Vincent Murray, Medicare Insurance Agent
About Me
Hello fellow Mainer, I'm VINCENT, a Licensed Medicare insurance agent for over 10 years, dedicated to serving central and northern Maine. As an Independent Medicare agent I am able to search the best Medicare plans for you based on what you want and need.
There are a lot of changes in the plans for 2026. You have 6 plans to choose from and as an independent agency I can help with any of these plans. Medicare is my area of expertise, and I'm committed to helping you pinpoint the most suitable plan for your individual needs and budget. I'll handle the research and comparison of plans from top national and local companies, so you can relax. Plus, my assistance comes at absolutely no cost to you.
Reach out to me today to discuss your Medicare insurance possibilities, and remember to mention you found me through Medicare Agents Hub!
Directions to My Office
My Google Reviews
43 Total Reviews (5.0 )
July 8, 2026
Vincent explained everything in easy to understand language and was very helpful in helping to decide what was best for me. i highly recommend him for your medicare decisions.
July 4, 2026
Vincent provided excellent service and made the entire health insurance process simple and stress-free. He took the time to explain all my options and helped me find the best coverage for my needs. Highly recommended.
May 27, 2026
May 16, 2026
Vincent was very helpful. He guided us through the M'care maze for my son on disability, then when WE made the choice that was the best for us he handled all the paperwork to get us enrolled ASAP. (Posted for my daughter, A Springer)
May 11, 2026
Vince is an excellent guide in a stressful transition. I am lucky to have found him.
Articles by Vincent Murray
Q&A with Vincent Murray
Answer:
Call a local Independent Medicare agent and have a two-way discussion.
- For some people I would recommend exactly that.
- For other people I would recommend exactly not that.
If you have been paying for a supplement for 10 or 15 years, now is probably not the time to switch. Now is when you will be more likely to have larger bills. Switching to a Medicare Advantage plan now may not be the best idea.
If, however, you are just beginning Medicare, I would recommend a Medicare Advantage plan for Zero dollars, a hospital umbrella policy, and a cancer, heart attack and stroke policy. Looking through a Medicare Advantage's co-pays, those would be the areas of greater risk.
By choosing to protect yourself in case of Cancer or a Heart Attack umbrella package would make the most sense for most people.
Answer: When you say fully covered, what do you mean? Free, no. Covered, yes. Mental health services are covered under both Original Medicare and Medicare insurance plans. With Original Medicare, you would pay 20% after your Part A deductible of $1,736, if applicable, and after your $288 Part B deductible. For Medicare Advantage plans, you would have a copay for the therapy session, and there usually isn't a medical deductible. To recap, covered yes, free no.
Answer:
Maybe.
If you have Medicaid and a DSNP plan, in the state of Maine, you may be able to get these benefits. New rules for 2026 require a chronic health condition to be able to use your card allowance for groceries. Your doctor and your insurance company figure that out on the back end based on your medications, health history and the insurance company's policies and adherence. If in doubt, call me; we will figure it out together.
Answer:
There’s ongoing political debate about expanding the role of private insurers in Medicare, but a complete privatization of Medicare is unlikely in the near term without major legislation and enormous political resistance.
Right now, Medicare already operates as a hybrid system:
Original Medicare is government-administered.
Medicare Advantage plans are run by private insurers but funded by Medicare.
Part D prescription coverage is privately administered.
Private involvement has grown substantially over the past two decades. More than half of Medicare beneficiaries are now enrolled in Medicare Advantage plans rather than traditional Medicare.
The debate usually centers on:
whether Medicare Advantage should continue expanding,
whether traditional Medicare should remain equally available,
and how to control long-term costs as the population ages.
Supporters of more privatization argue:
competition can improve efficiency,
plans may offer extra benefits,
coordinated care models can reduce waste.
Answer:
Maybe, selecting a zero-dollar plan may not be the best. Also, selecting a plan that is $55 a month doesn't make it better. Find a local Medicare agent to assist you. Look through your summary of benefits as well as have them compare other plans available in your area.
