Nicolas Cain, Medicare Insurance Agent

Answer: What I value most about running a Medicare-focused agency is the ability to deliver strategic, compliant solutions that truly empower our clients. We don’t just sell plans — we build trust, optimize benefits, and ensure long-term satisfaction in a highly regulated space.

Answer: The Medigap Birthday Rule lets clients in CA, OR, ID, IL, NV, and LA switch to a plan of equal or lesser value without medical underwriting around their birthday. Missouri has a similar rule on the policy anniversary date instead.

Answer: Yes, a consumer can be denied a Medicare Supplement if they apply outside protected enrollment periods and have health issues.

Answer: Yes, stricter regulations can help protect seniors from misleading or aggressive Medicare Advantage marketing and ensure agents provide clear, accurate plan information. Transparency and accountability are key to maintaining trust in the system.

Answer: Its a great idea to review your Medicare plan annually, especially if your costs, coverage, health needs, or network have changed. Open Enrollment (Oct 15–Dec 7) is the best time to switch.

Answer: “Will my coverage still meet my needs if my health changes suddenly?”

Most people focus on current costs, but planning for unexpected health events ensures you choose a plan that protects you long-term.

Answer: Medicare covers skilled nursing facility (SNF) rehab for up to 100 days if you meet certain criteria (like a prior 3-day hospital stay). But it does not cover long-term custodial care in a nursing home.

If you need long-term care after rehab, you’ll likely need to pay out-of-pocket, use Medicaid (if eligible), or consider long-term care insurance.Which we can also help you with!

Answer: Yes! In 2025, Medicare Part D adds a $2,000 annual out-of-pocket cap and a new payment plan to help spread drug costs monthly, making expensive medications more affordable.

Answer: You’re right to be cautious—choosing the cheapest Medicare plan isn’t always the best move.

Lower premiums often mean higher copays, limited provider networks, or less coverage for your specific medications and health needs. It’s crucial to look beyond price and consider overall value, including doctors, drugs, and benefits.

Answer: For a healthy 65-year-old, Original Medicare plus a Medigap Plan G and a Part D drug plan is usually the most cost-effective setup.

Answer: Look for a Medicare plan that offers:

• Nationwide network coverage (like Original Medicare or a PPO Medicare Advantage) for domestic travel.

• International travel coverage or emergency care benefits abroad.

• Prescription drug coverage with mail-order options for refills on the go.

This keeps you covered wherever you are.

Answer: If they have employer coverage that’s creditable (meets Medicare standards), they can usually delay enrolling in Medicare Part B without penalty.

Once they retire or lose that coverage, they’ll have a Special Enrollment Period to sign up. It’s important to confirm their employer plan qualifies before delaying.