What's the most important question I should be asking about Medicare that I probably haven't thought of yet?

Question

Andrew Bennett · Accepted Answer

The question you aren't asking might just be what options give me most control of my healthcare?  The opposite question is important as well, What might limit my healthcare?  With Advantage plans you have to stay in-network for your care and often there are prior authorization hoops to jump through.  

With Medicare supplements there are fewer prior authorizations and when there is one they are generally just looking for Fraud, Waste, and Abuse.  What they are not looking for are ways to protect their profits.  They aren't looking for how they can squeeze more money out of the system to pay their CEO or have more money for their marketing budget.

Yes, there are times when an Advantage Plan is the right fit.  It does depend on your budget and the amount of control you have really depends on the company you go with.  In general though I think you retain more control of your healthcare with traditional Medicare and a supplement.

Gary Church · Answer

The most important question should be about how you'll use Medicare throughout your lifetime, what health concerns you may have in the future, where you will live, and your access to doctors and hospitals—both today and if you move in the future.

Answered by Gary Church on August 19, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Mike Alexander · Answer

You time limits and when is the right time to enroll.
, in order to avoid a late enrollment penalty which can be costly

Mark Bilgere · Answer

If you have decided that Medicare is the right choice, then the most important things to know are if your doctors and medications are covered by a specific plan? Too often people are swayed by "extra benefit". These can be nice additions, but your health plan should be focused on your healthcare first and then extra things. Doctors and medications are the foundation of your future healthcare.

Answered by Mark Bilgere on September 9, 2025

Broker Licensed in TX, AR, IN & LA, MN, NE & OK

Answered by Mark Bilgere Medicare Insurance Agent

Daniel Brechin · Answer

Medicare at a glance is simple.  A covered situation, you will owe 20% of the bill.  With a supplement, it will pay for that 20%
A supplement will pay the 20% with a monthly premium.  With a Medicare Advantage, you will have a copay.

Danny  Brechin 
Contact me.

William Lawler · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/whats-the-most-important-question-i-should-be-asking-about-medicare-that-i-probably-havent-thought-of-yet#william-lawler

Christopher Boyd · Answer

Will all of my doctors, pharmacies, and hospitals accept the plan I am signing up for. If so, what are the co-pays?.

Bill Wheeler · Answer

The most asked questions I have ran into Medicare is:
Is what are all the benefits that come with original Medicare and how to access more.
Like does original Medicare offer help with homecare services?

Charise Karjala · Answer

The most important question to be asking about Medicare is what it doesn't cover. We all know that doctor visits, hospitalization, skilled nursing, and operations, all that kind of stuff, is included in Medicare, thank goodness we have that. However, the largest thing that Medicare does not cover is long-term care, custodial care, dementia, Alzheimer's, where there's round-the-clock care that's required. We're told that $341,000 is the average amount that you and I, turning 65, will be required to pay out of pocket. So this is a question that 40-year-olds or 20-year-olds should be asking because that will be the age at which we can start to make plans to accommodate these needs. Right now, people who are turning 65 don't necessarily have the wherewithal and means to pivot and purchase general policies that can assist with long-term or custodial care because those are not covered. So that is the most important question that I should have been asking about Medicare that I probably haven't thought of yet.

So here's the deal. If you're turning 65 and there's nothing you can do about it, tell your kids who are 40 to get into a long-term care policy, to buy critical illness policies. And you, mom and dad, need to structure your estate so that it's protected and you can derive part of it to support long-term care, either in or out of a facility, or that you can protect your assets so you can utilize state resources, or finally that you have the means to pay family members to care for you. That's that. Great question.

So here's the deal. If you're turning 65 and there's nothing you can do about it, tell your kids who are 40 to get into a long-term care policy, to buy critical illness policies. And you, mom and dad, need to structure your estate so that it's protected and you can derive part of it to support long-term care, either in or out of a facility, or that you can protect your assets so you can utilize state resources, or finally that you have the means to pay family members to care for you. That's that. Great question.

Edward Smith, ChFC, CRPS, AIF · Answer

Are my doctors in network, How are my prescriptions covered by the insurance companies formulary list, will I be traveling a lot, Does the plan I am considering pay for charges outside of their primary network.

Answered by Edward Smith, ChFC, CRPS, AIF on June 22, 2025

Broker Licensed in OH, GA, IN, KY & TN

Answered by Edward Smith, ChFC, CRPS, AIF Medicare Insurance Agent

Jonathan Potter · Answer

Do you have any history of major illness or a family history of major illness. Do you have a decent amount in savings for medical expenses or an HSA from an employer?

Steven Graves · Answer

Many people focus on their immediate healthcare needs, but it’s just as important to consider how your health, medications, or lifestyle might evolve in the coming years. Choosing a plan that not only fits your current situation but can also accommodate potential changes can save you time, money, and stress down the line. A thoughtful, forward-looking approach can make a significant difference in your overall Medicare experience.

Steven Graves

Vincent Murray · 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.

Answered by Vincent Murray on October 8, 2025

Agent Licensed in ME, FL & NH

Answered by Vincent Murray Medicare Insurance Agent

Nikki Rowland · Answer

Medicare does not cover everything.  You should always ask, are there gaps in my coverage that could leave me with unexpected out-of-pocket costs?

Lauren Fodde · Answer

“What is my total out-of-pocket risk for the year if something serious happens?”

Most people focus on:

$0 premiums
Extra benefits

…but miss the big picture cost.

What this question uncovers:

Your maximum out-of-pocket (MOOP)
Hospital and specialist costs
How your plan handles worst-case scenarios

Why it matters:
The right plan isn’t just about saving money when you’re healthy—it’s about protecting you financially if you’re not.

Bottom line:
Don’t just ask “What’s the premium?”
Ask “What could this cost me in a bad year?”

That’s where the real differences between plans show up.

Jacqueline Proffit · Answer

The most critical question most people overlook isn’t about what Medicare costs today, but how your choices today limit your options 10 years from now: "How will my choice today affect my ability to change coverage if my health fails in the future?"Most people focus on monthly premiums and current doctors. However, the "hidden" logic of Medicare centers on Medical Underwriting. Why this question is the most important: The Medigap "One-Time" Window: When you first join Medicare, you have a six-month Medigap Open Enrollment Period. During this window, insurance companies must sell you a Supplement (Medigap) plan regardless of your health history. The Trap: If you choose a Medicare Advantage plan now because it's cheaper, and five years later you develop a chronic illness and want to switch to a Medigap plan (which has more predictable costs and no networks), you may be denied. In most states, after that initial window, insurers can use "medical underwriting" to charge you significantly more or refuse to cover you entirely based on your health. The Long-Term Impact: Approximately 80% of healthcare usage occurs after age 60. A plan that looks great while you are healthy might become a financial burden if you lose the "guaranteed issue" right to switch to a more comprehensive supplement later. Other "Missed" Questions to Consider: The Question Why It Matters: "What is my Total Out-of-Pocket (MOOP) in a 'Bad Year'?"Many focus on $0 premiums but forget that a single major surgery or hospital stay could hit a $5,000–$9,000 "Maximum Out-of-Pocket" limit."Does my plan require 'Prior Authorization' for specialists?"Original Medicare doesn't care if you see a specialist. Many Advantage plans require your primary doctor to "ok" it first, which can delay care."Are my drugs on the 'Formulary' and what tier are they?"A drug can be "covered" but placed in a Tier 4 or 5 category, costing you thousands more than if it were Tier 1 or 2."Will this plan cover me if I travel or move?"Original Medic

Answered by Jacqueline Proffit on April 1, 2026

Broker Licensed in FL, AR, CA & 15 other states

Answered by Jacqueline Proffit Medicare Insurance Agent

Tasha Riggs · Answer

The question today is, what's the most important question I should be asking about Medicare that I haven't thought of yet? Well, since I don't know what questions you've thought about, let me share this: when you go on Medicare, you do have to go to ssa.gov and apply for A and B. You have to have both. You've got to find something that covers 20% of the bills because Medicare only covers 80%. You need to cover that 20%, and you also need a drug card.

There are only two ways to do that: one is with a Medicare supplement, and the other is with a Medicare Advantage plan. Both are absolutely amazing. I think the biggest thing people don't know about the two is that with a Medicare supplement, the doctors bill Medicare directly. With a Medicare Advantage plan, the doctors bill the carrier you bought it from, whether it's United, Blue Cross, or Cigna.

