Questions people ask us

A Medigap policy sits behind Original Medicare and pays the bills Medicare leaves you. You keep the freedom to see any doctor in the country who takes Medicare, and you pay a monthly premium for that.

A Medicare Advantage plan replaces Original Medicare with a private plan. It usually costs less each month and often includes drugs, dental and vision, but you use a network, you may need referrals, and some services need approval in advance.

Neither is better. They are different trades, and which one fits depends on your doctors, your travel, your prescriptions and how you feel about surprises.

Often, but not automatically. Plan G covers everything Original Medicare leaves except the $283 Part B deductible, so your year is very predictable.

Plan N costs less each month and asks for small copays instead. High-deductible Plan G costs much less and protects you against a catastrophe rather than everyday bills. We will run all three against your actual situation.

Because of a 2015 law. Plan F is closed to anyone who first became eligible for Medicare on or after January 1, 2020. If you were eligible before then you can still buy it, and if you already have it you can keep it.

Keeping it is not always the best move. No new, healthier people are joining Plan F, so its premiums tend to rise faster than Plan G’s.

The plan charges no premium of its own. You still pay your Part B premium every month, and you pay copays when you use the plan: for a specialist, a scan, a hospital stay.

The number to look at is the plan’s yearly out-of-pocket maximum, which is the worst case. That is the real price of a $0 plan.

If your employer has 20 or more employees and you have coverage through that job, you can usually delay Part B without penalty and pick it up later through a Special Enrollment Period.

If the employer has fewer than 20 employees, Medicare usually needs to be primary and delaying can leave you with unpaid claims. Ask your benefits office to put the answer in writing, then call us before you decide.

You wait for the General Enrollment Period, January 1 to March 31, and coverage starts the first of the month after you sign up. A Part B penalty of 10% per full year missed is added to your premium for as long as you have Part B.

Before you accept that, call us. A surprising number of people qualify for a Special Enrollment Period they did not know about.

Partly. If you are in a Medicare Advantage plan on January 1, the Medicare Advantage Open Enrollment Period from January 1 to March 31 gives you one change: a different Advantage plan, or back to Original Medicare with a drug plan.

It does not guarantee you a Medigap policy. If you want a supplement, the company can ask about your health at that point.

Moving opens a Special Enrollment Period. Medicare Advantage and drug plans are local, so your current plan may not exist at your new address.

Tell us before you move if you can. The window usually runs from the month before your move through two months after it, and it is easier to arrange in advance than to fix afterwards.

Nothing. If you enroll in a plan through us, the insurance company pays us a commission that it sets. Your premium is exactly the same as it would be if you enrolled directly or through anyone else.

No, and there is a practical reason as well as a principled one. We are paid to keep people in the right plan for years, not to place them once. A plan you cancel in April costs us money.

If the honest answer is that your employer plan is better than anything we can offer, that is the answer you will get.

That is most of what we do. Claim problems, pharmacy surprises, a specialist who has left the network, a letter you cannot make sense of. Call the same number and ask for Yolanda.