- Star rating
- Dental
- Vision
- Hearing
- Gym memberships
- Over-the-counter cards.
Let's be honest, though... I believe for the next 2 to 3 years, extra benefits aren't going to be an option, so look at your copays.
- Max out-of-pocket
- Inpatient hospital stay
- Surgery copay or coinsurance, big difference.
- MRI's and CT scans
Go over all of these in a one-on-one meeting with your LOCAL representative. Make sure to find one that does annual reviews each year. There shouldn't be any surprises.
Answer: Why would you be in trouble? If something is suspicious, talk to your local agent. We direct you to the appeals or grievances protocols set up by your Medicare Advantage plan. We all want happy beneficiaries, we strive to help you figure things out, and don't be afraid of getting in trouble, silly.
Answer:
Medicare insurance companies bombard seniors with confusing mail and TV ads, which are the major insurance FMOs. What is worse is the illegal telemarketing calls you get. We recommend finding a local Medicare specialist who represents many different carriers and can give you clear, unbiased advice based on the plans available in your area.
Mail you can throw away if it doesn't come from Social Security, or your insurance plan, or communication from your local independent agent... throw it away. If in doubt, call me. I can listen to your recap of the advertisement and direct you to throw it away.
Now, how to stop them from calling you??? I only wish I knew.
Answer:
Yes, cataract surgeries are covered by Medicare as long as it is medically necessary. This would be an outpatient surgery. Even though Dental, Vision and hearing aren't included with Original Medicare, if you have a Medicare Advantage plan, this would fall under surgery, and you would pay your copay.
If you have a Medigap plan, this would also be a surgery, and that would be paid for after deductibles for Plan G and your deductibles and copayments for Plan N.
Answer:
If you’re in a cancer clinical trial involving personalized or genetic-profile-based treatment, Medicare will often cover a significant portion of the “routine patient care costs” — but not always the experimental treatment itself.
standard cancer care you’d receive even outside the trial
This applies to many oncology trials, including precision medicine and genomic-guided therapies.
What Medicare Usually Does Not Cover
Medicare typically does not pay for: the experimental drug/device itself (unless otherwise covered), tests done only for research purposes, extra monitoring required solely by the study, items the sponsor provides free, purely investigating genetic testing not considered medically necessary.
Often, the trial sponsor (drug company, university, or cancer center) pays those costs.
Answer:
Experience. What I have experienced is how to help you best is by giving you the choices available. This may seem obvious, but isn't. The safest option is to go with a Medigap plan, but those are expensive. The least expensive way is a Medicare Advantage plan, maybe... and for most people. We never recommend a Medicare Advantage plan without an umbrella package. What is an umbrella package? These protect you when it rains.
Why do we have insurance? In case something big happens. Most of the copays on a Medicare Advantage plan are fairly reasonable. The two biggest costs are usually overnight stays in the hospital and chemotherapy drugs.
We have umbrellas for both.
This is what experience gives you, choices. A) supplement, B) Medicare plan with an umbrella, or C) just a Medicare plan and take your chances. It is our job to show you how to protect yourself and then let you choose.
Medicare plans can be gotten through a telemarketer who doesn't know Maine or through a new Medicare agent who is afraid to tell you some of the downsides to Medicare Advantage.
Present, advise and give you the choices you need is how an experienced Medicare agent will help you best.
Answer: We go over the changes every year in our annual review. Alternatively, you get an annual notice of change every year from your current Medicare plan. Simple: call me and ask; I am happy to go over the changes every year in our annual review.
Answer: With Original Medicare, no. With a Medicare Supplement, no. With a Medicare Advantage plan, usually, how much depends on the plan. This is what we help you with when we meet; we find out what benefits you want and/or need. In 2026, these benefits are being reduced or eliminated. We can help you with Northeast Delta Dental if we can't find a plan with sufficient benefits in your area.
Answer:
You paid into it your whole life. Problem is, we have raised children that aren't repopulating for various reasons. Hopefully, we can elect representatives who can fix this in the next 8 years. Otherwise.