Another important point is that I hear a lot of times, and I've literally seen it on doctors' websites, that it says it replaces Medicare. Medicare Advantage cannot and will not replace Medicare. Nothing replaces Medicare. To a doctor, it may feel like that because they're billing the carrier instead of Medicare, but it does not replace Medicare. So, you always have to keep A and B.

The reason why that's so important is that many times when someone goes on a Medicare Advantage plan, they think it replaces Medicare. I've had this happen with a client who said, "My doctor told me it replaced my Medicare." So, if it replaced my Medicare, why am I spending $186 a month on Medicare and then having it come out of my Social Security? He went and canceled it, thinking it replaced his Medicare, and now he doesn't have insurance for a year and is being fined by the IRS for not having B or D.

So, it's very important to know that Medicare Advantage does not replace Medicare. Medicare is still involved; they're just paying the bills in the background. Remember, Medicare Advantage plans don't replace Medicare.

Nick Mangini · Answer

What is the "REAL/TRUTHFUL" difference between Medicare Supplement Plan (Medigap) vs Medicare Advantage plan? What are the actual real pros & cons? What surprises/limitation would I have with an Advantage Plan vs Medicare Supplement Plan (Medigap)? Which provides the best coverage so I can have comprehensive coverage that will last me for the rest of my life on Medicare?

Answered by Nick Mangini on August 22, 2025

Broker Licensed in FL, AL, AZ & 32 other states

Answered by Nick Mangini Medicare Insurance Agent

Kelsey Hentzen · Answer

I believe this question depends on your own health concerns. Are there any prescriptions you are taking that need discussed? Are you doctors in network with the plan you chose? Everyone's Medicare journey is different. I would highly recommend talking with a broker and not a captive agent to ensure you are getting many different options when it comes to your Medicare choices.

Answered by Kelsey Hentzen on June 15, 2026

Broker Licensed in KS & MO

Answered by Kelsey Hentzen Medicare Insurance Agent

Andrew Firmin · Answer

What are my current and future healthcare needs, and how will the decisions I make today affect the coverage I might be need in the future. As you think about this, know that Medicare doesn't provide coverage for everything and you may need to consider additional coverage such as: Cancer/Critical Illness, Hospital Indemnity, or Recovery and Homecare coverage. Build your Medicare Planning around protection packages. This is why we say Medicare is the intersection of your healthcare and financial wellness!

Answered by Andrew Firmin on April 9, 2025

Broker Licensed in MA, CT, DE & 13 other states

Answered by Andrew Firmin Medicare Insurance Agent

Joseph Bachmeier · Answer

One of the questions that I'm asked quite often is, “What am I not thinking about in regards to Medicare?” Is there something that I'm missing, some information? A lot of folks think that long-term care is covered under Medicare or Medicare Advantage plans, and it's not. Medicare will cover some skilled nursing care. Skilled nursing care is the care around the clock, 24 hours a day, that is required, and it has to be prescribed by your doctor. It's only covered for a certain amount of days. Custodial and intermediate care is care that most people fall into after their hospital stay, and that's the care most people do need. Unfortunately, Medicare doesn't cover that care, but that's where you would get a post-hospital care plan. There are some really good carriers out there like UnitedHealthcare and Aetna who offer those plans and will cover that benefit. So that's a big thing with post-hospital care. A lot of people don't think about it. They think that once they're done in the hospital, they're good to go, but there's a lot of care that is needed after your hospital stay. Some carriers have some really good products and plans that can cover that benefit. I hope that helps, and talk to you soon. Have a great day.

James Hale · Answer

“How will this plan work for me if my health changes significantly in the next 5–10 years?”

Most folks shop Medicare based on today’s health, doctors, and costs. But life happens — new diagnoses, surgeries, chronic conditions, or just plain aging. That’s when the real regrets show up:

*Medicare Advantage networks can shrink or drop your specialists.
*Prior authorizations and denials often increase.
*Out-of-pocket costs can explode even with “good” plans.
*Switching back to Medigap later can be denied or become very expensive if you’re no longer healthy.

Jason Denniston · Answer

Most people ask about premiums first, but a better question is, “What kind of help will I have after I enroll?” Medicare can get confusing fast once bills, referrals, prescriptions, or claim issues start happening. Working with a real person who answers the phone and helps year after year matters a lot more than most people realize in the beginning.

Answered by Jason Denniston on May 12, 2026

Broker Licensed in IN, CO, FL & 10 other states

Answered by Jason Denniston Medicare Insurance Agent

David Bell · Answer

It depends on what questions you have asked. Most think about costs and budget, your general health and how much care you are likely to need in the future. The most common, un-asked question is the future of premiums, deductibles and other out of pocket expenses. The answer is  they will probably go up. Remember, insurance is generally not for today, but for tomorrow, so make sure you are covered well when everything is great and when they get bad, your coverage will be great. Use an agent for sure. 

Hope that helps. Contact me if you need more help.

Lilyana Uzdenova-Gomez · Answer

“What kind of pathway would work better for my needs long term: Medicare Advantage vs Medicare Supplements?” is the question I encourage my clients to consider. Your income, your provider network, your traveling habits, your family health history-all may play into making the right decision.

Answered by Lilyana Uzdenova-Gomez on January 19, 2026

Broker Licensed in FL

Answered by Lilyana Uzdenova-Gomez Medicare Insurance Agent

Adam Ashby · Answer

The most important question that most individuals spend almost no time thinking about is - What is most important to me today? The differences between Medicare Supplement and Medicare Advantage are significant - both serve a very important purpose. You need to be able to talk through your current needs and establish what value does each one bring to me and then decide for yourself what is better. So many of us are used to being told by our employer what our benefits are going to look like and then we have to adapt. You have the opportunity to choose what you need and work with a Broker who will fill that need. As a bonus, ask your broker how many carriers they represent - make sure that you are not working with someone who has limited your options by only working with one carrier.

Answered by Adam Ashby on April 9, 2025

Broker Licensed in CO, GA, IL & 6 other states

Answered by Adam Ashby Medicare Insurance Agent

David Wynne · Answer

The most over looked question when asking about Medicare and many people don’t realize that, if your income is above certain limits, you’ll have to pay more for Medicare Part B and Part D. This is called IRMAA (Income-Related Monthly Adjustment Amount). It can catch people off guard, especially if you sell a home, take money from retirement accounts, or have a high income in retirement. Planning ahead can help you avoid paying more than you need to!

Answered by David Wynne on May 12, 2025

Broker Licensed in SC, GA, MI, NC & PA

Answered by David Wynne Medicare Insurance Agent

Dino Pappadis · Answer

What are the coverages, limitations and gaps of Medicare and what are your options to protect yourself

Mark Garrett · Answer

What is my main priority it selecting a plan. Is it the most comprehensive coverage to last throughout my life time or is it maximize savings. Remember, approximately 80% of your health insurance usage comes after the age of 60. So knowing your priorities really assist a broker in helping you find the best plan for you.

Answered by Mark Garrett on April 8, 2025

Broker Licensed in FL, AL, AZ & 19 other states

Answered by Mark Garrett Medicare Insurance Agent

Jeffrey Jon · Answer

I think one of the most important questions to ask is if the plan will allow me to continue to travel anywhere and be covered. 
If there is no network, you can travel any where in the United States and be covered. HMO's and PPOs are not universal in their ability to allow you to go anywhere and get coverage.

Wagdy Saadalla · Answer

How does this plan align with my personal lifestyle and future goals, and not just my health needs?

Jamie Goble · Answer

Well there a lot of questions when it comes to Medicare.  How much is it? Are my Doctors covered? Will my meds be covered. Wat id the max out of octet for my plan. 

What is the difference between  Medicare Advantage plans and supplement?
Should I stay with original medicare?

Will I be covered if I go out of my state?the questions are =different for everyone. Every situation is different. So the questions are different.

Colleen Williams · Answer

Why this is important:

When you first enroll, you face choices like Medicare Advantage vs. Original Medicare + Medigap.

Some options (like Medigap) can be harder or more expensive to switch into later because of medical underwriting, depending on your state and timing.

