Todd Bostic, Medicare Insurance Broker

Answer: You will probably be penalized, depending on if you have had it before. You can also get it waived if you have Medicaid or a Low Income Subsidy.

Answer: Depending on which plan or company you are with, it is quite possible you can keep your same doctor. In some cases, you may have to pay more for their services, but you should be able to keep seeing them.

Answer: You have to keep drug coverage while you have Medicare coverage. If you don’t, you will be charged an IRMAA surcharge.

Answer: I would choose benefits over reputation every time, some times reputation can cost more and better benefits do more for you than better reputation.

Answer: What it means for Seniors is that you have a maximum per year that you will have to pay for medicine and when you have high medication, it can mean that you are not paying as much there.

Answer: The cost for Medicare is typically around $200 for each person however it goes up each year. You can get a discount if you’re on Medicaid or you have a Medicare reduction plan with a Medicare advantage plan but typically is the same price for everybody.

Answer: Yes insulin is guaranteed not to cost more than $35 for a one month supply, as long as it’s on the formulary. Not all insulin’s are covered by every plan. You should double check to make sure your medication is covered by your insurance during AEP every year so you don’t have the issue you are going through now.

Answer: The simple answer that is yes, however, you would have to pass underwriting and if you’ve got been diagnosed with a serious illness, then you probably wouldn’t pass underwriting so if you’re gonna change to a supplement, you need to do that before you are diagnosed with an illness.

Answer: Well, if you wanted to get a Medicare supplement, I would recommend a plan G. But the most cost-effective way is a Medicare advantage. However, considering you want to go with a cost-effective if you were to go with a Medicare supplement, I would probably recommend a plan in if you went with a supplement, however you would still need a part D for your prescriptions. So it would just depend on which direction you really wanted to go and the reason I would recommend a plan G is because you might would need to go through underwriting if you would need to wait lighter to get a lower cost supplement.

Answer: There are more than a couple of reasons. One, that particular company may just simply cost more than the other companies if they only offer one plan or two if they do offer more than one plan that particular plan that cost more could be a plan that would charge less for prescriptions, and the plan cost less would either cover less prescriptions or charge more for certain prescriptions. There’s no simple explanation for the reasoning for the cost of heart D there are numerous explanations.

Answer: Because Medicare plans are different from county to county I would recommend looking into it. Some companies are not available in some counties but the next county over, they are.

Answer: You must report your IRMAA anytime you have any earned income and you are on Social Security. Typically if you are above a certain age, you don’t have to, but if you are under 70, you do need to.

Answer: Typically people want to go with the plan that is least expensive, and if they do that, you are losing benefits somewhere.

Answer: What that is is typically you have a maximum of up to so many each benefit period. If you go over that, you reach into your reserve days. Once you use those, you have to pay a percentage of your hospital stay. Most people don’t use their reserve days unless they have a catastrophic event.

Answer: You can’t pick a plan based on cost. Most Medicare Advantage plans are $0 or close to it. When deciding which one to pick, you need to determine based on the benefits, not the cost. If it cost a little more every month and you see a specialist pretty often, you need a plan with lower specialist copays.

Answer: If you have a Medicare Advantage plan, you need to notify the company within 30 days, and if you have original Medicare, you need to notify them because your premiums could go up or down.

Answer: I would not say one is better than the other, but I Medicare Advantage is more of a pay as you go versus pay in advance. Some people feel you get better benefits with original Medicare rather than a Medicare Advantage plan, but you have to pay for a prescription drug plan and vision, dental, and hearing benefits, while an Advantage plan usually offers all 3 of them.

Answer: A broker is someone that offers service for more than one company, and an agent is someone that offers services for just one company.

Answer: I enjoy helping people that need my help and not trying to take advantage of someone. There are some insurances that it feels like I am taking advantage of someone just talking to them.

Answer: Well, the cost of living increase will cause your social security check obviously to go up, but it isn’t by at least $25, and you pay your part B premium, then you will not see an increase in your check, it is going from $185 to over $210 a month.

Answer: Some independent agents get paid more for Medicare Advantage plans than they do Medicare Supplement plans so they prefer getting paid instead of helping people. I on the other hand, want to help people get what they need, not just what is going to pay me the most money.

Answer: By law, Medicare must have insurance equivalent to the same or better coverage that you had with your employer.

Answer: Depending on the plan that you choose, some plans do cover acupuncture and/or alternative therapy. You simply need to verify through the Summary of Benefits.