Medicare's hospital insurance fund is projected to run out of money in 2033, but even then, it is expected to cover about 89% of benefits. Therefore, while there may be reductions, Medicare will not completely stop providing benefits.
Answer:
Plans change every year. If this was the case when you signed up, then the agent didn't inform you well. If it changed after you signed up, it is important to do an annual review with your Medicare agent to stay informed.
Some plans do include comprehensive dental, although they all used to. If it is important to you, we recommend Delta Dental as a separate policy.
Answer: If you're on a tight budget, I recommend finding a Medicare Advantage plan with the lowest maximum out-of-pocket possible. Then get an umbrella package that covers 2 to 3 years of that maximum out-of-pocket. Most years, you should save money. If you have a bad year, you would have the umbrella package to help you out. Paying for a plan that only covers half of your costs is not recommended, especially if you're on a budget.
Answer: Yes, Medicare Part B covers a range of outpatient mental health services, including therapy sessions that can help you manage stress and burnout as a caregiver. You may also be eligible for a yearly depression screening to assess your mental health.
Answer:
Do not answer illegal telemarketing calls... PLEASE. IF you do, you are rewarding them for illegal behavior. Please stop it. Contact a local Medicare expert and get actual help.
A Scope of Appointment (SOA) is a required form that you must sign before discussing Medicare Advantage or Part D plans with an agent, ensuring transparency about what will be covered in the meeting. This practice is normal and applies to all agents, including those in call centers, which must also obtain a signed SOA before discussing these plans.
Answer:
Medicare Part B covers most medically necessary blood tests and other diagnostic tests. To qualify, a person’s doctor must write an order for the test.
If an individual is admitted to a hospital as an inpatient, Medicare Part A will cover the costs of blood work.
Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare. Private insurers administer Medicare Advantage plans, and the plans comprise Parts A and B benefits and often also include prescription drug coverage and additional benefits like optical or dental care.
Like Parts A and B, Medicare Advantage plans cover the costs of blood work and other tests.
Answer: I don't recommend these. Either do an actual supplement and pay the $270 per month, or do a Medicare Advantage plan with an umbrella package for cancer, heart attack and stroke. A high-deductible supplement plan is the worst for both. If you are under 65 and not on Medicare, it might make sense.
Answer:
Not really. You still have a choice. If you are more comfortable with a Supplement, do that. It's around $270 per month whether you need it or not and gives you the peace of mind.
Medicare Advantage plans have a maximum out-of-pocket that protects you.
As long as your Medicare advocate informs you how to protect yourself with a Cancer, Heart Attack and Stroke policy, you can be very well protected and save over half of the cost. If you get a $25000 cancer diagnosis and separate $25000 heart attack and stroke umbrella package.
You would still save about $150 per month compared to a supplement. Lesser policy amounts are available.
Answer: No, if you choose a Medicare supplement, it becomes your primary insurance and Medicare is your secondary. Same goes for a Medicare Advantage Part C and D plan.
Answer:
The worst mistake is just having Medicare A and B.
- No maximum out of pocket.
- $1600 deductible for Part A.
- 20% coinsurance, higher than most copays.
- Zero dental, vision, hearing.
- Separate PDP with higher cost share.
Answer: I love helping seniors save money and solve problems. Over the past 10 years, I was able to help people increase benefits and reduce premiums. Now that plans are tightening their benefits and increasing their prices, it is equally enjoyable helping seniors navigate the changes and finding the best options available. I wish the benefits were still going up; however, having someone like me explain the changes is helpful to all Medicare beneficiaries.
Answer: On an HMO, your doctor simply fills out a prior authorization; it is easy. Your doctor does it, not you. If this bothers you, simply choose a PPO plan in your area to avoid this issue.
Answer: Yes, unless you have creditable coverage through your employer or somewhere else. You have 3 months after your 65th birthday before late enrollment penalties begin. The penalties can increase your monthly premiums for as long as you are enrolled in Medicare.