Prescription drug coverage (Part D) and provider networks can also change — what works now might not meet your needs if your health changes.

Many people focus only on the immediate premium costs and not on how their choices will shape their ability to access care (or pay for it) five or ten years down the road.

In short: you’re not just choosing for today, you’re choosing for your future self too — and some paths lock you in more than others.

Anthony Castelluccio · Answer

There are so many great questions, it's hard to narrow it down to the most important question. Is your Agent sitting down face to face with you to review all of your questions either at your kitchen table or their office? I am a visual learner myself and I know I would prefer to sit down to review all of the many different options people have. This process can be overwhelming and I simplify the full process and walk through the timeline you need to be aware of!

Answered by Anthony Castelluccio on March 31, 2025

Agent Licensed in PA, DE, MD, NJ & VA

Answered by Anthony Castelluccio Medicare Insurance Agent

Dustin Haffner · Answer

What will this cost me in a bad year—not a good one? Total MOOP

The most important Medicare question isn’t about:
Premiums
Dental
Vision
$0 plans
It’s about future you!

Jane Ahrens · Answer

What is the difference between a Medicare Supplement (Medigap) policy and a Medicare Advantage Plan? Will I always be able to purchase either?

James ONeal · Answer

What's the most important question I should be asking about Medicare that I probably haven't thought of yet?

One of the most important Medicare question you might be overlooking is: 

"Will my current Medicare plan continue to meet my needs if my health changes?" 

This is crucial because your health circumstances can shift significantly as you age, and your plan's coverage and costs need to align with those changes.

Steve Thornton · Answer

What will my total out-of-pocket costs be each year — in the worst-case scenario?

Most people focus on premiums, but it’s the deductibles, copays, coinsurance, and max out-of-pocket limits that can really hit your wallet — especially with a serious illness or hospital stay.

Knowing your worst-case costs helps you choose the plan that truly fits your health and budget.

David Moscowitz · Answer

What plans are available in my area, @ am I eligible. I will be turning 65 in 3 months when should I apply?

What documentation do I need to have to be able to consider a Medicare advantage plan, and how do I go about getting what I need?

Nathan Danovski · Answer

“How will my Medicare choices today affect my ability to change coverage in the future?”

“If I develop a chronic condition later, will my plan still cover the specialists and medications I’ll need?”

Michael McGarrigle · Answer

One of the biggest questions people don’t think to ask is: “How will this plan work for me if my health changes?”

A lot of decisions get made based on what things look like today—but Medicare is something you live with long term. Doctor access, specialist flexibility, out-of-pocket exposure, and your ability to make changes later all matter more over time than just the monthly premium.

That’s something we walk through with our clients every day. We’re not just looking at what works right now—we want to make sure your plan still works if your situation changes.

If you’re not sure, that’s exactly what we’re here for. We’ll go through it with you and help you think through the “what ifs” so you can feel confident in your decision.

Thomas Ashton · Answer

If I am still working do I need to sign up for Medicare? How do I determine if a Medicare Advantage Plan or a Medicare Supplement is right for me?

Doreen Dann RN, BSN, MHA · Answer

If researching a Medicare Supplement plan, ask to review the rate plan to see what the rates are for ages 77 plus. Its important to know the year they become a standardized rate by age. This is where many age rated plans become competitive for the enrollee.

Answered by Doreen Dann RN, BSN, MHA on April 9, 2025

Agent Licensed in CA, AZ, CO & 9 other states

Answered by Doreen Dann RN, BSN, MHA Medicare Insurance Agent

Jason Hark, MBA, CMIP · Answer

One of the most important questions you might not have thought to ask is:
"Will my Medicare plan still meet my needs if my health changes?"

Medicare Melanie · Answer

The most important question  about Medicare can be elusive. There's so many questions that need to be asked, that you will never be able to ask them all. The best thing you can do, is have a consultation with your local independent broker. Ask for a Medicare 101, so you can get all the important details!

Here's just a few important topics - 

1. Will I be responsible for an IRMAA surcharge?
If so, do I qualify for an appeal?

2. Will I qualify for Extra Help (LIS)
If so, will my broker help me apply?

3. What are the pros and cons of Medicare Supplements VS Medicare Advantage for my specific needs?

4. What are the pros and cons of Medicare Supplement Plan G VS Medicare Supplement Plan N for my specific needs?

5. When scheduling an appointment with an advisor, always ask - Are you an Independent Broker?
You deserve unbiased advice, and life long service. That's what you will get with an independent Broker. 

God Bless.

Charles Boone · Answer

Why am I not working with a Licensed Medicare/Health Insurance Broker? 

I say this because Medicare can be so confusing and complex that it requires you go to school and obtain a license to fully and accurately comprehend it. 

In addition to that, Medicare changes every year so it also requires continuing education as well as successfully passing exams each year. 

Knowing this, a Licensed Medicare Broker works on your behalf, free of charge, and has a legal fiduciary duty to do what’s in your best interest. 

Plus, any good Broker will make sure you understand your options, explain why some may be more advantageous than others, and service your policy for the life of you being enrolled in Medicare. 

So to be able to obtain that level of expertise at no cost, I state again. The most important question you should be asking about Medicare that most haven’t thought of yet is….

“Why am I not working with a Licensed Medicare/Health Insurance Broker?”

Kim Fisher · Answer

When do I enroll and what type of plan is best for me and my health needs and financial situation? Also do I have to answer health questions when I apply for plans to go along with Medicare.

Yasmine Lopez · Answer

“What won’t Medicare cover — and how could that affect me if something serious happens?”

Most people focus on premiums, copays, and the extras like dental or vision. But the real heart of Medicare planning is understanding the gaps — the stuff that isn’t covered or could leave you vulnerable when life takes a hard turn.

Here are the hidden questions I wish more people asked upfront:

What if I get cancer or need infusions — how much will I actually pay?

What hospitals and specialists can I access if I get seriously ill?

What does Medicare cover if I can’t take care of myself — like needing help at home, in rehab, or in a facility?

Will I still be able to change my plan if my health declines?

If something happens tomorrow, is my coverage built for the big stuff — or just the basics?

These aren’t fun questions, but they’re the ones that matter most. My job is to walk you through them before they become urgent — so you’re protected, confident, and fully informed.

Amber Sigg · Answer

Don't just look at what is right in front of you. Try to look at what may be coming up for you in the next year or two, especially if you are trying to stay on the same plan. I know that no one can predict the future, but if you are truly trying to plan and stick with something, try and look at the big picture as best you can and look at all of your options so you can make the best decision for you and your needs.

Answered by Amber Sigg on December 2, 2025

Broker Licensed in CO & WY

Answered by Amber Sigg Medicare Insurance Agent

Michael Brady · Answer

Can you explain all my options? What are the down sides of all options? What are the advantages of  each option?

Grant Evans · Answer

There are a few, but I think knowing where and when to use your medicare card is not spoken about enough. When do you show your medicare card and where should I keep it?

Ronald Plocinski · Answer

How do I want my health insurance coverages delivered to me in my retirement? 

Everyone starts by enrolling into Original Medicare. After that, ask yourself - of the two supplemental options: 1) Medicare Advantage or 2) MediGap, how do I want my health insurance coverages delivered to me in my retirement?

If you fine with co-sharing until you hit a max out of pocket but with lower premiums - then Medicare Advantage might be best for you. However, if you are ok paying higher monthly premiums but having steadier monthly costs for you medical care, then MediGap is likely for you.

Donna Walbert · Answer

Q: If I continue to work and have group insurance, do I need to sign-up for medicare?
A: Not necessarily, but is dependent upon the size of the employer, coverage and costs to maintain the group insurance through the employer sponsored program. It is best to talk with a licensed professional to help you navigate through the cost analysis and to avoid any potential late enrollment penalties down the road.

Daniel Weeks · Answer

What's the difference between a Medicare Advantage plan (MAPD) and a Medigap Supplement? How do they work with Medicare?

Keaton Lewis · Answer

This might sound a bit cliche since it's coming from an agent, but I would ask: "What are the reasons why I should work with an agent?" Over the years I've had many clients and come across many beneficiaries who are confused and overwhelmed with relentless, intrusive, and misleading advertising. It has become worse that it's ever been in the last year alone. As an agent, it's my job to understand what's happening in the industry so you won't have to! Trying to understand and navigate everything is like trying to get a college degree without the help of a teacher. I'm here to help relieve the burden, and it costs you nothing to use me!

