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Michael T. Braden March 19, 2026 Medicare Part D Copy Of Braden Medicare Insurance's Medicare Negotiates Drug Pricing Poster MEDICARE IS FINALLY NEGOTIATING DRUG PRICES DIRECTLY WITH THE DRUG MANUFACTURERS Having been an Independent Medicare Broker for over 10 years, I was always frustrated by the sky-high prices seniors had to pay due to Medicare's Prescription Drug Prices. Finally, the first 10 drugs with their Medicare costs lowered took effect on 1/1/2026. This has been long overdue, and it will be a blessing for far too many Americans who rely on Medicare every day. But Medicare is not stopping there. Beginning in 2027, we will see Medicare lowering the costs of at least 15 Prescription Medications each year over the next nine years. I hope this article is a quick read and that you all enjoy the information provided. Our goal every day is to teach and inform others about Medicare and their Medicare choices, and to answer any questions we are asked. UPDATES ON MEDICARE'S NEXT WAVE OF RE-NEGOTIATED DRUG PRICES Under the Inflation Reduction Act, Medicare was authorized to negotiate its own Drug Prices. CMS (Medicare) announced it would negotiate new pricing for the 10 Most Popular Prescription Medications each year over the next 5-10 years. Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 NEGOTIATION PROGRAM CENTERS FOR MEDICARE & MEDICAID SERVICES In August 2022, President Biden signed the Inflation Reduction Act of 2022 (P.L. 117-169) into law. The law makes improvements to Medicare by expanding benefits, lowering drug costs, and improving the sustainability of the Medicare program for generations to come. The law provides meaningful financial relief for millions of people with Medicare by improving access to affordable treatments and strengthening Medicare, both now and in the long run. For the first time, the law gives Medicare the authority to negotiate the prices of certain high-expenditure, single-source drugs without direct generic or biosimilar competition. The Centers for Medicare & Medicaid Services (CMS) selected 10 drugs covered under Medicare Part D for the first cycle of negotiations on initial price applicability in 2026. They engaged in voluntary negotiations with the drug companies for those drugs. Below is the list of negotiated prices, which the statute refers to as Maximum Fair Prices (MFPs), for 10 drugs covered under Medicare Part D that will go into effect beginning January 1, 2026, based on negotiations and agreements reached between CMS and participating drug companies. CMS negotiated in good faith, consistent with the requirements of the law, on behalf of people with Medicare and the Medicare program. Throughout the negotiation process, the CMS team took into account the factors outlined in the law when negotiating these prices, which supports the need for innovation and drug development to achieve better prices for people with Medicare and the Medicare program. CMS engaged in genuine, thoughtful negotiations with each participating drug company. CMS developed an initial offer for each drug, consistent with the process described in the statute and the agency’s guidance, and each manufacturer responded with a counteroffer.  CMS held three meetings with each participating drug company to discuss the offers and counteroffers, review evidence, and seek a mutually acceptable price for the drug. During the negotiation process, CMS revised its offers for each drug upward in response to these discussions. Likewise, many drug companies revised their counteroffers for their drugs downward, based on the discussions with CMS. For five of the selected drugs, this process of exchanging revised offers and counteroffers led CMS and the drug company to agree on a negotiated price during a negotiation meeting. In four of these cases, CMS accepted a revised counteroffer proposed by the drug company. For the remaining five selected drugs, CMS sent a written final offer to those drug companies, consistent with the process described in its guidance, and in each instance, the drug company accepted CMS’s offer on or before the statutory deadline. Impact of the Negotiated Prices Overall Medicare Spending and Out-of-Pocket Spending in 2023: For the time period between January 1, 2023, and December 31, 2023, about 8.8 million of the 54 million people with Medicare Part D coverage were dispensed these drugs to treat a variety of conditions, such as cardiovascular disease, diabetes, autoimmune diseases, and cancer. These selected drugs accounted for $56.2 billion in total Part D gross covered prescription drug costs during 2023, or about 20% of the total. During that same period, people with Medicare Part D prescription drug coverage incurred $18.9 billion in out-of-pocket costs for all Part D-covered drugs, including $3.9 billion for drugs selected for negotiation. Estimated Medicare Net Savings in 2023: Compared to 2023 Medicare spending net of all rebates and certain fees and payments, if the prices agreed to between CMS and participating drug companies under the Negotiation Program had been in effect during 2023, the negotiated prices would have saved an estimated $6 billion in net covered prescription drug costs, which would have represented 22% lower net spending in aggregate. Projected Savings for People with Medicare Part D Coverage: When the negotiated prices go into effect in 2026, people enrolled in Medicare prescription drug coverage would save under the projected defined standard benefit design an estimated $1.5 billion. 