Answer: Plans have a star rating from 1-5 stars. The higher the star rating, the higher the satisfaction. Most Medicare plans aren't sold out of a van at 7-Eleven. LOL You have a summary of benefits, and that is what you pay. No more. It is a written contract.
Answer: For 2026, it is $2100. It is important to you if you have expensive prescriptions; after $2100, your prescriptions are zero cost. It is important if you don't that you now know why the deductible and copays are higher. Insurance companies lose money on the former and make up some of the costs by raising deductibles, copays and tier levels.
Answer:
Talk to your Medicare advocate about applying for Extra help from your state.
Full Medicaid dual eligible and QMBY pay premiums, copays and coinsurance. DEL pays for Part B premium and reduced prescriptions; most PDP premiums under $36.
Answer: You would normally get the higher of the two. Not both. If and when this happens, you should call your Medicare advocate to see if you qualify for Medicaid.
Answer: Ask your Medicare advocate for a summary of benefits and an evidence of coverage. With most plans, lab tests are either free or fairly inexpensive.
Answer: You could always compare a discount program to the co-pay for your PDP. However, any prescription not put through the insurance company does not count towards the $2,100 maximum for prescriptions in 2026.
Answer:
No. This is not true. Medicare only pays for visits while you're alive. Ask a silly question, get a silly answer is what my Grandmother told me when I asked how old she was.
But seriously, what we recommend for the living if you have a Medicare Advantage plan is to always get an umbrella plan that covers cancer, heart attack and stroke.
For life insurance, we always recommend Whole life Policies, as term life policies expire at age 75 or 80.
Answer: IRMAA does not go away automatically if your income drops; you need to report the change to Social Security to have it adjusted. If you experience a significant income reduction, you can file an appeal to request a lower IRMAA based on your current financial situation.
Answer:
You must be making more money than your husband did. As you can see, if you both made the same, it would be the same amount.
Standard Single: <= $106,000
Married Filing Jointly: <= $212,000
$206.50
1.4x Standard Single: <= $133,000
Married Filing Jointly: <= $266,000
$289.10
2.0x Standard Single: <= $167,000
Married Filing Jointly: <= $334,000
$213 and so on.
Answer:
Older Americans Become Majority
The number of Americans aged 65 and over grew 38.6% between 2010 and 2020, reaching 55.8 million people. This group will reach 82 million by 2050, when nearly one in four Americans will be of retirement age.
By 2034, the U.S. will reach a historic milestone: for the first time, adults aged 65 and over will outnumber children under 18. This demographic crossover represents a permanent shift in America’s age structure with profound implications for the economy and social programs.
Baby Boomers Drive the Crisis
The primary force behind this demographic shift is the aging of the Baby Boomer generation. This massive cohort of 73 million people born between 1946 and 1964 began turning 65 in 2011 and is now moving fully into retirement.
By 2030, all Baby Boomers will be 65 or older, expanding the older population to the point where one in every five Americans will be of retirement age. This surge creates an unprecedented demand for Social Security and Medicare benefits.
Answer: No agent should push anything. It is your choice. I would recommend a supplement or a Medicare Advantage plan. If you do an Advantage plan, we never recommend one without umbrella coverage for Cancer, Heart Attack, or Stroke. We have insurance to protect us, both a supplement and a MAPD, with an umbrella could protect you. Again... your choice.
Answer:
Call me. We look up your medications, and the website shows us the lowest-priced plans based on premiums and copays. Drugs are Tier 1 - preferred generic, Tier 2 - generic, Tier 3 - preferred brand, Tier 4 - brand, Tier 5 - specialty, and Tier 6.
Most plans have a deductible for tiers 3-5. We do this for you.
Answer: Individuals under 65 can qualify for Medicare if you have received Social Security disability benefits for 24 months, have End-Stage Renal Disease (ESRD), or have Amyotrophic Lateral Sclerosis (ALS).
Answer:
You automatically get Part A as long as you or your spouse has worked 40 quarters. You can delay Part B if you're still on your spouse's employer plan.
What you should know:
- How much is your premium, because it is usually considerably more than the employee.
- How much is your deductible?