Answered by Keaton Lewis on March 26, 2025

Broker Licensed in ID, AZ, CA & 12 other states

Answered by Keaton Lewis Medicare Insurance Agent

Kyle Kokot · Answer

If I am still working and have employer coverage, what are my options? Do you know that you can continue to work and drop your employer coverage and take on Medicare? You can also delay your Medicare and keep employer coverage without any penalties!

Answered by Kyle Kokot on April 7, 2025

Broker Licensed in NC, AL, AR & 30 other states

Answered by Kyle Kokot Medicare Insurance Agent

Taylor Blankenship · Answer

What are the most important things you need out of your medical plan? Are my doctors in network with the plan? Do I have the best drug coverage with this plan? Do you have an agent ready to put in the work to make sure you’re getting your full benefits from a plan?

Answered by Taylor Blankenship on April 8, 2025

Agent Licensed in NC

Answered by Taylor Blankenship Medicare Insurance Agent

Betsy Mullison · Answer

When choosing your Medicare coverage, it’s essential to consider how the plan will meet your current and future needs. Understanding enrollment periods and your ability to switch plans is key. Many people mistakenly believe they can switch from a Medicare Advantage plan to a Supplement plan during the Annual Enrollment Period—without realizing that medical underwriting is required for that change.
So, an important question is "Do I understand the Medicare Plan enrollment periods and requirements?

Candace McWilliams · Answer

The most important question to ask depends on your specific situation and budget. But a great place to start is: Which Medicare plan best meets my healthcare needs and budget? From there you have plenty of options. That why working with a licensed sale agent can help in these important decisions.

Answered by Candace McWilliams on March 31, 2025

Agent Licensed in IN

Answered by Candace McWilliams Medicare Insurance Agent

Giselle Donval · Answer

You should be asking about what matters most to you when it comes to your coverage. Be it affordability, ability to see providers, benefits you’re most interested in etc. Sharing your most important quality about the coverage you’re looking for helps us agents tailor your experience to you, and greatly increases your chances of being completely satisfied with your coverage choice.

Answered by Giselle Donval on April 8, 2025

Broker Licensed in MD, DC, IN & 6 other states

Answered by Giselle Donval Medicare Insurance Agent

Steven Bleicher · Answer

Most Medicare members presume that a car accident would automatically be covered. Not necessarily! Depending on the severity of the health issues, for example, whiplash is not covered since a neck brace is given and no admittance to a hospital would occur. But naturally, if you have broken any body part, the ambulance driver normally brings you to the nearest hospital.

Answered by Steven Bleicher on May 23, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Andrew Zurbuch, MBA · Answer

Does this new coverage with Original Med cover me outside of the United States.

Answer: No, Original Medicare Part A & Part B does not cover Medicare Beneficiaries outside of the United States. Except for limited coverage near the U.S. border.

Jim Tretola · Answer

There are many questions, but perhaps the most important is what will my maximum out of pocket for the year.

Timothy Brown · Answer

What is the cost for Medicare Part B which changes annually and the timeframe to enroll in Part B (Medical) and Part D (Prescription Drugs) before incurring late enrollment penalties. Lastly, what are my options to help cover the copays & coinsurance that Medicare doesn't pay for.

Answered by Timothy Brown on June 1, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Kristen Skinner · Answer

Are all my medications covered? Are my doctors in network? Do you have Chronic Illness plans that would cover more of those illnesses? Do you have any plans with Over the Counter benefits?

Frank Carta · Answer

In order to effectively answer this question, I would like to know if you are currently employed
and still have creditable coverage.

Priscilla Ramos · Answer

Will this plan truly work with my doctors, medications, and lifestyle all year?
Most people focus on price, but this question uncovers the real costs, coverage, and surprises.

Kris Moen · Answer

“If my health changes suddenly, how will my coverage protect me next year — not just today?”

Most people focus on:

-premiums

-networks

-drug copays

-dental or vision perks

but they forget the #1 risk with Medicare:

-Your health can change overnight,
-but your ability to change plans does not.

Dana Dane · Answer

What is the difference between Medicare Supplements and Medicare Advantage Plans?  Which plan is right for me?

Chad Watkins · Answer

What is the difference between Medicare Supplement and Medicare Advantage Plans? Many people think these things are the same, but they're actually quite different. A Medicare Advantage Plan is typically either an HMO or PPO type of plan, where you have to worry about doctors and hospitals being in-network. They usually have a lower premium than a Medicare Supplement, and depending on where you're at, certain service areas have a zero premium plan that doesn't cost you anything beyond what you would normally pay for just the Part B premium.

Medicare Advantage Plans typically include prescription drugs. They do have a maximum out-of-pocket limit, referred to as MOOP, of a maximum of $9,350. So that is your worst-case scenario, even if something catastrophic were to happen. They usually provide some coverage for dental, vision, and hearing, but it's typically not comprehensive, more preventative. For dental, things like checkups and cleanings are covered, and sometimes they will offer a rider to give you more comprehensive dental coverage.

Medicare Advantage Plans are locked in for one year, and you can only get the plans that are in your service area. A Medicare Supplement has a higher premium, but you get better coverage. You don't have to worry about networks; you can go to any doctor or hospital that you want. Medicare Supplements do not include prescription drugs, so you'd probably want to get a standalone prescription drug plan. Medicare Supplements also won't provide anything towards dental, vision, and hearing, but again, you can get a standalone dental, vision, and hearing plan.

So if you have any other questions, please feel welcome to give me a call. I am licensed in every state and D.C.

Leslie Helene Sussman · Answer

The most important question I would ask is How are my Medications and preferred Pharmacy going to be covered. (which plan would be best to cover my Medications and Pharmacy).    
A thorough needs analysis is critical when choosing a Medicare plan.

Michael Yost · Answer

Should I enroll in a Medicare plan or stay on my group health insurance plan? Many people think Medicare is too confusing and they don't want to deal with it now. They feel very comfortable with their group plan because that's what they are used to. So many families I've spoken with over the years got better coverage on Medicare and paid less, saving $$. People may be missing out on better coverage and savings if they don't take time to compare and talk with a broker about their options.

Betty McCarty · Answer

One question that usually flies under the radar is "How will my Medicare coverage adapt as my health needs change over time?”

Don Golding · Answer

There's no one question. Everyone's situation is unique. A better approach to your situation is to understand how your plan works for you.  What are the premiums? Copays and coinsurance? Is there a deductible? Are my medications covered? What's NOT covered? I recommend a comprehensive analysis of current circumstances and future needs. I would suggest this be done with an independent broker to maximize your choices.

Heidi Delaney · Answer

Who is my reliable resource, and will they be there to help me when I have a question?  It is important to work with someone who is knowledgeable, who can help you with any Medicare plan type and will go to bat for you against the carriers if a problem arises.  The individuals at the insurance company and the phone numbers you see on TV are less likely to have the same contact for you and be less willing to help you later.

Jeffrey Barone · Answer

How does Medicare work with with the different healt insurance plans on the market?

How can I be sure that Medicare and a plan I choose will work together?

Are there any programs that are offered by Medicare that ma lower my cost?

Jessica Breland · Answer

That answer would be different for each person depending on circumstances. I recommend finding a local advisor that would sit down & go over everything with you in detail. I go over everything, in detail, with each person because most of the time people don't know what questions to ask. I look at initial consultations as informative/educational appointments.

Christopher Orr · Answer

Are you already drawing social security, because if so it's automatic. If no, you must call Social Security or go online and create a login and apply.

Victor Gerber · Answer

I would say, if someone is staying working on employer coverage that if they have HSA at work, not to take any Medicare because you can no longer contribute to HSA if you do. But if you do not have HSA you should take part A only at 65.

Mary Manos-Mitchem · Answer

The most important Medicare question isn’t “How much is the premium?” It’s “What does this plan cost me if my health changes?” Because your plan should protect you on your worst day, not just your best.

Angela Brewer May · Answer

Do I want to stay on employer coverage or enroll in Medicare and get a secondary? This is important because many times employer coverage has a lot of gaps and actually costs more than Medicare. I can help you compare...

