My passion around Medicare started when my parent's turned 65. And to this day, every client gets the "mom test" (ie. Would I make the same recommendation to my own mom?). I love helping people understand the unnecessarily overly complex structure of Medicare in ways that are easy to understand. In this complexity, unfortunately many people don't realize some of the opportunities and pitfalls that come along with Medicare, and I love being able to help them make notice. Consider me a nerd who loves to read contracts, but I do this to help ensure folks buy what they want and need, and to make sure they actually buy what they thought they were buying. As the old adage says, "Do the right thing and the money will follow".

Quite simply because we understand and live our daily lives in the local community. This is important because we're intimately aware of local health providers and health networks and as an active member of the community, we also contribute to our local economy! Having that been said, I work with folks how they prefer to work - whether that's virtually via phone or email, or we meet up for a cup of coffee. Lastly, there's no 1-800 number associated with a giant call-center that could be halfway across the country or world! When my clients call me, only I answer.

This sounds cliche coming from me, but the biggest mistake folks going on Medicare make is not having an independent agent help them with their options. When you call into an insurance company for help, their sole job is to sell you their product, whether it's the best option or not. Conversely, you want someone who has a financial incentive to assist you in finding the right type of coverage and plan by reviewing ALL of your options with many insurance companies and not leaving anything to chance. Imagine a doctor who only wrote you prescriptions from one pharmaceutical company; you'd have questions about their motives just as I would too!

One more thing. The price you pay for insurance is regulated by the State's Department of Insurance. So this means the price you pay is exactly the same if you purchase directly from an insurance company or you purchase the exact same plan through me! And I never charge for anything I do today and in the years to come to continue to support you and your needs!

If feels obvious, but unfortunately, simply not knowing all of your options. There are so many nuances and rules for folks who initially become eligible for Medicare, whether from a disability, turning 65, working past 65 and subsequently retiring. Not knowing your full options could be incredibly costly both on your pocketbook but also on your quality of healthcare. Before making ANY decisions, make sure you've been aware of all your options, weighed all the pros/cons - you'll thank yourself later.

I always recommend someone to take a step back first, think about all the things you like and dislike about the health insurance you currently have or the coverage you last had (from employment prior to retiring, individual plan from your business, etc). This is a great starting point if you can have a list of likes/dislikes to help us set the tone for how to ensure your Medicare related coverage has most of the "likes" and little or none of those "dislikes".

Picture Medicare Part A & B as this: You're in a hospital room. The room and the bed itself is Part A (hospital) and anytime someone comes into the room or plug something into you, that's Part B (medical). Part D is the coverage for drugs (D as in Drugs). The problem with Original Medicare is that there is no annual out-of-pocket maximum. And that's where private insurance comes in - to help cap your financial exposures and reduce or eliminate your out-of-pocket costs.

As the old saying goes, "Nothing in life is free". Same applies here! The concept of a "Free" or $0 monthly premium Medicare Advantage plan can be misleading. It doesn't mean you won't have any healthcare costs, as you'll still have costs associated with copays, deductibles, coinsurance, alongside with the fact that your care will be managed by an insurance company that may/may not restrict you to a network of doctors and providers.

First off, never assume that something that is $0 per month is "free". There's always costs associated with health care, especially Medicare Advantage plans - in the form of copays, deductibles, and coinsurance. Having that been said, the reason why some Medicare Advantage plan providers are able to offer their plans for $0 monthly premium has to do with how they leverage government funding and strategic cost management. When a person leaves Original Medicare to a Medicare Advantage plan managed by an insurance company, it should be noted that the Medicare beneficiary is no longer a "liability" or on the "balance sheet" of the US Government, but rather is now the "liability" of the private insurance company - to manage their care and associated costs. As a result, Medicare Advantage plans receive monthly payments from Medicare for each individual they have enrolled in their plans. These payments are designed to help cover the costs that would have historically been provided under Original Medicare. Private Insurance companies also deploy strategic cost management through negotiating lower rates with providers, putting attention on preventative and healthy membership to help pass the cost savings to the individual.

Maybe! I love when I get to answer a question with a "yes" and a "no". Since Medicare Advantage plans are "managed care" plans, you may be restricted by a plan provider's network (of doctors and facilities) or the type of network (ie. HMO vs. PPO). This is why it is important to verify if your doctor is in-network for any plan you may be interested in. If the doctor is out-of-network, depending on the plan, you may or may not have any insurance coverage to see that doctor - resulting in significantly more out of pocket expenses.

Everyone and no one! Statistically, in 2025, Medicare eligible folks who choose private insurance, about 50% choose a Medicare Advantage plan while 50% choose Original Medicare with a Medicare Supplement plan. That goes without saying that while a Medicare Advantage plan works for some people, it doesn't work for everyone. There are many pros/cons for either option, so its most important that you assess what matters most to YOU, not your friends or family members. What you value in your health insurance coverage may or may not be what your friends value.

Unlike the health insurance plans you were most familiar with during your working years, Original Medicare does not have an annual maximum out of pocket. This means that you could be at risk of losing substantial savings to pay for medical bills. This is where private insurance comes in, to help cap and limit your financial exposure and risk.

Yes and No! While you can certainly change your Medigap plan at any time during the year, unless you have guaranteed issue rights (Based on state or personal situation), you may have to answer health questions and be subject to underwriting - meaning the insurance company does not have to approve you for coverage. But do not fear! A "decline" by an insurance company doesn't carry too much weight - it just means they don't want to provide you coverage. Every insurance company will look at you differently, so there is potential that another company will happily provide you your coverage. AND, as long as you continue to pay your premiums on your existing coverage, your existing company will continue to honor their promises and coverage.

Your choices around Social Security and Medicare are separate. I cannot provide tax or financial advice, so I do recommend you speak to a licensed financial advisor as to your strategy for Social Security withdrawal. As for Medicare, if you're no longer working, it is important to enroll in Medicare when you turn 65. Keeping in mind that the earliest your Medicare (Part A&B) would begin is the first day of the month in which you turn 65 (unless your birthday is on the 1st, and then Medicare would begin on the 1st day of the prior month). It's important to opt into Medicare when first eligible, especially if you do not have employer-provided health insurance from yourself or your spouse, to avoid any potential pitfalls (like Medicare associated penalties or late enrollment delays).

Great Question! There's really two answers here, so it depends on if your specialty medication is covered by Part B, or if it falls under Part D prescription drug coverage. Based on you having high costs, I am assuming your drug does not fall under Part B. As such, since every Part D plan has a "formulary" (list of covered drugs), by law, they must provide drugs that provide care to nearly every type of illness or issue. However, that doesn't mean your drug is on the formulary. And if it is not, you're not covered by insurance for the cost. You should work with your doctor to see if there is another acceptable drug that will have the same therapeutic benefits that is on your plans formulary. Otherwise, you can request an appeal from Medicare, and with your doctor's assistance, you can request a formulary exception - to get your Part D plan to cover the drug. If the drug is still too expensive, you should see if you qualify for any "extra help", by going to Medicare.gov for more information.