- How much are your copays on your current plan?
Part B through Social Security is $206.50 per month next year
- Zero Medicare Advantage plans
- Zero deductible
- Compare copays from Medicare Advantage plans with your current plan.
Remember to factor in your deductible with your current plan. We have insurance for a reason; if something happens, avoiding a $3,000-plus deductible is worth investigating Medicare, but let us help you compare.
Answer:
That it is complicated; it can be, but it doesn't have to be. A and B is Original Medicare. A is free, and B is $206.50 per month. That is through Social Security, and it is your ticket to do either a:
Part C and Part D Medicare Advantage plan or a supplement and a Medicare Advantage plan.
A supplement covers the 20% that Original Medicare does not cover, but you pay a premium of nearly $300 per month. You also need a separate Part D plan for prescriptions.
A Medicare Advantage plan is usually zero per month but has copays for each event.
Yes, you have choices for each of these, but we just explained the basics in one paragraph.
Having a local Medicare expert to make Medicare easy is a good choice. Then you decide.
Answer: Call your Medicare specialist to help you understand your copays. Specialist copays are usually reasonable; it is the costs of the treatments that can vary.
Answer:
IEP - 3 months before your 65th birthday, the month of, and 3 months after.
AEP - Oct 15th to Dec 7th. You can change plans.
OEP - Jan 1 to March 31st; you can change plans if you are already on a Part C plan.
SEP - you move to a new area or have a change in Medicaid eligibility or other.
Institutional SEP - any time you are in an institutional care facility.
For supplements, 6 months from the time you turn 65.
Answer: Don't answer the phone from illegal telemarketers!!!!! The only one who hates getting telemarketing calls more than you is a licensed Medicare agent who does things the right way. If you request information about Medicare, expect a call. Do not request Medicare information unless you know the person is local to your area. Never give your Medicare information to someone who you don't know. Make sure to ask for their Medicare License number and look them up on your state's Insurance website to make sure they are a legit Medicare agent.
Answer: Now is the time to plan. We never recommend a Medicare Advantage plan without Umbrella coverage for Cancer, heart attack and stroke. Usually 2 to 3 times your Maximum out of pocket for a Medicare Advantage plan. Having these large costs can really affect your quality of life. Knowing that you have a coverage in place, can help you manage those costs.
Answer: It depends. Comparing plans is a good idea. For 2026, the new plans are out. Reach out to a Medicare Advocate and ask for a free consultation. You can also view plans on my website.
Answer: Great question. Original Medicare covers preventive screenings for the same reason MAPD plans do: to lower costs overall. Medicare Advantage plans are incentivized to keep you healthy. An oz of prevention is worth a pound of cure.
Answer: I have been in Medicare for the past 10 years, and for 9 of those years, benefits were going up and premiums were going down. That is not the case for 2026. Where I live, 2 plans aren't accepted by the major hospital practice and 3 additional plans are no longer offered in most counties. Why? Costs are going up. More people are getting Cancer, more people have Myocarditis. Hospitals are raising the costs they are charging for Insurance plans, and Medicare plans are choosing not to offer plans in certain areas. Find a good Medicare Advocate who can help you navigate these changes.
Answer: Chemotherapy drugs are 20%. It isn't hidden, but it is often overlooked. All Medicare Advantage Part C plans have a maximum out-of-pocket. Once your copays add up to that number, medical costs are zero for the rest of the year. The fastest way to spend money is if you get a cancer diagnosis; 20% of the costs can add up quick. We recommend umbrella coverage that protects you against these big unforeseen costs. Selecting a policy that pays you 2 to 3 times your annual maximum out-of-pocket is a good idea. If you are thinking you can't afford this, that is exactly why you need it. If you can't afford $60 per month, you are putting your financial security in jeopardy. That is just the truth. When we were younger, we could get away with taking chances. As we get older, we need to consider a cancer diagnosis umbrella plan.
