Tameeka Johnson, Medicare Insurance Broker

Answer: Not necessarily. It helps to know that the agent is accommodating and accessible to you when needed. It also helps in knowing that the agent enough to undermine your best interest are being met. Normally cold calling can seem evasive and predatory based on high pressured enrollments. Consider all factors before relinquishing private information such as your Medicare number etc.

Answer: No you do not. If you feel that any carrier changes will affect your accessibility to health care, you should consider changing it to prevent unexpected charges. It's something you should discuss with your designated medicare agent. You may appoint one at anytime to assist you in navigating your options

Answer: Great question!

Medicare Part B helps cover medically necessary outpatient medical services, including doctor visits, specialist appointments, lab work, diagnostic tests, preventive screenings, mental health services, durable medical equipment (such as walkers and oxygen equipment), ambulance services, and certain home health services. It also covers many preventive services at little or no cost to the beneficiary. This should be gaged based on a few factors

Answer: Before choosing, understand these key differences:

1️⃣ Original Medicare (Part A & Part B)

Provided directly by the federal government

You can see any doctor or hospital nationwide that accepts Medicare

No network restrictions

You may need to purchase:

A Medigap (Supplement) plan to cover the 20% coinsurance

A separate Part D drug plan

Typically higher monthly premiums (if adding a supplement), but very predictable out-of-pocket costs

2️⃣ Medicare Advantage (Part C)

Offered by private insurance companies approved by Medicare

Usually includes:

Hospital (Part A)

Medical (Part B)

Prescription drugs (Part D)

Extra benefits like dental, vision, hearing, OTC, etc.

Often $0 additional premium (you still pay your Part B premium)

Has provider networks (HMO or PPO plans)

Has an annual maximum out-of-pocket limit

⚖️ What You Should Ask Yourself:

Do I travel frequently or live in multiple states?

Do I want freedom to see any doctor, or am I okay with a network?

Can I afford a higher monthly premium for more predictable costs?

Do I have chronic conditions that require specialists?

💡 Important: The “best” choice depends on your health, budget, doctors, and lifestyle — not just the premium.

Choosing the right plan can protect your retirement savings and reduce stress later.

If you'd like help comparing options based on your situation, feel free to reach out.

Answer: When you enroll in a Medicare Advantage (Part C) plan, your Medicare Part A and Part B costs no longer apply the same way as they do under Original Medicare.

Instead, your Advantage plan creates its own cost-sharing structure, which replaces the Part A deductible.

Here’s what that means for your situation:

Under Original Medicare, you would pay:

• A $1,676 deductible for each benefit period when admitted as an inpatient.

Under your Medicare Advantage Plan, you pay the plan’s inpatient copays instead:

• $350 per day for days 1–7

• $0 after day 7 (depending on your plan)

This means your maximum cost for a hospital stay could be $2,450 (350 × 7), instead of the $1,676 Part A deductible.

Key Point:

✔️ You do NOT pay both.

✔️ Your Advantage plan’s hospital copays replace the Medicare Part A deductible entirely.

Some Advantage plans have lower copays, some higher, but they all replace the Part A deductible with their own cost structure.

Answer: What Is Staying the Same / Why It’s Expected to Remain Stable

1. CMS Says Part D & Part D Programs Are “Expected to Remain Stable”

According to a CMS press release, average premiums, benefits, and plan choices for Medicare Part D are projected to remain stable in 2026.

That includes the Extra Help (also called the Low-Income Subsidy, or LIS) program for Part D.

2. Extra Help Cost Structure Remains Favorable

As of recent rules, many who qualify for Extra Help pay $0 for plan premiums and $0 deductible for Part D.

For prescription costs, there are fixed copays. According to Medicare.gov, in 2026, qualified beneficiaries will pay up to $5.10 for generics and $12.65 for brand-name drugs, depending on their Extra Help level.

Once your “total drug costs” (including amounts paid on your behalf) hit $2,100, you pay $0 for covered drugs under Extra Help.

3. Eligibility Criteria May Adjust (But No Major Overhaul Announced)

The income and resource limits for Extra Help are set by SSA/Medicare, and these can change year to year.

But right now, experts and agents say there are no significant program overhauls planned for 2026.

According to some licensed agents, any changes are likely “no more than the usual annual adjustments … Extra Help is expected to stay the same.”

4. Policy / Technical Updates for Part D Do Not Target Extra Help Directly

CMS has issued a proposed rule (for 2026) that includes “policy and technical changes” to Medicare Advantage and Part D.

But these changes are mainly about how plans operate (e.g., prior authorization, AI guardrails), not a restructuring of the Extra Help subsidy itself.

Answer: One of the biggest decisions that many people regret later,I would say is not having a Trusted Medicare Agent to guide them throughout their process. This allows the Medicare recipients to stay in the know when it comes to understanding and navigating plan challenges

Answer: You didn’t necessarily make the wrong choice — you just chose the option that gives you the most freedom, but also the most exposure to out-of-pocket costs.

Why Original Medicare Feels Expensive

No cap on medical spending. With Part A and B alone, the bills keep coming — there’s no yearly limit to protect you.

20% coinsurance adds up fast. Especially if you have specialists, imaging, or ongoing treatments.

If you don’t have a Medigap plan, you’re paying the difference yourself.

Why Medicare Advantage might have helped

Lower monthly premiums (many plans are $0).

Built-in financial protection: Advantage plans have an annual max-out-of-pocket, so there’s a limit to how much you’ll spend in a year.

Extra benefits like dental, vision, hearing, and gym membership often included.

But here’s the trade-off

To get those savings, Advantage plans:

Use networks, meaning you may not be able to see all your doctors.

Require prior authorizations more often.

May treat out-of-network care as not covered.

