Susan Winters, Medicare Insurance Agent

Answer: You can apply for a Medicare Savings Program, Extra Help or even Medicaid through the state in which you live. You can call a local agent who would help you walk through all your options and ensure you are getting the help you need.

Answer: The commercials often oversimplify complex benefits, gloss over limitations, or promote benefits not available in all areas. I think that the commercials can be misleading but CMS Center for Medicare Services has been monitoring these commercials closely. This is not only with celebrities. The monitoring helps, but when you have an honest agent they help you make sense of all the benefits or limitations in plans

Answer: Medicare Part A generally does NOT cover outpatient surgery because it primarily covers inpatient hospital care, skilled nursing facility care, hospice, and some home health care.

Answer: Giveback Plans: Some Medicare Advantage plans offer a “giveback” — they reduce your monthly Part B premium by giving back part of it. This can help lower your overall costs.

Medicaid: If your income and assets are very low, you may qualify for Medicaid, which can help cover Medicare costs, including premiums, deductibles, and copays.

Low-Income Subsidy (LIS) / Extra Help: This program helps pay for your Medicare Part D prescription drug costs if you qualify based on income and resources.

Answer: Yes, You have 8 months to enroll in Part B (and Part A if you haven’t) starting the month after your employment or employer coverage ends—whichever comes first. It is good to also note that COBRA or retiree coverage does NOT count as active employer coverage for delaying Part B without penalty.

If you miss the 8-month SEP, you might have to wait for the General Enrollment Period (Jan 1–Mar 31) and pay a lifetime late enrollment penalty on Part B.

Answer: To be clear gift cards and incentives are used for educational seminars and not incentives to enroll. It is part of the Marketing strategy many carriers use, it is not considered illegal. There is however a limit on how much can be given they are considered nominal gifts under $15 to thank you for taking the time to learn more about your Medicare options.

Answer: If you stay with Original Medicare alone without a supplemental plan whether it is a Medigap plan or a Medicare Advantage, you have full provider freedom, but there’s no maximum out-of-pocket limit. You’ll pay 20% of all costs, which could add up to thousands—or more—if you have a serious illness. Medicare Advantage plans, on the other hand, give you that financial protection with an annual maximum and often include dental, vision, and hearing benefits. The trade-off is you’ll be in a network.

Answer: Having a Medicare Supplement gives you peace of mind. There are no networks—you’re free to see any doctor in the U.S. who accepts Medicare. For many clients, that flexibility and predictability are the biggest benefits.

On the other hand, if you don’t mind copayments and coinsurance and you tend to stay healthy, you could save thousands over 5–10 years with a lower-cost plan. However, if you develop a serious health condition, a high-end plan can quickly pay for itself and eliminate surprise bills.

Answer: When you first sign up for Medicare Part B at age 65 or older, you have a 6-month window where you can buy any Medicare supplement/Medigap plan with no health questions asked. This is called your Medigap Open Enrollment Period, and it guarantees your approval regardless of pre-existing conditions. After those 6 months, if you apply for a Medicare Supplement/Medigap plan, the insurance company can require medical underwriting, which means they can charge more or even deny coverage based on your health.

Answer: Annual Wellness Visits is a plan to keep you healthy and covers, Review of your health risk assessment, health history and medications, check your height, weight, blood pressure, BMI, screenings for memory and depression, Discuss your risk for falls, and create a personalized prevention plan. This DOES NOT cover a full physical exam, labs, bloodwork, tests, or treatment.

Answer: Medicare Advantage plans are required to cover everything Original Medicare (Parts A & B) covers—this includes outpatient eye surgeries when deemed medically necessary by your doctor. You’ll be responsible for cost-sharing—coinsurance, copays, and deductibles. It is best to check you evidence of coverage with your carrier

Answer: I can help seniors navigate the confusing world of Medicare and making sure that they're getting the health options that they need and deserve from a trusted agent in their area