Rodney Powell, Medicare Insurance Broker

Answer: Medicare Part B covers cataract surgery as a medically necessary procedure, including surgeon fees, facility costs, anesthesia, and a standard monofocal lens for basic vision.

However, premium lenses (multifocal or toric) and extra services like laser astigmatism correction aren’t covered — you’ll pay out-of-pocket for these upgrades.

Standard Part B deductibles and 20% coinsurance apply, though Medigap may help with coinsurance.

Medicare Advantage plans may offer similar coverage, but check your plan for details on premium lenses.

Answer: I teach the best Medicare 101 Boot Camp seminars you’ll ever attend — no PowerPoint, just me and a dry-erase board, explaining Medicare in a way you’ll remember.

Plus, I record the live sessions and share shorter clips on my "Medicare Video Guy" YouTube channel, so you can watch whenever you want.

Answer: Advantage plans have a maximum out-of-pocket limit, which helps cap your hospital and outpatient medical costs.

If you don’t have enough in personal savings or an HSA, a hospital indemnity and catastrophic illness policy can be a good safety net.

These policies usually pay per hospital stay, so two hospitalizations in one year are typically covered, BUT always check the details of any plan before signing up.

Answer: IRMAA doesn’t go away automatically if your income drops — you need to report the change to Social Security and request a review.

If you’ve had a life-changing event like retirement or a significant loss of income, you can file Form SSA-44 or contact Social Security to have your IRMAA reassessed.

Otherwise, Social Security will keep using your most recent tax returns (from two years prior) to determine your IRMAA amount.

Answer: Yes, if you lose employer coverage, you qualify for a Medicare Special Enrollment Period (SEP).

• For Original Medicare (Part A and/or Part B), you have 8 months from the date your group health plan ends or you stop working — whichever comes first—to enroll without penalty. This only applies if your coverage was through active employment (not COBRA or retiree coverage).

• For Medicare Advantage (Part C) and Part D (prescription drug coverage), the SEP is shorter: you have 2 months from the date your employer coverage ends to sign up.

Key points:

• The 2-month SEP for Part C and Part D starts when your employer coverage ends — not when employment ends.

• Missing this window may mean waiting until the next Annual Enrollment Period and possibly facing late enrollment penalties.

Answer: Creditable coverage means your group health insurance is at least as good as Medicare. To qualify, you must be actively working for an employer with 20 or more employees.

This matters if you delay enrolling in Medicare beyond your initial eligibility at age 65, often because you’re still working and covered by your employer’s plan.

Coverage that does NOT count as creditable includes:

• COBRA

• VA benefits

• Health sharing ministries

Answer: Some Advantage plans have a $-ZERO premium, but that doesn’t mean you pay nothing.

You’ll still have out-of-pocket costs like deductibles, copays, and coinsurance when you use services.

Answer: • Limited provider networks

• Most require referrals from your primary care doctor

• Out-of-pocket costs like deductibles, copays, and coinsurance

• The big one — prior authorizations are often required for many services

Answer: While it's possible to self-enroll for Medicare plans, it’s also easy to miss important details. Most people simply don’t know what they don’t know. Working with a trusted independent Medicare agent won’t cost you more, so take advantage of the guidance.

• Medicare has many options — Original Medicare, Medigap, Advantage plans, and drug plans. You'll get help with comparisons and find what fits your needs.

• Agents review your providers, prescriptions, finances, and health needs to recommend plans suited to your personal needs.

• They help you avoid missed deadlines, penalties, and coverage gaps.

• Independent agents have access to plans from a variety of insurers, not just one.

• You’ll want ongoing support for questions, claims, plan changes, and annual reviews — even after you enroll — again, at no cost to you.

Answer: No. The Annual Enrollment Period doesn't let you switch to a Medigap plan without answering health questions. The only ways to avoid medical underwriting are:

• During your Medicare Supplement Open Enrollment Period (the first 6 months after you start Part B at age 65)

• If you live in a "birthday rule" state (like California, Oregon, Idaho, Illinois, or Nevada) where you can switch Medigap plans each year around your birthday without health questions

• If you qualify for a Guaranteed Issue situation, such as losing coverage or moving out of your plan's service area

Answer: It usually comes down to whether you have "creditable coverage." That means:

• You’re actively working for a company with 20 or more employees.

• Your group health insurance is as good as, or better than, Medicare.

If so, you have options — you can stay with your group plan or move to Medicare — whatever works best for your needs.

Answer: Make choices with your future self in mind. Don’t just look for the best deal at 65 — think about what you’ll need at 75.

We're not always trying to solve a math problem. It can be more about autonomy over your healthcare when it matters most.

Answer: Medicare agents are all about guiding people through consequential decisions. I realized most of my friends didn’t understand Medicare.

This work is really about walking people through choices that fit their needs — I help them optimize their prescription coverage and keep the doctors they trust.

People appreciate having someone reliable they know they can trust, and that’s genuinely rewarding, personally.