Answer: If it felt like a timeshare pitch, I am not sure who you saw. Our services are free, and what you choose is up to you. Medicare seminars should help you understand the ABC's of Medicare. Having someone to help you through the choices should be a positive experience. If you prefer, find someone who has a website who explains all of your choices and where you can see the actual plans with no implied or perceived pressure. We all hate timeshare pitches.
Answer: Well, you are a little late for this question, lol. Good news is there is no donut hole for 2025, and the maximum on drugs is $2000. $2100 for 2026.
Answer: We can give you the general parameters, but ultimately it is SSDI that determines if you qualify. In general, once you have been on Disability for 2 years, you qualify for Medicare.
Answer: Who am I going to choose for my Medicare advocate? Where can I see information on all of the plans and decide myself? Is there a Medicare training seminar I can attend in person or on the web? The most important questions are the questions we ask you to help determine what choices to give you.
Answer:
It depends. If you mean Original Medicare and a stand-alone Part D plan, almost always Medicare Advantage plan. Mostly because if you just have Original Medicare, you have no maximum out-of-pocket.
Most Medicare Advantage plans also have no deductible for hospital coverage.
If we compare costs for Part D with Medicare Advantage C and D combined, most Medicare Advantage plans will have lower costs as well.
Answer: Yes, you need a new Medicare advocate to help you make new choices for your Medicare coverage based on your new plan area. If you just moved, you need a new doctor and a new Medicare advocate. That is what is great about Medicare Agents Hub. There are agents nationwide who would love to help you.
Answer: Telehealth is available on most all Medicare Advantage plans. However, making a 50-mile trip to see a doctor when necessary is probably a good idea. You have choices, and for routine checkups, Telehealth may be a viable option.
Answer:
It depends on your Medicare eligibility. If you are Medicare-eligible, any Medicare Advantage plan would be less expensive than COBRA. Medicare Part B will be $206.50 in 2026, and most Medicare Advantage plans are zero dollars with zero medical deductible. Copays on Part C Medicare Advantage plans would probably be less than what you are currently paying now, but the only way to know is to compare all costs, deductibles and copays.
If you have lost a spouse, our heart goes out to you. Let us help you enroll in Medicare A and B and let's get you on whatever plan you want.
Answer:
We understand. So many variables: A, B, C, D, or Supplement (Medigap) with a Part D prescription plan. You do not have to do this alone.
It might seem overwhelming to you, but we do this every day. We have a two-way conversation with you so we can find your needs and explain which are the options you have. Having an expert on speed dial is the best way.
Our services are always free, and we care about helping you understand enough to make informed decisions.
Let us help you make Medicare easy!!!
Answer:
The Centers for Medicare and Medicaid Services (CMS) reimburse Medicare for RPM services. It defines RPM as using digital technologies to collect health data from patients in one location and electronically transmit that information securely to providers in a different location.
CMS outlines who qualifies for remote patient monitoring as follows:
- Individuals with chronic conditions like diabetes, hypertension, heart disease, asthma, or COPD.
- Post-surgical patients who need to monitor their recovery and wound healing.
- Geriatric patients, particularly those with multiple chronic conditions or limited mobility.
- Patients in rural or remote areas who have difficulty accessing in-person care.
- Patients with acute conditions that require close monitoring, such as COVID-19.
Answer:
Huge Financial Risk. Part A deductible of $1639, Part B deductible of $259. 20% is usually more than the co-pay on a Medicare Advantage plan. With a Medigap plan, you would pay a higher premium but would have no costs over and above your Part B deductible with a Plan G.
Most importantly, you are in a huge Financial risk if you have just Original Medicare. NO MAXIMUM OUT OF POCKET with Original Medicare. So God forbid you are 6 months in the hospital and have $400,000 worth of bills... You owe 20%, and there is no cap.
With a supplement, you pay only the Part B deductible, then you pay nothing. With a Medicare Advantage plan, you have a maximum out-of-pocket, usually under $9000.
Answer:
It depends. A lot of seniors believe they have great insurance and feel no need to compare Medicare costs and benefits. Just because you are still working doesn't mean you wouldn't be better off with Medicare.
- Of course, it depends on how much you are paying now.
