chronic Special Needs Plans available, and those can often be joined outside of the normal enrollment periods.

It only takes a quick review to catch issues early and avoid surprises.

Answer: I wouldn’t call it a “trap,” but there are a few things people don’t always realize going in.

The biggest one is that Medicare Advantage plans are network-based. You may need to stay within a specific group of doctors and hospitals, and referrals can be required. That’s not always an issue—until you need care outside the network or want more flexibility.

Another thing is the cost structure. These plans often have low or even $0 premiums, but you’re paying as you use services through copays and coinsurance. If you have a more serious health year, those costs can add up quickly.

Also, switching later isn’t always as easy as people think. In many cases, moving from a Medicare Advantage plan back to a Supplement can require health underwriting, depending on your situation.

For some people, Medicare Advantage works very well. But it’s important to understand the trade-offs upfront so you’re not surprised down the road.

Answer: In 2026, the Part D out-of-pocket cap increases to $2,100. Once a client reaches that amount, they won’t pay anything further for covered prescriptions for the rest of the year.

This is a big benefit for those with high drug costs, especially specialty medications, because it creates a clear ceiling and more predictability.

That said, not everyone will reach the cap, and some plans may have higher deductibles or cost-sharing upfront.

Overall, it’s a positive change—but it makes reviewing Part D coverage each year more important than ever.

Answer: This is one of those situations where there’s no one-size-fits-all answer and it really calls for a quick review.

The first step is making sure your current plan gives you access to the specialists and facilities you need. Networks, referrals, and out-of-pocket costs can all come into play—especially with more complex conditions.

We’d also want to take a close look at your prescription coverage. Specialty medications can be very expensive, so it’s important to check the formulary and see if there are any patient assistance programs or Extra Help options available.

Before making any changes, it’s best to look at the full picture and see what options make the most sense for your situation.

Answer: I’ve had this come up with clients, and it catches people off guard.

What usually causes it is the change in filing status. After a spouse passes, you go from married to single, and Medicare uses income from a couple years back to set your premiums. The income brackets for single filers are lower, so even if your income didn’t really change, your Part B and Part D premiums can go up.

Sometimes there’s also a small increase on the Medicare Supplement side if there was a household discount that no longer applies.

The one thing I always suggest is taking a look at your current income. If it’s gone down, you may be able to file an appeal with Social Security and get those premiums reduced.

It’s not always obvious, but definitely worth checking into.

Answer: Most people I talk to don’t realize how many decisions are involved with Medicare until they’re right in the middle of it. It can feel overwhelming pretty quickly.

That’s where working with a Medicare agent really helps.

Over the years, I’ve found that no two clients are the same. Some want the most predictable coverage possible. Others are more focused on keeping premiums down. Some travel, some don’t. Some take very few prescriptions, others have several. There’s no “best plan”—only the plan that fits your situation.

One of the biggest advantages of working with an independent agent is having options. We’re able to look at multiple companies and compare what’s available, instead of being limited to just one. That alone can make a big difference in both cost and coverage.

Another thing people don’t always see right away is how important timing is. There are certain windows where switching plans is easier, and other times where health questions come into play. Making the wrong move—or waiting too long—can limit your options later on.

And just as important, this isn’t a one-time decision. Plans change. Rates go up. Drug coverage changes. Doctors come in and out of networks. It helps to have someone you can call when those things happen, instead of trying to figure it out on your own each time.

In most cases, there’s no additional cost to work with an agent. The goal is simply to help you understand your options and make a decision you feel good about—not just today, but down the road as well.

At the end of the day, it’s about having someone you trust to walk you through it and be there when you need help.