Tabitha Self, Medicare Insurance Broker

Answer: There are advantages and disadvantages to both options. That is why it is important to meet with a licensed Medicare Broker that represents plans of all types to ensure you have the best plan type and carrier for your situation and budget.

Answer: I love being able to help people find the best options for their situations. Life can be challenging & Medicare can be confusing, so I want to help make it as easy as I can for those that I represent. I think about my own elderly mother and how I want to be sure she has the best care possible - I feel the same for my clients.

Answer: Unfortunately, you may not be able to do that if you are not within your original eligibility trial period, have a special enrollment period or guaranteed issue based on your state of residence. It is best to work with a licensed Medicare broker to determine if you are able to switch without health questions or even if you do have health questions, determine the best plan option for your situation.

Answer: It is important to review your Medicare Plan options, including Medicare Part D plan annually to ensure all of your medication is reviewed. A licensed Medicare Broker can input all of your medications into the Medicare enrollment tools to provide the best Medicare Part D plan options for your situation.

Answer: True Long-term care coverage (stays over 100 days) is not covered by Medicare. However, skilled nursing care coverage in a skilled nursing facility is available for up to 100 days per benefit period. But after the 100 days, Medicare does not cover ANY of the cost unless the beneficiary is released from the facility 60 full days before a new benefit period will start.

Answer: You can check with CMS to determine if you might qualify for a "SEP" - special enrollment period that may be available for specific circumstances, such as a qualifying life event (employment health coverage ends, spousal health coverage ends, chronic condition diagnosis, etc). Otherwise, you may need to wait until the Annual Enrollment Period from Oct 15 - Dec 7 each year to change the plan you are currently in. Check with a licensed Medicare Broker for your best options.

Answer: "Zero-premium" simply means the cost to enroll and stay enrolled with the Medicare Advantage plan selected. However, many Medicare Advantage plans require copays for doctor and hospital visits as well as prescription drugs if a Medicare Advantage with Prescription Drug Plan is elected. In addition, many Medicare Advantage plans only cover what original Medicare covers, so it is important to meet with a licensed Medicare Broker to determine what type of plan is most appropriate for you.

Answer: Your Medigap (Medicare Supplement) policy can only be terminated for lack of payment. It is best to meet with a licensed Medicare Broker to ensure that you are enrolled in the best plan for your needs.

Answer: As of 1/1/2025, the donut hole was eliminated in favor of a maximum out of pocket of $2100 for prescription drugs with a Standalone PDP plan OR a MA-PDP plan. However, it is important to meet with a licensed Medicare broker to review your Medicare Part D options annually during Annual Enrollment Period from Oct 15 - Dec 7 to ensure you are on the best plan possible for the specific prescriptions you take.

Answer: Yes, Medicare programs should expand, which would help to address health disparities among minority seniors. It is important to work with a licensed Medicare broker that can assist minority seniors find the best plan options as well as other programs that will assist with addressing some of the disparities.

Answer: There are many carriers that provide Medicare supplement plans. It is best to meet with a licensed Medicare broker (who contracts with many carriers) that can find the best Medicare supplement for you at the best price.

Answer: The cheapest Medicare plan may not provide the providers that you would like to see for medical issues. In addition, the cheapest Medicare plan may not cover everything that you feel should be covered - for example, Medicare Part A, which is free to those that qualify, only covers up to 90 days (without using lifetime reserve days) in the hospital with a significant copay per benefit period. It is best to meet with a licensed Medicare agent to review your options to ensure you get the best coverage for the least cost.

Answer: A licensed Medicare agent has completed extensive training regarding the Medicare program and plan options. In addition, licensed Medicare agents are trained to work with individuals to determine their specific needs and desires for type & extent of coverage. A licensed Medicare agent is an actual person, and not a "bot" or "AI" that could miss nuances of your specific situation. It is important to review your Medicare plan annually to ensure your coverage is still the best option for you due to life changes or doctor changes that have occurred within the year.

Answer: Annual Enrollment Period for Medicare changes starts on Oct 15 for plan year beginning the following Jan 1. I definitely recommend discussing your options with a licensed Medicare broker. You can also check with CMS (or work with a licensed Medicare broker) to determine if you may be eligible for a "SEP" - special enrollment period because of your husband's retirement or your own transfer from SSDI to SS.