Answer: Your plan N only has a copayment for doctors appointments and Emergency Room visits, according to the Summary of Benefits.

Answer: Check the Summary of Benefits and if they match up with the advertised benefits, that is what the company MUST honor.

Answer: You should check your benefits every year to make sure that you are getting the most benefits that you need, and you are getting what you want. If you are not, shop around and see what is available.

Answer: It depends on if you have a Medicare Advantage or Medicare Supplement plan. If you have a Medicare Advantage plan, you just need to budget for cost of living increases and possibly decrease in your health. However, if you have a Medicare Supplement, you need to budget for increases in premiums due to age increases, and that is it.

Answer: By law, you can’t back date it, but you do have what is called Special enrollment periods you might be eligible for to allow you to start the next month

Answer: Everyone is required to pay for the part B benefits every month it will normally come out of their Social Security check. With that said I’m assuming that you can have it automatically taken out of your Social Security check every month.

Answer: It really depends on what kind of plan you are wanting to enroll into. If you are wanting to enroll into a Medicare Advantage plan, you can enroll 3 months before, the month of, and three months after you turn 65. If you are wanting to enroll in a Prescription Drug Plan, same thing. However, if you are looking into a Medicare Supplement, you can enroll up to 6 months in advance.

Answer: Yes, Medicare Advantage and Original Medicare both cover Home Health Care. Many people look at Medicare Advantage plans as nothing more than a scam, but if you are frugal and trying to save money, just look at it like a prepaid plan versus a post paid plan or like cell phones. Prepaid phones can be original Medicare and pay as you go can be Advantage plans.

Answer: Determine if you want to pay a monthly premium for your health insurance, then decide if you want a Medicare Advantage plan or Medicare Supplement plan. A Supplement Plan will have more comprehensive coverage, but you don’t get dental, vision, and hearing coverage. You also have to pay for your prescription drug coverage, instead of it being included.

Answer: A Medicare advantage plan has a maximum amount of pocket a Medicare supplement buying doesn’t have a maximum out of pocket.

Answer: It could be very hard because you’ll have to pay 20% of the cost of the medical expenses because Medicare only pays 80% and with a Medigad plan, that would cover the extra expenses.

Answer: The biggest problem with a PPO is cost for seeing a doctor out of network cost. What I mean is that cost is more expensive than in network cost more than in network cost and your benefits would be less than HMO.

Answer: You only need part B once you finish working. You can delay Part B as long as you would like and you are not penalized for not having Medicare in the interim.

Answer: In 2025, there is no longer a donut hole. You don’t have to worry about that anymore. Medicare wants to make prescriptions more affordable.

Answer: Yes, if you don’t take certain knock out medications and this is your first Medicare Supplement plan, yes you should qualify for Guaranteed Issue with no problem. Thank you

Answer: On your 65th birthday, it no, your disability doesn’t go until death, once you turn 65, your disability will change to regular social security benefits and you can enroll in a Medicare Supplement or Medigap starting 6 months before your 65th birthday.

Answer: You don’t need to sign up for Medicare again because you will automatically be enrolled into Medicare again

Answer: With Medicare Advantage plans, the payment doctors get is limited, but some doctors don’t mind because they feel like they will get more patients and make more money, but with Medicare Supplements, they can actually charge a little higher, up to 15% higher and still get paid, but some people feel like they just want to be paid by the customers so they can charge whatever they want.

Answer: If you are disabled and unable to work anymore, you have to be on disability for 24 months and then you get Medicare, but if it is something you will heal from, then no.

Answer: Not enrolling in part D after they enroll in Part B, but if you have a Medicare Advantage plan, you are automatically covered.

Answer: It keeps you from getting penalized by the government each month because you don’t have drug coverage. However, if you take medication, it helps lower the cost of medication.

Answer: I tell each person that they should make their own decision, because it depends on their health usually. If you are sick and have a Medicare Supplement, keep it, but if you are healthy, you are wasting money on a supplement, but some day you may need one, so it’s really what you can afford.

Answer: One thing people don’t think about when they turn 65, is that they have to either get a drug plan with their Medicare Supplement, or they have to get an Advantage Plan, that usually doesn’t cost them anything.

Answer: Once you turn 65, even though you have been on disability, you are eligible for all Social Security benefits as if you had never been on it before. It’s up to you if you want to stay on a Medicare Advantage plan or switch to a Medicare Supplement plan. Just remember that if you switch, it comes with a cost for the plan, and you have to get a drug plan as well if you switch.