Beth Bohnsack · Answer

What if I need help with everyday activities like dressing, bathing, etc?                                         Who pays for non-medical home care as I get older?

Claire Akey · Answer

When you are new to Medicare, I would always look into all options available to you.  And I would always go through a licensed, experienced broker who is contracted with all the major companies.  That way you are not limiting your choices both for now and in the future.

Sheri Wright · Answer

Would I qualify for subsidies like the Connecticut Medicare Savings program? Many of my clients that are single and/or married do not take advantage of this great benefit. It can bring there costs down significantly. We can do a quick cost analysis to see if you may qualify.

Fred Manas · Answer

The most important question about Medicare that you may not have considered is: "Are there gaps in my coverage that could lead to unexpected out-of-pocket costs?". Original Medicare (Parts A and B) leaves significant expenses uncovered, and while Medicare Advantage plans (Part C) offer more comprehensive coverage, they often come with their own limitations. 
Here's why this question is crucial:
Original Medicare has limitations:  Original Medicare only covers a portion of your healthcare expenses. It doesn't cover routine dental, vision, or hearing care, or long-term care. Even for covered services, you'll face copayments, coinsurance, and a deductible. 
Medicare Advantage plans have their own gaps:  While Medicare Advantage plans often offer better coverage, they might have network restrictions, require pre-authorization for some services, and have their own copayments and deductibles. You may also face penalties for using out-of-network providers. 
Understanding your plan's limitations is key:  Carefully review your plan's benefits document, formulary (if it's a Part D plan), and provider network to identify any potential coverage gaps or limitations. 
Consider supplementary coverage:  You may need to consider purchasing a Medigap policy (Medicare Supplement) to help fill gaps in Original Medicare or explore other coverage options like supplemental plans offered by your employer. 
Be proactive in asking questions:  Don't hesitate to contact your plan or Medicare's website to clarify any uncertainties about your coverage. Understanding your plan's limitations and potential costs is crucial for making informed decisions about your healthcare.

Vachik Chakhbazian · Answer

How will my current and anticipated healthcare needs align with the coverage and flexibility of different Medicare plans.

Gary Henderson · Answer

Medicare supplement plans vs Medicare advantage plans.
Insurance companies want you to buy advantage plans. They make more money and cost you more

Mary Brown · Answer

Most people ask about monthly premiums. But the smarter question is, how will the choice I make at 65 affect my ability to get care and switch plans when I’m 75 or 85?

Andrew Kramer · Answer

If you like to travel, especially outside the US, your question would be, "Do I have any coverage outside the US and how would it coordinate with my Medicare plan?"

Dean Chiapetto · Answer

You need to use an insurance broker. Brokers Make a Difference! A broker is obligated by their license to provide all information and advise you on the plan that will work for you.

Mike Henry · Answer

Are my dr’s and hospital covered.  What about my meds. How is testing covered   Is this my best option. Anything else

Barbara Barnes, CMIP® · Answer

How much will it cost?

There is so much more to this question than just premiums.  Of course, premiums are a part of it.  Usually, Part A will be premium-free because you've already paid for it through payroll taxes, but there is a premium for Part B and Part D, and if you made more than a certain amount, the premium might be even higher than what most people pay.

Beyond Parts A and B of Medicare, you will need to choose how you want to receive those benefits.  Do you want just Medicare A and B?  Do you want to add a Medicare Supplement plan to Original Medicare for additional coverage?  What about Prescription Drugs?  Or do you want to forgo Original Medicare for a Medicare Advantage plan?  Each option comes with different costs, risks and rewards.  It's important to understand each option before you decide which is best for you.  Then you still need to choose an insurance company!

Once you've decided on a plan and know what premiums you will pay, there are your deductibles, coinsurance, copayments and fees for the covered services you receive.  Did you know that with Original Medicare, there is no out-of-pocket limit on how much your claims could cost?  Usually, Medicare Advantage plans will have a maximum out-of-pocket amount, but that could be thousands of dollars.  Medicare Supplements limit your out-of-pocket risk, but they often have higher premiums.  Unless you have a low income and qualify for Medicaid, you will pay more than just the basic premiums for Medicare Parts A and B.

Confused yet?  That certainly is not my goal, but I do want to convey to you that Medicare is complicated.  This is why having an experienced Independent Insurance Agent who specializes in Medicare Insurance is so important.

Andrew Kelly · Answer

What are the measurable differences between "Original Medicare" and "Medicare Advantage? (The pros/cons of both)

Eizel Mere · Answer

The questions you should be asking are: What is not covered by Medicare? How can I cover myself for those instances?

Joseph Peck · Answer

How can i figure out which is the best way for me to be on medicare? Supplement? Advantage plan. Contact me and i help you figure out whats best for YOU.

Antonio Rodriguez · Answer

That’s a great question — and honestly, one that most people never ask.
The most important question to ask about Medicare is:
👉 “How will my coverage fit my health needs and my lifestyle over time?”

Most people only focus on the cost or the name of the plan. But what really matters is whether your coverage still fits if:
	•	your health changes,
	•	you move or travel more,
	•	your prescriptions change, or
	•	your doctor stops accepting your plan.

Medicare isn’t one-and-done — it’s something you should review each year to make sure it still works for you. That’s where I can help walk through options and make sure you’re covered both now and down the road.

Julie Thompson · Answer

What additional benefits does my plan offer?  Can I get rewards for my healthy activities? Do I have OTC benefits? Does my plan cover dental, vision and hearing? Are all my drugs covered on this plan?

Charles Borg · Answer

How much freedom will you have in choosing doctors? How will they be covered? Can I change doctors whenever I want to?

Toni Chavez · Answer

This is a reflective question not knowing what’s been reviewed with you thus far I’ll do my best to answer.  

I would ask if you were still traveling what’s covered in network vs out of network if you're looking at a Medicare Advantage Plan (Part C)

I always recommend work with a license broker who will advocate and guide you not only on initial enrollment into Medicare, but for future years to come.  Plans could 
change every year as well as your health as you get older.

Independent brokers represent the client, not the company which allows us to guide you based on your situation in an unbiased approach.

Our services are no cost to any Medicare beneficiary. We get paid directly from the carrier for the plan we place you in, so we are incentivized to make sure we do needs analysis. And recommend the plan. That makes the most sense for your situation at the time of enrollment...

Andre Cabral · Answer

You should always ask beforehand "who will make medical decisions as to what is necessary to me: my Doctor or the insurance company?"

Jim Willis · Answer

Supplements work together with Medicare and pay what Medicare does not pay.  That is the statement most of them make to you.

Ask what Medicare does not cover, even slightly, and hence your Supplement will not cover either.

Ask what are all of the copays, deductibles, and other costs that the supplement does not cover

I have had peopple sit down in front of me and tell me they paid nothing for their doctors during the year.  By the time we added their premiums, drug plan costs, deductibles and copays, we came up with about $6200.  I have a $1900 maximum out of pocket expense on my Medicare Advantage plan with all the same coverages they had.  I have switched over 700 people and ALL of them are happier with the Medicare Advantage plan

Robert Remin · Answer

Robert Remin, expert Medicare plan advisor, licensed in NY, CT, NJ, and FL. There are probablyy several important questions such as cost, coverage options for health and drugs, extra benefits for vision, hearling...I would not any one question more important.

Jami Mead · Answer

Long and short is did you explore Medicare Advantage or Medicare Suppliment options to work along with your Medicare. Your cost can be reduced for medical with these options and usually with a few extra perks. I am always happy to schedule a free consultation with you to review your options.

David Christian · Answer

While most people don't like to get too deep into the weeds of how Medicare works, I believe all Medicare reciepients should ask how it works (the breakdown of Parts A, B, C, D, Medi-gaps & Prescription Drug Plans).  Since there are no group plans for Medicare, you & your broker should be determining what's best for your individual health care & financial budget and not your best friend's or even your spouse / partner.  What's good for the goose isn't always what's good for the gander.  Once you know how it works and narrow down the best way forward for you, make sure all your doctors and prescriptions are covered.

Kevin Chaikin · Answer

The most important question you should ask about Medicare is what option between Medicare supplement and Medicare advantage is better for me now AND in the future.  And can I change from one to the other down the road?  This decision when starting Medicare can have lifelong implications.

