Michael Yost, Medicare Insurance Broker

Answer: Should I enroll in a Medicare plan or stay on my group health insurance plan? Many people think Medicare is too confusing and they don't want to deal with it now. They feel very comfortable with their group plan because that's what they are used to. So many families I've spoken with over the years got better coverage on Medicare and paid less, saving $$. People may be missing out on better coverage and savings if they don't take time to compare and talk with a broker about their options.

Answer: My strategy is to best explain both options to someone and let them decide what is best for them. Medicare is a very complicated system and people need to understand how their plan options work so they can make an informed decision.

Answer: You can enroll 3 months before turning 65. You can also enroll the month of your date of birth and 3 months after. This gives you 7 full months to apply when turning 65.

Answer: Yes you have to be careful on who you meet with. Agents should be independent and show both options equally. Unfortunately some agents do push advantage plans because they pay more commissions. If you meet with an agent that does push one plan over another, you may want to look for someone else to help you with your options.

Answer: I would find and work with an independent solid broker that can help go through and explain your options. You need someone to help you review your situation, possibly compare your current health insurance to the Medicare options, and help figure out what your best option is. If you are definitely going to enroll in a Medicare plan, your first step is to enroll in Medicare Parts A + B.

Answer: Medicare does not cover the shingles shot. The shingles shot is covered under Part D (a prescription plan). Once you enroll in a prescription drug plan, the shingles shot should be covered at 100%.

Answer: There may be less advantage plans available to choose from. Also you may have to stick with a PPO as it may be harder to find doctors that are in networks.

Answer: Medicare does not usually cover routine eye exams. However, there may be exceptions that they would cover (Medicare would cover an eye exam after cataract surgery).

Answer: Some people that are on Tier 3 medications or higher would be saving alot of money with the new $2,000 max. It used to be $8,000 and was dropped to $2,000. There's been some significant changes last AEP with how the drug structures work and it's been a nice improvement/savings for many seniors.

Answer: Yes most Medicare plans are county based. If you move out of a service area, you most likely will have to change plans.

Answer: There's been some nice changes in the drug structures of Medicare, especially with diabetes medications. That's where meeting with a broker (someone like us) can help compare the drug plans in your county with the medications you take, to see what the better route to go is.

Answer: That they did not enroll in a Medicare plan sooner. They stayed on their employer insurance when they could have switched to a Medicare plan, while working, and got better insurance coverage and saved $$.

Answer: Yes plans vary by county. If someone moves out of a county or service area, that person would probably have to change plans to the new county they are in.

Answer: If you had a HMO, the bills would be even higher. HMO's pay $0 for care outside of the network. It's always good to stay in network but at least the PPO does give you flexibility to go in or out of network. Usually, you have a coinsurance for going out of network, which is something better than nothing.

Answer: There are individual travel plans that we can help with. There are some Medicare plans that also cover international travel.

Answer: Someone could be penalized, depending on their situation. If someone has employer coverage, they may be able to stay on their employer plan without any penalties. That's something we help people with to see if they need to apply for Medicare or not. Each scenario is different.

Answer: Typically, yes you do. The first 6 months on Part B you can enroll in any supplement with no health questions. After the 6 months passes, then you would have health questions to switch or enroll in a supplement.

Answer: I think the best way to choose the right healthcare company is working with a broker. A broker is someone who should be independent and able to shop many carriers. If you need a no cost broker to help you look at options feel free to reach out to me.

Answer: No. A supplement plan is not health insurance. A supplement plan "supplements" Medicare health insurance. A secondary insurance would be having 2 insurance plans, one would be primary, one would be secondary.

Answer: I think it depends on what agent is helping you recommend plans. There are plans that can help lower your out of pocket expenses. There are plans that can help pay the medical bills. It's important to work with a broker that can explain all of your options in a way that you understand what you are enrolling in and what to expect.

Answer: Yes that is correct. That was one big change with drug coverage for 2025. There were also some other big changes with prescription coverage too in addition to the $2,000 max.

Answer: You can compare drug plans on www.medicare.gov. You can also work with an independent broker (someone like us) to help you compare many options. It's important to meet with an independent broker each year to review your prescriptions since drug plans and formularies can change each year.

Answer: During the annual enrollment period, AEP, (10/15 - 12/7), it's always good to review your coverage. Your health may change, medications may change, and Medicare plan options may change. However, if your health changed prior to AEP, you may be eligible to change or update your plan sooner.

Answer: There should be a phone number for member services on the back of your insurance card. I would call them.

Answer: You have to pay Medicare’s deductible of $257. Once you pay that deductible, you’ll have a $20 copay for a doctor visit and a $50 copay to the ER. Your supplement will pay 100% of the remainder for the rest of the year.

Answer: I would start applying for Part A/Part B 60-90 days before your retirement date. You want to give social security time to process your applications. You also want to review all Medicare options to see what your best route will be in choosing a plan.

Answer: Some MAPD plans cover dental and cover it very well. Other plans barely cover anything, just like you mentioned. A broker (someone that works with all of the plans) could help you figure out which MAPD plan pays very well on dental.

Answer: Yes you can change a supplement at anytime of the year. However, it may be hard to switch to a different supplement because of underwriting that you would have to go through and get approved.