Steve Thornton, Medicare Insurance Broker

Answer: With over 18 years of experience helping seniors get the extra benefits they deserve, I’ve seen firsthand how overwhelming Medicare can be. That’s why working with a knowledgeable agent can make all the difference. Here’s why:

Maximizing Your Benefits – Many seniors miss out on extra help, such as dental, vision, hearing, and even money-saving programs. I specialize in finding benefits you may not know exist.

Simplifying the Process – Medicare is complicated, but I break it down so you can easily understand your options and make confident decisions.

Access to Multiple Plans – Instead of calling different companies, I compare plans for you, ensuring you get the best coverage for your health needs and budget.

No Cost to You – My services are completely free. I’m paid by insurance carriers, so you get expert help at no extra charge.

Year-Round Support – Medicare isn’t just about enrollment. I’m here to assist with claims, plan reviews, and any changes throughout the year.

Avoiding Costly Mistakes – I help seniors avoid penalties, coverage gaps, and expensive surprises by ensuring they enroll correctly and on time.

Peace of Mind – You shouldn’t have to figure this out alone. I make sure you feel confident that your healthcare needs are covered.

Answer: 1. Compare Plans Annually

Medicare plans change every year, including premiums, copays, and covered services. What was a good deal last year may no longer be the best option. The Medicare Annual Enrollment Period (Oct 15 - Dec 7) is the best time to review your plan.

2. Check for Extra Benefits

Many Medicare Advantage plans offer dental, vision, hearing, and even over-the-counter allowances at no extra cost. If you’re paying out-of-pocket for these, you may be able to switch to a plan that covers them.

3. Review Prescription Drug Costs

If you have a Medicare Part D or Medicare Advantage plan with drug coverage, make sure your medications are still covered affordably. Use Medicare’s Plan Finder tool (Medicare.gov) to compare drug costs.

4. Look for Assistance Programs

Depending on your income, you may qualify for Medicare Savings Programs, Extra Help for prescriptions, or Medicaid assistance, which could reduce your costs significantly. Many people don’t realize they qualify!

5. Work with a Licensed Medicare Agent

As a Medicare professional with 20 years of experience, I can compare plans for you, ensure you’re not paying for coverage you don’t need, and find ways to lower your costs—all at no charge to you.

Would you like a free plan review to see if you’re overpaying? Let’s connect and make sure you’re getting the most out of your Medicare benefits!

Answer: If your income has recently decreased due to retirement or another qualifying life event, you may be eligible to lower your Medicare Part B premium in two ways. First, you can request an IRMAA (Income-Related Monthly Adjustment Amount) reconsideration through Social Security. Medicare bases your Part B premium on your tax return from two years prior, so if your income has dropped significantly since then, you can file Form SSA-44 to request an adjustment based on your current income.

Second, you can explore Medicare Advantage plans that offer a Part B premium “giveback”. These plans, offered by private insurance carriers, provide a monthly rebate — also known as a Part B premium reduction — which lowers the standard $174.70 monthly Part B premium for 2025. The giveback is applied directly to your Social Security check, reducing the amount withheld each month.

Answer: Working with a local agent gives you face-to-face support, personalized help with doctors and plans in your area, and someone you can count on year-round — not just during enrollment. They also know local programs that could save you money.

Virtual agents can be great too — just make sure they’re licensed in your state and familiar with your local options.

It comes down to what’s most comfortable and convenient for you!

Answer: Medicare Part B covers 80% of outpatient care after you meet the deductible, but you’re still responsible for the other 20% — and there’s no yearly cap if you only have Original Medicare.

To lower costs, look into Medicare Supplement or Advantage plans, which can help cover that 20% and limit your out-of-pocket spending.

Answer: SNPs are Medicare Advantage plans made for people with specific needs:

✅ C-SNP – For chronic conditions like diabetes or heart issues

✅ D-SNP – For people with Medicare & Medicaid

✅ I-SNP – For those needing nursing home-level care

They offer customized benefits and care designed to fit your situation and lower your costs.

Answer: ✅ Yes! It’s smart to meet with more than one Medicare agent — just like you’d compare quotes when buying a car or home insurance.

Different agents represent different options. A broker represents multiple carriers and plan types, which gives you a broader view to help find the best fit for your needs and budget. In contrast, a captive agent typically works for just one company and can only offer plans from that carrier.

Just be sure to work with a licensed, trustworthy agent who takes the time to explain things clearly — not just sell you a plan.

Answer: Medigap lets you see any doctor or hospital that accepts Medicare — no networks.

Medicare Advantage plans usually have networks. HMO plans typically don’t cover out-of-network care, and PPOs charge more if you go out.

If you travel or want doctor flexibility, Medigap may offer more freedom.

Answer: Yes. Medicare Advantage plans vary by county, and what’s available (and covered) depends on local networks and carriers. Even Medigap prices and drug plans can differ by ZIP code.

Location Matters!

Answer: It helps cover final expenses, protects your loved ones from debt, and can even build cash value in some policies. It’s a smart way to protect your family and leave a legacy.

Answer: Usually not. During AEP (Oct 15–Dec 7), you can leave Medicare Advantage and return to Original Medicare — but Medigap plans may require health questions unless you qualify for a guaranteed issue right.

You may skip health questions if you’re in your Medigap Open Enrollment or using a trial right (first 12 months on MA).

Answer: Dental, vision, and hearing care.

Original Medicare doesn’t cover routine dental cleanings, eye exams, hearing aids, or dentures. Many people don’t realize this until they’re hit with a big out-of-pocket bill.

Consider a Medicare Advantage plan that includes these benefits, or look into standalone coverage if you stay on Original Medicare.

Answer: The Medigap birthday rule lets you change your Medigap plan around your birthday without health questions — as long as you switch to a plan with equal or lesser benefits.

States with a Birthday Rule:

• California

• Oregon

• Idaho

• Illinois

• Nevada

• Louisiana (recently adopted, with slight differences)

Each state has its own version of the rule, including how long the window lasts (typically 30–63 days after your birthday).

It’s a great way to shop for a better premium or company without medical underwriting!

Answer: What will my total out-of-pocket costs be each year — in the worst-case scenario?

Most people focus on premiums, but it’s the deductibles, copays, coinsurance, and max out-of-pocket limits that can really hit your wallet — especially with a serious illness or hospital stay.

Knowing your worst-case costs helps you choose the plan that truly fits your health and budget.

Answer: Start with the basics:

• What Parts A, B, C & D mean

• The difference between Original Medicare vs. Medicare Advantage

• What’s covered, what’s not, and what it costs

Then help them understand key decisions:

• Do they need a drug plan?

• Should they consider a Medigap or Advantage plan?

• What plans fit their doctors, meds, and budget?

Keep it simple, use visuals when possible, and give them room to ask questions — clarity builds confidence.

Answer: It’s growing fast because of low premiums and extra benefits, but MA plans also come with networks and prior authorizations that Original Medicare doesn’t.

Bottom line: It’s not one-size-fits-all. The best plan depends on your health, doctors, and budget. Always compare before you decide!

Answer: It’s growing fast because of low premiums and extra benefits, but MA plans also come with networks and prior authorizations that Original Medicare doesn’t.

Bottom line: It’s not one-size-fits-all. The best plan depends on your health, doctors, and budget. Always compare before you decide!