So it’s not about regret — it’s about choosing what matters most:

🔹 Doctor freedom? → Original Medicare (preferably with a Medigap for protection).

🔹 Lower bills and cost protection? → Medicare Advantage.

What you can do right now

If you’re drowning in bills, you can look into:

A Medigap plan (if you qualify for an enrollment window).

Switching to a Medicare Advantage plan during an enrollment period if the network fits your doctors.

Programs that help with costs, such as Medicare Savings Programs or Extra Help.

You’re not stuck — you just need a plan that better matches your health and your budget

Answer: Medicare plans update their premiums, drug formularies, and coverage annually. Reviewing your plan during Open Enrollment (Oct 15–Dec 7) ensures your coverage aligns with both your budget and your health needs.

Answer: Planning ahead is one of the smartest steps you can take. If you expect your health to decline in the next decade, here’s how to budget for Medicare in a way that protects your coverage and keeps your costs predictable:

1. Start with your essential Medicare costs

Every beneficiary should plan for these fixed monthly expenses:

Medicare Part B premium

Part D prescription drug plan premium

Medigap or Medicare Advantage plan premium

These form the foundation of your annual healthcare budget.

2. Prepare for rising medical needs

As health needs change, so do out-of-pocket costs. Build in room for:

Copays and specialist visits

Deductibles

New prescriptions

Occasional hospital stays

A good rule of thumb is to add a 10–20% annual cushion for changes in your health.

3. Consider enrolling in a Medigap plan sooner rather than later

If you anticipate higher medical usage, a Medigap plan can greatly reduce your long-term out-of-pocket expenses. It’s often easier and more affordable to enroll while you’re still relatively healthy.

4. Plan ahead for prescription costs

Medication needs often increase over time. Choose a Part D plan with strong formulary coverage and set aside funds monthly for changes in medication tiers or new prescriptions.

5. Build a dedicated “Health Emergency Fund”

Setting aside 3–6 months of medical expenses can help cover:

Surgeries

Inpatient stays

Rehabilitation

Unexpected conditions

This prevents surprise medical bills from disrupting your retirement budget.

6. Review your plan every year

Medicare plans update their premiums, drug formularies, and coverage annually. Reviewing your plan during Open Enrollment (Oct 15–Dec 7) ensures your coverage aligns with both your budget and your health needs.

7. Don’t forget long-term care planning

Medicare does not cover long-term custodial care. To prepare, consider:

Long-term care insurance

Hybrid life/LTC plans

Bottom line from Jos Management Inc.:

Budget for your current Medicare cost

Answer: It's not better or worse, it simply depends on what you may have going on. Some clients switch to medicare and a PDP plan aligned with a supplemental policy from MAPD Plans temporarily if they need certain services that their MAPD plan may not cover entirely. After thoes services are received; they switch back to continue their all inclusive MAPD plans. Its all based on the client's needs

Answer: All Healthcare in America is in need of this in my opinion. But understanding your rights and knowing your options along with having a trusted guide such as a Medicare agent can help you navigate the heathcare system as a whole when it comes to your long term experience. No system is perfect. Knowledge and information is always your friend when it comes to staying on top of it.

Answer: Good Signs of a Trustworthy Agent

They take time to understand your health, budget, and doctor preferences.

They explain multiple options — not just one product.

They encourage you to take time to review materials.

They disclose who they’re licensed with and what companies they represent.

They’re transparent about their commission (if you ask).

They provide their license number and contact information in writing.

Ensure that you and your agent have a good dialect so that they know whats important to you. Are they responsive when you reach out? Are they actively advocating between yourself and the insurance companies? Do they seem genuine? These are all things that you want to pay attention to when choosing your Trusted Medicare agent

Answer: What I enjoy most about working with Medicare clients is teaching them about the benefits of their plan and sharing the benefits of how it can be built to fit the individuals needs

Answer: Yes — BREZTRI Aerosphere may be covered under Medicare, but coverage and cost depend on the specific plan.

Key points:

About 87% of Medicare Part D plans list the drug on their formulary.

According to the manufacturer, 81% of Medicare Part D patients pay $50 or less per month for BREZTRI.

Coverage isn’t guaranteed; it depends on the plan’s formulary, tier placement, and whether prior authorization or step therapy applies.

It helps to have an appointed Medicare agent to assist you in comparing plans that would cover any prescriptions and keep you up to date with yearly plan changes and updates

Answer: Your Medicare coverage does not automatically follow you in the same way when you move to a U.S. territory. While you can keep your Medicare Part A (Hospital Insurance), your coverage for Part B (Medical Insurance) and Part D (Prescription Drug Coverage) will be significantly affected, and your access to healthcare will be affected. Providers who accept Medicare will be extremely limited.

1. Contact Medicare Directly: Call 1-800-MEDICARE. They are the definitive source for the most current rules and can tell you about any provider options in your specific destination.

2. Contact Your Plans: Inform your Part D, Medicare Advantage, and/or Medigap plan providers about your move. They will explain the disenrollment process and your eligibility for a Special Enrollment Period.

3. Research Local Healthcare: Before you move, contact the Department of Public Health or the major hospitals in the territory (e.g., Guam Memorial Hospital, Schneider Regional Medical Center in the Virgin Islands) to understand how they handle patients with U.S. Medicare. Ask specific questions about billing and reimbursement.

4. Investigate Local Insurance Options: Look into the local health insurance market in the territory. You will likely need to purchase a local private health insurance policy

For more detailed information, contact us.

Answer: Hello, That's a great question. It depends. There are plan changes that occur each year that may or may not affect the benefits offered in your previous year's plan. It's always good to take a look each year to see where you stand. This way you can be ahead of any surprises in cost or coverages