Natalee Nimmo · Answer

I would ask about what the major differences are between Medicare advantage and Medicare supplement. I would ask about what are the differences in prior authorizations, networks, coverage while traveling, max out of pockets amounts, & co-pay amounts. I would also include, if you had to have chemotherapy or radiation treatment for cancer; What would it cost you and is that covered under a Medicare advantage and or Medicare supplement? I would also ask if your agent is a broker and what carriers are they licensed or appointed with and can they run comparisons and comparative quotes for you?

Ingrid Kollmann · Answer

What is creditable coverage and why should I be aware of it.  What happens if I am unable to provide it?

Claudia Englert · Answer

What’s my maximum out of pocket on a Medicare Advantage Plan. Medicare by itself doesn’t have a maximum out of pocket.

Ashley King · Answer

One thing I see often is that people new to Medicare focus mainly on premiums or extra perks, but the long‑term impact of their choices is just as important. Many also never learn about their early Medigap opportunities, like their Guaranteed Issue window, state GI protections, or birthday rules until those options have already passed. These rules can make a huge difference in long‑term flexibility and affordability, which is why I focus on educating people upfront about both their immediate choices and how those decisions can affect them 5–10 years down the road.

Tony Hardwick · Answer

The most important question to ask is "Are you happy with your healthcare coverage?" It's also important to ask if the client wants to increase benefit amounts or reduce any co-pays they may have.

Jerry Cohen · Answer

I think the most important question a person should be asking about Medicare is how will MediCare cover things if I develop a serious medical problem. Which plan will be easier for me to get the care that I need if I develop a serious medical problem a Medicare supplement or a Medicare advantage plan?

Robert Nunn · Answer

What is the unintended consequences of my actions what am I not seeing that could hurt me later . So I complete compliant presentation of MAPD and Med Supp is vital not just the one the agent pushes you because it is good for them ,so willingness to take time with you till all the questions are answered.

Patricia Graham · Answer

Do you know what your plan covers?  Do you have an agent to walk you through all the changes to Medicare?  Have you reviewed your prescription coverage?  Are you in old rates for what you are paying for your plan? Let's review your coverages.

Deborah Kemp · Answer

What is my yearly maximum out of pocket. Does reset on January 1? What are the gaps in coverage? Deductibles?

Robert Simm · Answer

So the question is, what is the most important question I should be asking about Medicare that I probably haven't thought of yet? I would say the most important thing you could do when getting set up on Medicare A and B, and whether you're choosing Medicare supplemental coverage or a Medicare Advantage plan, is to do your diligence. Don't just select the first thing that the first person says when they deliver this information to you. You want to, number one, research that person, research the company, and research whether this company will still be around next year. Surprisingly, that's important. You also want to research the different plan options as well. Like I said, if you just do your due diligence, then I think you'll be in a very good position to make a solid decision on your Medicare coverage. I wish you the best of luck with that.

Kathleen Gonzales-Byrd · Answer

I want to minimize my out of pocket costs and have access to quality medical provider so please tell me which plan is best for me based on my current medical status

Thermon Holliday · Answer

How does Medicare work if I become unable to speak for myself?  

Regardless of circumstances, if you were to become incapacitated and unable to communicate your healthcare wishes you, will need to have a legally designated party to speak for you.  Typically, this requires a Power of Attorney.  The majority of Medicare members simply believe my loved ones can make healthcare determinations for me.  Unfortunately, not always true.  Get a Power of Attorney (POA) for Healthcare today!

Tonya Mowan · Answer

Some of the important questions that sometimes are forgotten are the what ifs: 
What happens if I'm in the hospital for weeks? 
Will Medicare help if I need Rehab or a skilled nursing facility? 
What if I need Home Health? 
How will my plan handle high medication cost or specialty treatments? 

There are several what ifs in this world and how someone views them could make an impact on one chooses a plan to address their concerns.

Russell Scott · Answer

What is the most efficient way to cover the larger out-of-pocket expenses that can come up in retirement?  Examples include cancer diagnosis, extended hospital stays, short-term and long-term care.

Lori Marion` · Answer

The first consideration when ir comes to Medicare is budget. Depending on your income,  you may qualify for additional help to cover costs.

Sonya Chandler · Answer

How often can I change my Medicare Plan?  How can I avoid paying high out of pocket cost? Is there a difference in cost when using pharmacies?

Jajuan Knox · Answer

A big one people often overlook is, “Will this plan actually cover the doctors, specialists, and medications I use most?” It’s easy to focus on premiums, but out-of-pocket costs can add up fast if your doctors aren’t in-network or your prescriptions aren’t covered.

Randy Hill · Answer

That's a really smart question!

Most people getting ready for Medicare are thinking about things like, “How much will it cost?” or “Which plan should I pick?”  and those are really good questions!

But the most important question you probably haven’t thought of yet is:

“How will my health needs change in the next 5 to 10 years, and will my Medicare coverage still fit?”

Here’s why this matters.
When you first pick a Medicare plan, it’s easy to just look at today:

What doctors you see right now

What medicines you take right now

What hospitals are close to you right now

But: As you get older, your health could change.

You might need different doctors, specialists, surgeries, hospital stays, or expensive treatments you don’t need today.

The problem is:
Some plans (like Medicare Advantage plans) have rules like small networks or you need "permission" before getting care (called prior authorization).

If your health gets more complicated, it can be harder to change plans later — especially if you want a Medicare Supplement (Medigap) plan, which often requires answering health questions after your first enrollment window.

Simple Example:
Imagine picking a cheap, easy plan at 65, but then at 70 you get really sick and realize your plan doesn’t cover what you need and now it’s too late (or too expensive) to switch.

So in short:
The best question to ask is:
“Will this plan still take good care of me if my health gets worse in the future?”

Tip:
Choosing stronger coverage early even if it costs a little more. This can save you a lot of money, stress, and problems later.

If you want, I can help you go over options that not only fit your needs today, but also protect you for tomorrow!

Emmond Wills · Answer

How will my health and income changes over the next few years affect my Medicare costs and coverage?

This question helps you plan ahead for premium adjustments, drug costs, and eligibility for savings programs — instead of reacting after expenses pile up.

Leann Burkholder · Answer

Ask about extra benefits, like dental, vision, and over the counter options.  Also, ask for comparisons for hospital stays, cat scans, and maximum out of pocket costs.

Babs Atwell · Answer

Be certain to ask your agent or broker what services they offer throughout the year and how they plan to support you as you transition to Medicare. It can be very complicated and confusing and a good agent or broker, such as myself, will give year round support!

Hector Vazquez · Answer

Do I know all the gaps present in Original Medicare and am I prepared to face them with my choice of plan?

Calvin Fritz · Answer

How will my current health needs and medications be covered under the different Medicare plans?

Medicare has multiple parts (A, B, C, and D), and understanding how each part covers your specific needs—especially if you have ongoing health conditions or take regular medications—can save you a lot of time, money, and stress.

Brian Williams · Answer

Should I review my Medicare Advantage Plan each year, even if I like the plan that I have?  Are all Medicare Advantage plans the same, if not what areas are significantly different?

Gene Page · Answer

Many people have asked me, "What is the best Medicare Plan?" 

That has more to do with you, and less to do with the plans that are available. Do you have more than one place you call home? Do you see providers in multiple states? Do you have any chronic conditions? Do you qualify for Extra Help or Medicaid? Do you currently pay a premium for your health care? Do you feel things like Dental, Vision and Hearing are of great importance to you? Are you able to pay additional for those added benefits? Do you have an employer subsidy? Are you currently part of a managed care program, (HMO/PPO)?

The bottom line is, there is no "Best" plan. There are many good options that depend on your personal needs, finances, and location. Not all plans are available in all locations. Not all members qualify for all plans. A good agent will take the time to have that conversation with you so that you are able to make an informed decision. Call centers tend to believe one size fits all. They want to get you through the process as quickly as possible so they can move to the next call. Some agents look at commission rates while others look to put you in something more permanent but will have annual rate increases. Ask questions and work with someone who knows those answers. There is never a fee you pay to the agent, so don't feel like you need to navigate the maze on your own.

