Tom Kowalczyk, Medicare Insurance Broker

Answer: When I started my agency, my goal was simple: to eliminate the fear and anxiety my clients experience regarding their Medicare and health insurance needs.

By leveraging 20 years of industry experience and knowledge, I am able to make the complex simple for those I serve.

It is truly rewarding to see the gratitude and appreciation my clients express when I share the expertise I have acquired to help them navigate these decisions.

Answer: Medicare can be complex, and it is important not to rush into a decision. I recommend speaking with an independent broker who can educate you on the different options available, as well as the specific benefits and gaps associated with your choices.

Please take the time to stay informed and work with a trusted broker to help guide your decision-making process.

Answer: Brokers are compensated by the insurance company once you enroll in a plan, meaning the advice and services we provide are at no cost to you. The premium you pay remains the same regardless of where you purchase your coverage.

For this reason, I recommend choosing a broker you feel comfortable with and who will provide the level of service you expect.

Answer: Many Seniors are unaware that if you do not enroll in Medicare Part B and Part D during your initial eligibility window, you may be assessed a late enrollment penalty when you sign up later. If assesed a late enrollment penalty, they typically stay with yo for life. These penalties are typically waived if you maintain other qualifying coverage.

You can easily avoid these penalties by speaking with a licensed professional who can guide you through your Medicare enrollment decisions.

Answer: If you are enrolled in a Medicare Advantage (Part C) or a standalone Prescription Drug (Part D) plan, your current benefits, copays, and premiums are valid through the end of the calendar year.

Each year, insurance companies must file their benefits with the Centers for Medicare & Medicaid Services (CMS). These companies often make adjustments based on new laws, regulations, prescription drug pricing, and other factors.

Because of these annual changes, it is important to review your coverage during the Annual Enrollment Period, which runs from October 15th to December 7th. This ensures your plan will continue to meet your needs for the upcoming year.

Answer: The Medicare Part B Deductible is an annual deductible which applies to all Medicare part B services(non Inpatient Hospital services).

Each January it will reset for the new calendar year.

Answer: There an no major changes expected for the Medicare Extra Help program in 2026. Each year Medicare updates the income limits and minimum copay amounts.

For 2026, the expected eligibility requirement for an individual are:

income at or below $1,956/ month and assets at or below $17,600.( limits are higher for married couples)

If approved for Medicare Extra Help you will not pay more than $5.10 for a coverage generic medication or $12.65 for an covered brand medication.

Answer: Medicare Advantage plans are an alternative to having Original Medicare parts A & B as your primary coverage. in 2025 more than half the Medicare eligble population is currently enrolled in a Medicare Advantage plan.

Is a Medicare Advantage plan right for everyone? It depends on each persons unique needs. Speaking with a local licensed broker is a great tool to help you understand all your options.

Answer: You do not need to sign up for Medicare again if you already have both Medicare part A and Medicare part B.

Now that you are turning 65, you are entitled to your second eligibility period which provides you some guaranteed issue rights. This is an important time to review your health and prescription coverage options and make any changes you feel necessary.

Talk with a local independent health insurance broker to understand your situation.

Answer: Most people think they have to sign up for Medicare at 65, but that is not always true. It depends on your situation.

If you have credible health and prescription drug insurance through an employer or spouse's employer, then no. You do not need to sign up for Medicare at that time.

If you do not have credible health and prescription drug insurance then you may face late enrollment penalties, which can last a lifetime.

Work with a local independent agent to help you understand your situation.

Answer: Medicare updates the Medicare Part B Premiums each year. The premiums increase to adjust for inflation and other costs. Some years premiums remain stable others they go up.

Answer: Great question. No you should not show your Red, White and Blue Medicare card if you are enrolled in a Medicare Advantage plan. When you are enrolled in a Medicare Advantage plan, the plan you are enrolled in is financially responsible for your claims. If you show your Medicare card and the provider bills Medicare. Medicare will deny the claim because they will recognize you are enrolled in an Advantage plan and all claims should go to that plan.

Answer: Extra Help, also know as Low Income Subsidy is a program from Social Security that helps eligible individuals with the cost of there Medications. It works with any Medicare Prescription drug plan( stand alone plans and Medicare Advantage plans with Prescription Drug coverage). To qualify in 2025 your income must be below $1,903 a month and you must have less than $9.660 in countable assets.

If you qualify you will not pay more than $4.90 for any covered Generic medication or $12.15 for any covered Brand medication. The Extra Help program will cover all cost above these copays. In addition the Extra Help program may cover a portion of your plans monthly premium.

Answer: The initial enrollment period for Medicare is typically a 7 month window.

You can enroll in Medicare starting three months before the month you turn 65, the month you turn 65 and up to 3 months after the month you turn 65.

Answer: The short answer is you did not make a mistake.

The choice between choosing a Medicare Advantage plan or a Medigap(aka Medicare Supplement policy) is a personal choice based on ones health personal needs and preferences.

Over time many individuals needs or situation may change and your choice for your insurance coverage may change as well. There are opportunities to review your coverage and needs to see if a different plan or program would work best for you.

Contact an independent broker for a no obligation benefits review.

Answer: It depends. If you are eligible for Medicare and you have other health insurance from a spouse or retiree coverage from an employer and the coverage is considered creditable coverage, you may not need to do anything.

Individuals who do not have spousal coverage or retiree benefits will need to enroll in Medicare parts A and B. Then evaluate your health insurance needs and decide if you would like to add additional coverage to cover things Medicare does not.

I recommend talking with a local health insurance broker to learn about your options and determine what works best for you.

Answer: Medicare will automatically enroll you in Medicare Part A and and send you your Red, White and Blue Medicare card about 3 months before the month you turn 65. Your Medicare Card will have both Medicare Part A and Medicare Part B on it.

You will have the option to decline Medicare Part B if you have other credible health coverage(ex. from a spouses employer). If you do nothing, Medicare will begin deducting the Medicare Part B premiums from your social security or disability income.