Answer: Typically unless it’s part of a skilled nursing or hospice care plan, it doesn’t cover 24/7 of the cost for in-home care for dementia patients who wander or need supervision.

Answer: There is nothing that can be done for you about that, however if you are in good health, it really doesn’t matter.

Answer: You would pay the $1676 first each year, because it’s your deductible, then for days 1-7 of your hospital stay as long as they were consecutive. If you leave the hospital and come back, the hospital stays start over, and the deductible starts over every year.

Answer: All wellness visits are covered whether HMO or PPO, that is a Medicare requirement. So it really doesn’t matter what type of plan you have to get a wellness visit covered.

Answer: Yes, each plan can offer different benefits for different regions. But depending on whether it’s a PPO or HMO, it can offer different benefits.

Answer: Check to see if it offers Travel benefits. A PPO typically can be used anywhere in the country, but an HMO has to offer travel benefits to be used outside of the state.

Answer: You should check to make sure the agent you are working with has no complaints against them by getting their NPN number and you can look up all of their information online. You can check with the State Department of Insurance to double check information.

Answer: That is why you should make sure that your agent double checks all of your meds to make sure they are covered before switching.

Answer: That is when you can switch one time in your life and use what is called a trial right to try out a MAPD if your Medigap gets canceled, or if you are in an open enrollment period or have a special enrollment period.

Answer: Travel expenses such as being able to get a ride to and from the doctor or pharmacy, depending on the plan.

Answer: Unfortunately, when you turn 65, the amount of Medicare mail you receive doesn’t change until the day you die, and even then, it takes a few years to stop.

Answer: There are Chronic care plans specifically designed for people with diabetes so you can save money on diabetic medications.

Answer: With a Medigap you are basically prepaying for your expenses, so when you go to the hospital or doctor or even have lab work, that will not cost you anything. However, with a Medicare Advantage, if you travel and have an emergency, it is covered, no matter where you are, you just have to pay for some of your copayments and it might be worth the savings.

Answer: Every year Medicare changes so much that it is hard to be certain that you can get peace of mind with Medicare.

Answer: I can’t guarantee it, but more than likely, most Medicare Advantage will not cover 100% of eye surgery you will probably have a copay to go with it.

Answer: IRMAA is income related monthly adjusted amount, and that is if you work or have a retirement plan that is substantial. Most people don’t hit that number and it gets higher every year. You can get with your insurance agent to discuss more about how it works with you individually.

Answer: Because with a Medicare Advantage plan you have copays for all of your procedures with the exception of probably seeing your primary care doctor and with original Medicare, when you get a Medigap plan, you don’t pay anything other than your monthly premium.

Answer: Some Seniors are losing their Medicare Advantage plans because the plan is leaving the county or state that they live in. When the company leaves the county or state and you lose your plan, you are allowed to get a new plan of your choice just like you would during an open enrollment period. Just speak to your agent to find out more about getting a new plan.

Answer: The simple answer to that question is No. You need to answer all medical questions before enrolling.

Answer: Federal law requires that each person have part D coverage in case they need medicine You automatically are enrolled in Part A, and if you have worked enough quarters, you qualify for Part B. Once you qualify for Part B, that qualifies you for Part D as well. My opinion is to verify the plan is the right one for you.

Answer: Actually you can postpone Medicare until you are ready for it to begin. To get full benefits, you have to wait until you are 70 anyway.

Answer: You can purchase dental and vision coverage from through a private plan or through most Medicare Advantage plans that offer one or both.

Answer: Beginning in 2025 the donut hole is now gone. However, you can pay out the cost of expensive medication over the course of the remainder of the calendar year.

Answer: I will not say there is a BEST company because it all depends on a customer’s needs. What might be good for one person, may not be good for another.

Answer: Extra help is for people that are on a low income or receiving assistance from the state. Sometimes it’s only based on your income because even though your income is low, it’s not low enough for extra help for food, but it can be extra help for medicine.

Answer: October 1 you might start hearing from your current agent, but you can’t start enrolling until October 15.

Answer: In an emergency, your Medicare Advantage would work when you first got there, but you would have to see if there is any other option available to you when you got there because typically most plans will not move to a territory.

Answer: I wish they knew to be careful about who you talk to on the phone, telephone agents are going to try to convince you that they have the best thing since sliced bread and all you have to do is take the plan.