- What is your deductible?
- What are your copays?
Remember, we have insurance for a reason. Most don't expect large medical bills in any given year. Even if you have great employer insurance, you probably have at least a $3000 deductible. You should include this in your overall costs. In short, we don't know until we check; most Medicare Advantage plans include prescriptions and have a zero-dollar premium and no deductible for medical.
Answer: There are no disadvantages to being on a PPO. With an HMO, however, you either go to in-network Doctors or you pay full price. With a PPO plan, you pay a lower copay for in-network doctors, but you have the freedom to go to an out-of-network provider and just pay a higher price. As with all plans based on your County, a PPO and HMO or HMO POS should be evaluated based on the benefits, Costs and all of your doctors being in network, preferably. At least with a PPO plan, you have the option to see out-of-network Doctors. So there are no disadvantages to being on a PPO.
Answer:
Great question. The answer is never.
You risk too much if you just have Original Medicare. $1,600 deductible for Part A, no maximum out-of-pocket; with a supplement, you can see any doctor that accepts Medicare.
With a national company for Part C, get a PPO. If your PCP isn't in network, you can still see any doctor that accepts Medicare.
So I would never ever ever recommend just having Original Medicare.
Answer:
We offer online training as well as in-person education.
It's as simple as A B C D.
Free consultation over the phone, in person or over Zoom.
We can make the whole process easy.
Answer:
Great question.
I wouldn't say a mistake; it's a choice for sure.
A national Medicare PPO plan would give you the same flexibility.
All Medicare Advantage plans have a maximum to protect your costs, and with a PPO, you can see in- or out-of-network providers. With a national plan, most doctors would be in network.
If Medicare Advantage plan, the two biggest costs are chemotherapy drugs and inpatient hospital stays. Both can be covered for small dollars and still save you $200 per month. Happy to give you specifics over the phone, in person or over Zoom.
Answer: Taking advice from Facebook or from people who aren't licensed Medicare agents can be very harmful. Having just Medicare A and B leaves you unprotected for major procedures. Part A has a $1,639 deductible, then your 20% kicks in, and Part B has a $257 deductible. Also, there is no maximum on just Original Medicare. 20% of $200,000 is $40,000. Choosing a Medicare Supplement is where you pay up front for coverage, and besides a $257 deductible, you would have no bills. All Medicare Advantage plans have a maximum out-of-pocket limit. Meaning after you hit that maximum, your copay would be zero for the rest of that year.
Answer: Is this procedure medically necessary? If so, your doctor should do a prior authorization or an appeal to try to get it covered. We have a summary of benefits and an evidence of coverage document we can research or call customer service for you to get to the best answer for you before the procedure is done. Once we help someone with a plan, it is our job to assist you throughout the year as these issues arise.
Answer: Wow, that is a great question, and for the first 9 years of helping people in Northern and usually rural areas, it wasn't an issue. There are 6 Medicare Advantage plans, and in 2025, one of those companies isn't accepted by the largest hospitals in Northern Maine. For 2026, we have another of those companies who will not be renewing their contract with Northern Light. That leaves 4 companies to choose from for the most part. We look up your doctors and your medications to ensure that they will be in network. Finding a plan that is nationwide, should the situation arise where you need medical help in another state, is an option worth making sure is available.
Answer:
I have been a Medicare agent since 2015. I love meeting seniors and helping to make their Medicare decisions easier. Most plans are zero dollars, so I get paid to help people make the best decision for them.
Meeting new people has been very rewarding. Over the first 9 years, benefits on all plans were improving, and it was exciting to get you more benefits for less money. In 2025, and I believe even more so in 2026, benefits will be tightening, so it is more important than ever to find a local agent who enjoys answering your questions year-round and helping you find the best plan for your individual wants and needs.
Answer:
Most plans include some coverage; how much they cover depends on your type of plan and the insurance company.
If it is a D-SNP plan, you will have a greater allowance.
We can compare your plan against other plans to help you know. Give us a call anytime; we are happy to help.
Thanks.
