Phillip Davis, Medicare Insurance Broker

Answer: Medicare Part A helps to cover your hospital stay as long as you are officially admitted as an inpatient. An overnight stay alone doesn’t guarantee that. If you were under observation status, it would be billed under Part B and can cost you more. Even with Part A, you would have a deductible before coverage kicks in, so it’s not completely free. After the deductible, most of the first 60 days are covered, but longer stays add daily costs. Many people get extra coverage, like a Medicare Supplement plan or Medicare Advantage plan, to help reduce out-of-pocket expenses.

Answer: For coverage outside of your plans service area I would suggest a Medigap plan along with a prescription drug plan. These plans travel with you.

Answer: You will not face a penalty for deffering part B as long as the coverage is considered creditable. Creditable coverage is the same or better coverage as Medicare. You must have prescription coverage and medical coverage through the employer without gaps the entire time to avoid penalties.

Answer: You should receive your Medicare card in the mail prior to your 65th birth month. If not, you should schedule an appointment befor turning 65 to make sure you are receiving benefits and request a new card.

Answer: There is no limit to how many out-patient therapy visits are covered. If your doctor orders rehab, Medicare will cover it.

Answer: Different carriers require pre-requisites for certain procedures. Your summary of benefits should be able to break this down for you.

Answer: The biggest underrated Medicare benefit I see is the network. For folks who travel, being limited to a network is prohibitive. Original Medicare, along with a supplement is a great way and stay covered while out of your service area.

Answer: Medicare drug plans have made some changes recently that may be causing your generic medications to cost more. While a new law called the Inflation Reduction Act is helping people by putting a yearly limit on high drug costs, some insurance companies have adjusted their plans. Because of that, certain lower-cost generic drugs may now be a little more expensive.

Answer: Medicare has an app called "what's covered" you can use to check if your service is covered by medicare. Additionally, if you have a medicare advantage plan, you should contact your plan and confirm costs with them.

Answer: Because Medicare does not offer dental and vision coverage you will need to have either a stand-alone plan and/or a Medicare advantage plan that has this benefit built in. If you have a Medicare Supplement you can not have an advantage plan so you would have to have a stand-alone plan. Even if you have an advantage, having a seperate dental/ vision plan will add more benefit.

Answer: You should absolutely review your ANOC with your agent every year. This will help ensure your agent can have as much information as possible to help ensure you always have the best plan for you.

Answer: You will need to sign up during the Medicare Annual Enrollment Period (AEP). The MA plan will disenroll you from your drug plan and will start January 1st of the following year. If you have a Medigap policy, you will need to cancel that plan effective January 1. AEP is from October 15th through December 7th of each year.

Answer: By far my favorite thing about being a Medicare agent is helping someone be in a better position after I meet with them than they were before meeting. If I can help someone save on prescriptions and co-pays and medical expenses and, as a result, they are able to do more things they enjoy, I am excited.

Answer: There are different special needs plans for different situations. Dual Special Needs Plans are for folks who have Medicare and Medicaid together, Chronic Special Needs Plans have benefits based on conditions the beneficiary has. They add extra benefits for those with Special needs.

Answer: We absolutely work with people who have dementia. If you have someone in your life that helps you with decisions we would request them be there to help you make a good choice for you. At the end of the day most advisors only want you to have the best coverage for you.

Answer: In my humble opinion it is the network and the lack of Skilled Nursing coverage. Medigap solves a lot of the issues that exist within Advantage plans.

Answer: The standard Medicare part B premium for 2026 is 206.50. The changes are largely driven by rising Healthcare costs.

Answer: If you are still on work insurance you don't necessarily need part B as long as your work coverage is considered creditable. This means it is at least as good as Medicare's standard coverage. However, depending on your coverage through work, Medicare may be a step up.

Answer: In most cases it is advised to have life insurance. If you are weighing the costs and can only afford medicare then you should weigh the costs of your premiums with those of your other costs. Life insurance provides more than just a check to your beneficiary. It also covers final expenses outside of burial or cremation. Medicare plans take care of you while you're here and life insurance takes care of your family when you aren't.

Answer: The Center for Medicare Services requires that agents fill out a scope of appointment with you before discussing any plan details. This ensures you understand that you will be participating in an appointment to discuss certain coverage options. Call centers should also be following this practice. In most cases agents are not allowed to discuss plan details until 48 hours after they have you sign the SOA

Answer: MedSup or Medigap plans can have international benefits. Talk with your local agent that offers these plans to find the coverage that fits you best!

Answer: Most plans adjust their formularies annually. This means that sometimes it's necessary to review and possibly change your coverage from year to year. To determine what your rx prices will be next year and what plans have the best benefits for you, it helps to reach out to a local agent and discuss everything.

Answer: There are some solutions to the costs associated with Medicare depending on income. If the beneficiary makes above a certain amount, they may pay more for their premium. Depending on state minimum income requirements, they may qualify for extra help programs as well.

Answer: Once you reach your Max out-of-pocket (MOOP) you should no longer have copays. The max out-of-pocket is just that. Your plan should pay for all approved covered services after the MOOP has been met.

Answer: Once you meet your annual deductible, you will pay 20% of the medicare approved amount for the ambulance ride.

Answer: Working with someone that understands the industry is a huge advantage. Agents can get to know you personally and help you to adapt to the ever-changing world of Medicare.