Answer: Original Medicare only pays 80% of your costs for Hospital and Doctors unless you have a Medigap plan. It doesn’t have any benefits like Dental, Vision, or Hearing either, you have to purchase that along with a prescription drug plan. MAPD plans have all of that included, but you have a copay for most services in most plans. Basically a Medigap plan is like a prepaid plan that gives you gold treatment. A MAPD plan is pay as you go. If you don’t use it you don’t spend much if anything.

Answer: To be totally honest and transparent, I’m not a fan of it. Companies have found a loophole that allows them attack seniors in a way that I don’t agree with.

Answer: You will just enroll in Medicare when you turn 70, and you will not be penalized for the delay. Waiting to enroll in Medicare is not uncommon.

Answer: You just need to notify 1-800-Medicare that you want to delay your enrollment, otherwise you will be penalized.

Answer: Get their NPN#. Once you get their license number check, for example in Texas you could check the Texas department of insurance to verify that their license is in good standing.

Answer: I would do some research and see if your plan is making changes you can’t live with, if they are leaving your area or dropping your doctor, definitely change, but all of the cosmetic changes are just personal preference.

Answer: The best advice is to compare the work insurance versus the Medicare coverage you are wanting to get, but from my experience, typically you will get more benefits from your work insurance.

Answer: There are 2 types of Special Needs Plans, or SNPS for short there is the Critical Care Special Needs Plan, or CSNP, and there is the Dual Special Needs Plan, or DSNP.

The CSNP is typically for people that have a critical illness like diabetes, or heart problems or on dialysis. Not all people with those conditions qualify and some plans have other conditions that allow people to qualify. In some cases it comes with a small monthly food allowance and specialist are usually less than typical MAPD plans.

The DSNP is for people that have both Medicare and Medicaid. DSNP plans have many benefits including a food card in most cases. Depending on the level of Medicaid a person is on, drugs, doctors, hospital visits, and many other benefits can be quite lucrative. However even if you have a low level of Medicaid, you can get a monthly food card.

Answer: People new to Medicare sometimes aren't aware that they can only enroll at certain times of the year and you must enroll in a plan that would be beneficial to them during their initial enrollment and they are Guaranteed to get into a Medicare Supplement if they want, where someone thinking about switching has to go through underwriting if they are currently on a Medicare Advantage plan and want to get a Medicare Supplement. I believe the more education you have the better it is for you.

Answer: Sometimes agents can find another special enrollment if you miss the open enrollment. You can talk to the agent about what you might be eligible for.

Answer: If you call an insurance carrier directly, they will only recommend one of their products for you, and try to keep you on what you have, a broker usually has more than one carrier and can give you multiple options.

Answer: You can contact CMS, and you would not get in any trouble as a matter of fact, it would actually be helpful if you did.

Answer: With an HMO, you are limited to in network doctors, but the cost is usually less, however, specialists usually require a referral from your primary care doctor. A PPO will give you more flexibility and is more like a Medicare Supplement when it comes to which doctors you can see. The downside to a PPO is that they usually have less benefits and the costs are usually higher for doctors, hospitals, and labs. But you also, in most cases, get less benefits because you are allowed to see more doctors.

Answer: One of the most common misconceptions about Medicare is that the only way you can get Medicare is if you are 65. People that have been on disability for 2 or more years can get Medicare as well.

Answer: Sometimes, agents will switch you to benefit themselves, so you need to make sure that if you switch, it will benefit YOU to. Open enrollment is usually the last time before the Annual enrollment period that you will be able to change plans unless you move or have a special election period. Make sure everything is right for you when you switch and you aren't switching just to get some benefits like some extra dental or vision if you need to see a specialist.

Answer: They don't make sure all of their medications are covered, they say they only take 1 or 2 medications, and then the agent signs them up for an inexpensive plan that doesn't cover all of their medicines. The Agent needs to verify all of the seniors medicines are covered at the least expensive cost for them, and then when you add the meds, the agent should still be able to tell you the most cost effective plan available to you over the course of a year, not just a month.

Answer: Medicare Advantage does have some coverage for hearing aids, and you can also buy additional coverage for hearing aids if you want it.

Answer: First thing I do is I sit down and talk to them and ask them if they have any questions that I can answer and help them with. I want to ease their mind so they aren't confused about anything going forward.