Ron Gambles · Answer

Between Medicare Advantage and Original Medicare with a Med Sup Plan and a Rx plan, which will best meet  my specific healthcare needs in the long term?  It is important to get a full understanding of the benefits and downsides of both options before choosing.

Holt Rushing · Answer

How do I know which route is best for my situation. What's the difference in copays vs deductibles? Will the plan cover me if I go out of the country?

George Francis · Answer

1. What will  Medicare do for me?
2. How do I determine which plan is best; Medicare Advantage or Medigap?

Scott Klag · Answer

Who I should choose to advise me on the myriads of choices and benefits that are available to Me. Face to Face is always better than over the phone.

David Schult · Answer

A lot of people focus on premiums and routine coverage, but the real financial risk often comes from:

Hospitalizations (deductibles and daily copays)

Skilled nursing facility stays (covered only for a limited time)

Specialist visits and outpatient procedures (20% coinsurance under Part B, with no out-of-pocket maximum unless you have a Medicare Advantage plan or Medigap)

Medications (especially high-cost Part D drugs or infusion therapies)


Why it matters: If you don’t have Medigap or a Medicare Advantage plan, there’s no “cap” on what you might spend in a bad health year.

Tami Baker · Answer

What are my out of pocket costs if I just choose original Medicare?

What is the penalty if I do not choose a Prescription Drug Plan?

Brittany Morris · Answer

The most important question you should be asking about your Medicare coverage is not a question you can ask your agent, but a question you must ask yourself does this plan fit me? In order for it to be the right plan for you it has to fit you - not your neighbor.  It must fit your budget, your lifestyle, cover your medicine, and provide access to your doctors.

Josefina Escobar · Answer

I don’t think there’s just one most important question, it’s really at least three key ones to start with. You should always ask- Are my doctors in‑network, are my medications covered, and is my pharmacy in‑network? There are other questions too, but those three are the foundation and can prevent the biggest surprises later.

Nicolas Cain · Answer

“Will my coverage still meet my needs if my health changes suddenly?”

Most people focus on current costs, but planning for unexpected health events ensures you choose a plan that protects you long-term.

Lesley Burns · Answer

Is my Doctor a part of this plan? With the plan that was offered to me, how can I access my benefits?

Nicolas Johnson · Answer

do I have an advisor who is going to keep up on all the changes with Medicare and has experience in the business? Will my advisor look out for my best interest, especially when my premiums change and help me to navigate future changes in healthcare coverage?

Elenys Peraza · Answer

“How will my Medicare choices today affect my flexibility and costs?”

Most people focus on immediate coverage, doctors, prescriptions, and premiums. 
Why It’s a Game-Changer
- Medigap vs. Medicare Advantage
If someone chooses Medicare Advantage now, they may lose the right to switch to Medigap later without medical underwriting. That’s huge if their health declines.
- Drug Coverage Gaps
Skipping Part D because they “don’t take meds” now? That can trigger late enrollment penalties and leave them exposed later.
- Network Restrictions
Some Advantage plans work great locally—but if someone moves or travels often, they may face limited access or higher out-of-network costs.
- Long-Term Cost Planning
A plan with low premiums today might have high out-of-pocket costs later, especially if chronic conditions develop.

Alexis Pepple · Answer

What other coverages can I add on to my Medicare that would protect me from critical illnesses like cancer, heart attack or stroke.  Also, how is long term care covered, most people do not realize that long term care is not covered under Medicare.

Lisa Schaad · Answer

One of the most important questions people don’t think to ask is, “How will this plan work for me if my health changes down the road?” It’s easy to focus on what you need right now, but the real value of a plan shows up when life takes a turn. Asking that helps you see past just today’s costs and think about how well the plan will protect you in the future.

Dismery Gonzalez · Answer

How will my health and cost change over the years, and how will it affect me? How can I prepare myself for the future.

Penny Wegner · Answer

What type of plan is right for me (Medicare Supplement or Medicare Advantage Plan)? Are my doctors in the network and are my prescriptions covered? What plan(s) allow me to travel (snowbirds)?

David Alelishvili · Answer

One of the most important questions you might not have thought to ask is: 'What happens to my Medicare coverage if my health needs change over time?"
Many people focus on what Medicare covers when they first enroll, but it's crucial to understand how your coverage might need to adjust as your health needs evolve. For example, Medicare offers different parts (A, B, C, D), and over time, you might find that you need additional coverage, like supplemental insurance (Medigap) or a different plan that better aligns with your needs. Additionally, asking about the flexibility of your plan, how it handles new treatments, specialist care, or prescription drugs, can save you from gaps in coverage or unexpected costs down the road. Knowing these details ensures that you’re not just covered today, but also set up for the future, as your healthcare needs change

Daniel Keenan · Answer

What is current premium for Part B.  Changes every year!  Once you have purchased Part B, your next question is, “When do I have to get PartD?”

Otumdi Omekara · Answer

The most important question about Medicare that is often not thought about is:
“What will my maximum out-of-pocket costs look like in a worst-case health year?”
This question matters because premiums might seem low, but if a beneficiary ends up in the hospital multiple times or needs expensive treatments repeatedly, the cost share can skyrocket. Every Medicare Advantage plan has a maximum out-of-pocket (MOOP) cost, which can be as high as $8,850 in 2025 (not counting drugs).

With Original Medicare, there’s no cap on out-of-pocket costs unless you buy a Medigap policy. Most people don’t think about this because they’re healthy when they enroll. But Medicare is insurance for the unexpected.
One question, that must be asked before enrolling in any plan, should be:
“If I get really sick, what’s the maximum I could pay under this plan?”

Althea Sanders · Answer

How does Medicare coordinate with other medical insurance (Medicaid, Tricare, etc.) or what are the complications with late enrollment? Do I have to have Part D coverage? What happens if I opt out of it?

Jeffrey Brucculeri · Answer

The question I get most often is "How and when should I enroll?" That is the important first step, and it is very confusing to most people. Beyond that, the most important question you should asking is "How do I decide whether to enroll in Part A and Part B, or delaying Part B?" It depends on whether you have employer coverage or not, whether you intend to keep your insurance through work, and how much that premium is compared to the Medicare Part B premium. If you do not have employer coverage, then you would definitely want to enroll in both Part A and B.

Clarence Davis · Answer

If Medicare doesn't pay for long term care expenses, What ways are there to help me cover them myself?

Johnnie Jeter · Answer

The most important question should always be concerning your benefits and what you actually have for example like, what carrier are you with Aetna? Humana? Etc.. do you have original. medicare and PPO or do you have Medicare advantage plan? You should also keep track of the special dates that you can make necessary changes if needed.

Jerry Wilson · Answer

Action Steps: How to Compare Plans
•	Compare annual costs, not just premiums
•	Check star ratings for quality
•	Verify provider networks and pharmacies
•	Review extra benefits like dental, vision, or fitness programs
•	Get expert help through a licensed Medicare insurance agent

Tatevik Melkonyan · Answer

One of the most overlooked questions seniors should ask is: “Do I qualify for Medicare Savings Programs or Extra Help, even if my income feels moderate?”

Programs like the Medicare Savings Programs (MSP) and Extra Help can pay your Part B premium, wipe out deductibles, and drop most Part D drug copays to $0.
 
Yet more than 40% of eligible seniors never apply, leaving thousands of dollars in benefits unclaimed each year.

A single application through Social Security or your state Medicaid office checks both programs at once. It’s free, confidential, and one of the smartest financial moves most seniors can make.

Tommy Lawson · Answer

Is my current health plan an HSA plan?  If so, you will need to discontinue your and, possibly, your employer's HSA contributions at least 6 months before applying for Medicare.  Don't try to full the system... you cannot fully fund your for the entire year either.  You are able to prorate your contributions depending on when your initial enrollment period begins, but make sure you talk to an agent or financial advisor when thinking about Medicare. 

-Tom Lawson

Rodrigo Ferrer · Answer

Is my state a guaranteed issue state for Medicare supplements? It's a very good idea to know how your particular state deals with Medicare Supplements. Many states only guarantee a person can enter a supplement without underwriting at extremely specific periods. If you fall out of those period you may be in for a shock when you try to enroll. My home state of CT for example is a guaranteed issue state year round and never requires underwriting. That means, a person can get on a plan pretty easily but the cost of those plans are definitely higher than non-guaranteed issue states. A good broker will know how a person can go onto a supplement when a person has just basic Medicare, when a person has Medicare Advantage, and when a person moves off or is cancelled from a private plan.

