Michael Reardon, Medicare Insurance Broker

Answer: Jose hard question, there is not one company that is one size fit all. It boils down to pricing and Financial stability. A plan N is the same as a plan N with either company.

A Good thing to look for within a company is the financial strength, complaints, service reputation ,availability in your state and ZIP Code and some plans include extra perks like discounts on vision, hearing fitness…

Answer: Who won the doctors do not like Medicare advantage plans because some plans require prior authorization and they do not like jumping through extra hoops to get services provided for their clients.

Answer: This is probably the most common question in Medicare, no you do not need to sign up for Medicare if you have credible coverage. You can postpone your part B as long as you have credible coverage.

However, if your company has fewer than 20 employees, you should sign up for Medicare part a and part B when your first eligible, Medicare becomes your primary and your employer pan plan becomes secondary.

Answer: Great question — this is a common source of confusion with Medicare coverage.

Here’s exactly how it works for chiropractic care under Medicare Part B:

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🦴 What Medicare does cover

Medicare only covers one specific chiropractic service:

Manual manipulation of the spine to correct a subluxation (a misalignment of the vertebrae).

That’s it.

If the chiropractor is performing this spinal adjustment and you have a diagnosed subluxation, Medicare Part B will help pay for it — as long as the provider is Medicare-approved.

✅ What’s included

• The spinal adjustment itself

• Documentation of medical necessity (the chiropractor must note a subluxation on X-ray or by physical exam)

• You typically pay 20% coinsurance after your Part B deductible

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🚫 What Medicare does NOT cover

Medicare does not pay for any other services provided by a chiropractor, even if performed during the same visit:

Answer: 💊 Option 1: Standalone Part D (with Original Medicare)

You’d have:

• Original Medicare (Part A & B) for hospital and medical

• A standalone Part D plan for prescriptions

• Optionally a Medigap plan to cover deductibles and coinsurance

✅ Pros

• Freedom of doctors: You can see any provider that accepts Medicare.

• No network restrictions for medical care.

• Easier to switch drug plans each year if your medication changes.

• Predictable coverage: Part D plans follow strict CMS guidelines and formularies are published publicly.

⚠️ Cons

• Premiums can be higher when you add Medigap + Part D.

• Separate deductibles and billing systems.

• Part D formularies vary: Some may cover your diabetes meds well; others may not. You’ll need to compare plans carefully each fall.

• No extra benefits (like vision, dental, or gym) that Advantage plans often include.

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🩺 Option 2: Medicare Advantage (Part C) with Drug Coverage

These plans bundle:

• Parts A, B, and D

• Often add vision, dental, hearing, and sometimes insulin or diabetic supply perks

✅ Pros

• One card, one plan (simplifies billing).

• Many plans now have $0 insulin copays or cap insulin costs at $35/month (part of the Inflation Reduction Act).

• Some chronic condition special needs plans (C-SNPs) are designed for people with diabetes, offering tailored benefits like nutrition, podiatry, and extra checkups.

• Sometimes lower or even $0 premiums.

⚠️ Cons

• Networks are limited — you must use doctors and pharmacies in the plan’s network.

• Prior authorization can delay certain supplies or new meds.

• Drug formularies can change, and you can only switch during open enrollment.

• If you travel or move often, coverage can get complicated.

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💡 For Diabetes Specifically

A few tips:

1. Check the Insulin and GLP-1 coverage (Ozempic, Trulicity, etc.).

• Some Advantage plans treat them as “preferred” (low copay), others as “non-preferred” (high cost).

• You can look these up in the Medicare Plan Fi

Answer: Yes, the part B premium will be increasing this year. They have not released the specific amount but are projected $206.50 and the deductible around 288.

The part B deductible will most likely increase to a cap of 615. The out-of-pocket maximum cap for part D will go up to 2100.

This is why it is important to use a insurance agent that stays on top of all of the constant changes in Medicare.

Answer: We are paid a commission from the insurance carrier for each application that we submit. It does not have anything to do with the customers that we are working with. We get paid the same regardless of the plan so we have no incentive to just pick one particular plan.

Answer: And really boils down to timeline. When is your mother’s 65th birthday, when will her current health coverage end? What is her current health? long-term care can drain your savings quickly. There are many options of protecting herself. You can add riders to your life insurance, annuities ect… look over her her current financial status. Her long-term living status…

Answer: 1. Part B Late Enrollment Penalty

It is a penalty that encourages people to sign up when they are first eligible. When you do not sign up for part B and you are first eligible and you do not have credible coverage you will receive a 10% of the standard part B premium for each 12 month. You could have part B but didn’t. The penalty is added to your premium for as long as you have part B.

2. Part D Late Enrollment Penalty

When it happens:

You go 63 days or longer without “creditable” prescription drug coverage after you’re first eligible for Medicare.

Penalty amount:

• 1% of the “national base beneficiary premium” for each month you were without coverage.

• That amount is added to your monthly premium for as long as you have Part D — again, typically for life.

Answer: ✅ Covered by: Medicare Part B

✅ Frequency: Once every 24 months (2 years) — or more often if your doctor says it’s medically necessary

Answer: You can meet in person, ask questions directly, and go over your plan options together.

• It’s easier to build trust when you can sit down with someone and review your paperwork side by side.

You can get help from anywhere, without leaving your home.

• Perfect for people with limited mobility or busy schedules.

Answer: It is a lot easier to talk with an agent who has a vast amount of knowledge that can break down into simple terms to make it easier to understand. Medicare is constantly changing, and it is good to talk with an expert that stays on top of all of the changes.

Answer: Medicare can be very confusing. There are life-changing events that may affect their needs. It can help reassure them that they made the best choice.