Answer: There are some Medicare Advantage plans that offer international coverage in case of emergency. I would double check with your agent to make sure you have the plan you are needing to get the coverage you are wanting.

Answer: If she switches to a PPO, she will be able to keep her doctors, but an HMO, she will need to double check to make sure that the plan accepts her doctors. Not all HMO's accept every doctor. My advice is to double check with the doctor to make sure that they accept the plan.

Answer: I believe working with an agent close to you allows you the opportunity to be able to sit down face to face with an agent, instead of having to decide based on a conversation. But based on which is better, there’s really not a a reason other than trust to pick one over the other.

Answer: Medicare Advantage plans do have a copay for emergency transportation. You will receive a bill for whatever the companies plan cost are if you have to use an ambulance, whether air or ground.

Answer: You can change you Medicare Coverage between October 15 and December 7 every year as many times as you want, and whichever plan you are on December 7 is the plan you have beginning January 1 for the following year. The first time you switch to a Medicare Advantage plan you have options if you are switching from a Supplement. You have what is called a "Trial Right" You have 12 months to switch back to the same plan you were previously on and you don't have to go through underwriting. If you wait longer than 12 months, you have to go through underwriting.

Answer: There are some generic medications that do cost more, but not many, and with the 2025 changes, it has affected the cost of prescriptions this year.

Answer: I don't recommend one over the other, what I do is give my clients both options, and let them make the decision for their self so it's an informed decision and they know I didn't force them into a decision.

Answer: If you move to a rural area, you would be eligible to change plans for 2 months. You can call any broker, and let them know you just moved to the area, and they will help you find a plan that will meet your needs.

Answer: Your plan probably does cover knee replacement, but it also requires your insurance to approve it first. So, simple answer is "yes" it will be covered, but they want to ok it first. There might be an extenuating circumstance that would prevent them from covering it.

Answer: Every year there is what is called an Annual Enrollment Period (AEP), and if you missed that, there is an Open Enrollment Period (OEP). There are other enrollment periods available if you move, or if you lose coverage, or other times, but those are the 2 main ones.

Answer: You get to talk to a person face to face, and you can see their honesty. I have been in telesales, and was NOT happy doing it. I feel like I couldn't show my honesty because I couldn't sit down next to you.

Answer: The difference in a Medicare Advantage Plan and a Medicare Supplement or Medigap plan is simply that you pay a premium every month for the Medigap plan, and you also have to purchase a drug plan, and if you want a dental, vision or hearing plan, you have to purchase that. With a Medicare Advantage plan, it typically comes with a drug plan in most cases, and a lot of times, it comes with a dental hearing and a vision plan. Sometimes it comes with an Over the counter benefit or transportation benefit.

Usually, in most cases the cost of the plan itself is very low, but the visits to doctors, labs, and hospitals all have a copay for Medicare Advantage, but a Medicare Supplement is all included. A lot of people that have a Medicare Supplement have one for security, so the debate on which is better between the two is up in the air. I will suggest the one you can afford, or the one I feel like you need, not the one that will make me the most money.

My Client is more important to me.

Answer: A couple of the changes that may be helpful is that the "Donut Hole" as it was commonly referred to, is eliminated. That should lower some higher cost medications, but if you are still having trouble with your medications being higher, you can pay them out over the course of the rest of the year now. Basically, if you get a medication in June, you can pay it out for the rest of the year, and it doesn't matter when you get it, you can pay it out over the rest of the year.

Answer: That would be the "Donut Hole" as most people refer to it. I was on Medicare for 17 years, and I would ultimately hit it every year around August, but I noticed that it started to get earlier and earlier every year. However, starting in 2025, it was eliminated, and there isn't a "Donut Hole" anymore.

Answer: Sometimes it just depends on the person, their age, and their health. If a person is young goes to the doctor a lot, get one at 65. I would also say it depends on finances, because you can also get an Medicare Advantage that doesn't cost anything and get an Indemnity plan to go with it to cover your expenses should you have any like hospital, ambulance, and there are some that cover doctors. But it all depends on your finances if you are not healthy.

Answer: My main reason for liking being a Medicare agent is, I was on Medicare, and if I can help someone on it that needs more benefits than what they currently have, that is a bonus to everyone, but I do not like anyone being told that they will get a $3000 food card if they are not eligible for it. I left a previous company because I was expected to tell people I could get them benefits that would be worth more than the $3000 food card, but I wouldn't deceive a person, so I left the company rather than lie.