Laverne Ward · Answer

Most people focus on what their plan costs today — premiums, copays, givebacks, dental, vision — but they rarely ask how that plan will perform if their health changes.

These question opens up deeper conversations like:
Will this plan still meet my needs if I’m hospitalized or diagnosed with a chronic condition?
If my prescriptions change, how will my costs look under this plan’s Part D formulary?
Would a PPO or an HMO give me more flexibility if I need to see a specialist out of state?
If I move or travel often, will my plan’s network follow me?
If my income or Medicaid status changes, how will that impact my plan choice or eligibility?

Jennifer Stark · Answer

Where do i start the process? Will Medicare provide me with the coverage I may need if I get sick and or have health issues.  Can an agent explain Medicare so I understand it clearly?

Brandi West · Answer

This is a complex question as Medicare is tailored to each beneficiary differently.  Here are a few things to consider.  

"When you're looking at Medicare, most people focus on the monthly premium. But the most important question to ask yourself isn't about the monthly cost—it's about how much you could potentially lose if you get seriously sick.

If you choose Original Medicare alone, you could have unlimited out-of-pocket expenses.

If you choose a Medicare Advantage plan, your out-of-pocket costs are capped for the year, giving you a financial safety net.

If you choose Original Medicare plus a supplement plan, the plan will cover most or all of your out-of-pocket costs, so you're also protected from uncapped expenses.

So, the real question is: 'How am I protecting myself against the financial risk of a catastrophic health event?' Your choice between Original Medicare with supplemental and a Medicare Advantage plan should be based on how you want to manage that risk."

Holly Baker · Answer

How often do I need to change my Medicare plan and are there certain limitations as to when i can change?

Gregory Dunham · Answer

If you are turning 65, the first questions to ask are, what choices are available to me and which of those choices best suite my lifestyle and healthcare needs.

If you are 65 or older, you should be asking if the healthcare plan(s) you have are being utilized.  Are there benefits you are missing or now need based on a change in health or lifestyle.

Roarke Andrews · Answer

Check to make certain that any medications you take will still be covered by your Part D plan next year.  As well as to confirm that your doctor will still be in-network as well, given that there are quite a few changes in networks.

Leonel Quintana · Answer

One of the first questions people aging into Medicare, or those who already have it, should ask themselves is: What are the differences between Medicare Supplement (Medigap) and Medicare Advantage, and which option is best for my situation? Understanding how both options work can make a huge difference in choosing the right plan for your needs

Elizabeth Baron · Answer

Can you explain to me the main differences between Medicare Advantage and Medicare Supplement plans?  How can I determine which type is more appropriate for me?

Tom Perrucci · Answer

When should I start the process of enrolling in Medicare, and what are my options to add additional coverages to make up the 'gap' that Original Medicare leaves.

Stacey Gaines · Answer

The most important question you might not be asking is how much you could spend out-of-pocket for health instances (for example:  like a hospital stay or serious illness). Further more, cost of medical  deductibles, copays, and coinsurance can add up significantly beyond the monthly premium.

Ed Taylor · Answer

You should be asking your medical resources who they would suggest you contact for your Medicare plan depending on whether it is primary care, dental, prescription, and so on.

Patti Bagley · Answer

Do I want to be tied to a network to receive care or do I want the freedom to see the providers I choose?  Would I rather pay a higher premium with lower out of pocket costs or would I rather pay a lower premium and pay copays as I utilize services?

Vicki Farley · Answer

What does Medicare not cover?
Basic Medicare does not cover 1. Hospital stay deductibles or all of the Out of Pocket C0-Pays,
2. Prescription Drugs, 3. Dental or Vision.

Jeannie Pond · Answer

"It's a little bit funny... This feeling inside...."

Should we be living in the now? Absolutely! It is essential to our and those we love's mental well being. It directly impacts our internal health. And...

When it comes to Medicare, seniors logically tend to focus on monthly premiums or whether their current doctor is in-network. That's what matters today, right? 

But the real game-changer is understanding how each choice—Medicare Advantage vs. Medicare Supplement, drug plan tiers, enrollment timing—can either protect or limit you down the road.

Consider these questions:

What will happen with my insurance plan if my health declines?

What if I move? Travel more? Need specialized care?

What are the long-term ramifications of Copays, co-insurance, deductibles and maximum out of pocket limits?

The importance of creating a long lasting relationship with your insurance agent is that Medicare isn’t just a set-it-and-forget-it decision. Your agent is your guide to how you’ll navigate aging, health, and independence. Your agent should be helping you get prepared.

Mitch Winstead · Answer

How many times a year does Medicare pay for my Part A deductible. Also if I have a Medicare Supplement will the Supplement pay for the deductible?

David Tucci · Answer

What is the primary difference between Original Medicare and an Advantage Plan. What do seniors own?

Gina Landers · Answer

For Medicare Advantage plan beneficiaries: Are all my doctors, hospitals in the network and are all my medications covered and how much will my costs be?

For Medicare Supplement plan and Part D beneficiaries:  What are my options when my Medicare supplement plan premiums increase?  

When can I review and change my Medicare Part D plan?

Lachea Harris · Answer

A critical, most often overlooked question is: 

How will potential changes in my health impact my future Medicare needs, and what are the long-term cost implications of those changes?. 

In addition, it is very important to ask:

 How do the different Medicare supplemental plans, like Medigap or Advantage plans, truly affect my out-of-pocket expenses in various healthcare scenarios?.

Benny Levy · Answer

What are my options for Medicare. Advatgae and /or supplement plans. How do they work and what are the ramifications if I chose meducate ivory supplement and vise verse.

Mike Laubert · Answer

Tell me about prior authorization and how it affect my Medicare Supplement Plan or Medicare Advantage Plan.

Larry Elliott · Answer

The most important question is which plan is best for you. You need to check if a Medicare advantage or a Medicare supplement will best fit your budget.

John Hunter Christian · Answer

The most important question is related to election periods. When are the election periods and how do Medicare recipients qualify for the different times?

DeeDee England · Answer

What does Medicare Cover and what does it not cover?  I know most people do not read their "Medicare And You" book and still it can be a lot of information to understand.  Working with someone like myself is a really smart move.  I know the ins and outs of Medicare like the back of my hand.  I also have access to most insurance companies in the area to ensure that your health coverage is the right fit, since Medicare is not a one size fits all.

Tim Roberson · Answer

Whether you want a med supp or you want an advantage plan. And when should you apply for Medicare part A and part B.

Daniel Jones · Answer

Understanding Medicare and how it works can be confusing to many. If you're going to choose a Medicare replacement or Medicare Advantage, you'll want to understand the difference between Network types, what is a PPO, HMO and HMO-POS for example, and more importantly, what does that mean to me as a health care consumer.

Charles Hart · Answer

How important is it for you to have access to facilities and doctors.  Some Medicare plans require you to use facilities and doctors that are in a network, usually close to your primary residence location. Other plans allow you to use doctors and facilities that don’t require a network and usually allow for nationwide coverage.

Craig Walker · Answer

Do I want to go the traditional path with a supplement and a prescription plan or a medicare advantage plan? There are pros and cons to both!

Julie Williams · Answer

If I am working and I have employer health coverage, do I need to take Medicare? I keep hearing about penalties.

Daniel Smith · Answer

Does medicare pay for my perscription drugs? Yes it will cover generic drugs listed in the formulary let's look up your medicine.
Which company has the bes plan for me? It depends on if you are firm on keeping your doctor and other needs you have like dental, hearing, and if you are low income your needs will need to be discussed.

Jackie Rodriguez · Answer

When is the right time to begin using medicare for my health insurance?  Everyone's needs are different and need guidance from an agent.  This decision will affect their healthcare options in retirement.

Heather Benjamin · Answer

That’s a great question! Medicare only covers 80% of Medicare covered expenses and does not cover Prescription drugs or other benefits like dental, vision and hearing. So you will want to consider what backup coverage you will want in addition to your Medicare insurance. For example, would you like a Medicare Advantage plan or a Medigap or Supplement. I can help you understand these options if you’d like more information.