2026 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2026 PLAN YEAR ELIQUIS dropped 56% from $521.00 to $231.00. JANUVIA dropped 79% from $527.00 to $113.00. FIASP & NOVOLog Flex Pens dropped 76% from $495.00 to $119.00. FARXIGA dropped 68% from $556.00 to $178.50. ENBREL dropped 67% from $7,106.00 to $2,355.00. JARDIANCE dropped 66% from $573.00 to $1697.00. STELARA dropped 66% from $$13,836 to $4,695.00 XARELTO dropped 62% from $517.00 to $197.00. ENTRESTO dropped 53% from $628.00 to $295.00. IMBRUVICA dropped 38% from $14,934 to $9,319.00. The prices above went into effect on January 1, 2026. 2026 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2027 PLAN YEAR The prices below will go into effect on January 1, 2027: OZEMPIC/RYBELSUS/WEGOVY is dropping 71% from $959.00 to $274.00. TRELEGY ELIPTA is dropping 73% from $654 to $175.00. XTANDI is dropping 48% from $13,480 to $7,004.00. POMALYST is dropping 60% from $21,744 to $8,650.00. OFEV is dropping 50% from $12,622 to $6,350.00. IBRANCE is dropping 50% from $15,741 to $7,871.00. LINZESS is dropping 75% from $539.00 to $136.00. CALQUENCE is dropping 40% from $14,228 to $8,600.00. AUSTEDO/AUSTEDO XR is dropping 38% from $6,623.00 to $4,093.00. BREO ELIPTA is dropping 83% from $397.00 to $67.00. XIFAXAN is dropping 63% from $2,696.00 to $1,000.00. VRAYLAR is dropping $44% from $1,376.00 to $770.00. TRADJENTA is dropping 84% from $488.00 to $78.00. JANUMET/JANUMET XR is dropping 85% from $526.00 to $80.00. OTEZLA is dropping 65% from $4,722.00 to $1,650.00. 2027 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2028 PLAN YEAR The Medications listed below will have newly renegotiated pricing that takes effect on January 1, 2028. TRULICITY . BIKTARVY. ORENCIA. COSENTYX. ERLEADA. KISQALI. $ENTYVIO. VERZENIO. BOTOX/BOTOX COSMETIC. LENVIMA. XOLAIR. REXULTI. XELJANZ/XELJANZXR. ANORO ELLIPTA. CIMZIA. Braden Medicare Insurance's Poster of Michael Braden's Business Card. Many of you have asked why we chose the Red, White, and Blue Flag Logo and color palette. The answer is in honor of my father, Tillman Braden Jr. Dad retired as a Chief Master Sergeant and is laid to rest at Arlington National Cemetery in Washington, DC. My father taught me to be polite, sincere, well-informed, never late, and to understand what it means to serve others honorably. As an Independent Medicare Broker, we are sincerely honored to serve our friends, family, and neighbors in retirement. We genuinely love what we do, we are patient, and we enjoy teaching and explaining things in a way that is easy for others to follow and understand. In addition to being an Independent Medicare Broker serving clients in 12 states, I am also a Certified Medicare Planner. If I can ever be of service to you or any of your friends or family, please feel free to call me anytime, or text, email me at mike@bradenmedicare.com , or submit a contact request on our website at www.bradenmedicare.com . Photo of Braden Medicare Insurances Society Of Medicare Planners Poster. Our founder and owner, Michael Braden, is a Certified Medicare Planner.

Michael T. Braden March 19, 2026 MEDICARE 101 Photo Of Braden Medicare Insurances 2026 What Is The Out-Of-Pocket Maximum With Medicare Poster In today's article, we are taking a closer look at what is included in Medicare's Out-Of-Pocket costs for both Original Medicare and for Medicare Advantage plans (Medicare Part C). Most new Medicare Beneficiaries are caught off guard when they learn that Original/Traditional Medicare has no limits on deductibles, copays, or coinsurance, which can add up without limit. However, Medicare Advantage plans must set a MOOP for each plan. MOOP stands for Maximum-Out-Of-Pocket Expenses. Moop amounts are designed to let you know that you cannot be charged any amount over your MOOP for your particular Medicare Advantage plan. Once you reach that amount, your plan will pay for all of your expenses for the remainder of the Plan Year/Calendar Year. Medicare Supplement/Medigap plans were designed to help reduce this exposure for those who prefer to be in control of their own Healthcare and choose Original Medicare vs Medicare Advantage plans. MEDICARE OUT-OF-POCKET EXPENSES Traditional or Original Medicare (Parts A and B) has no annual Medicare out-of-pocket maximum, so, in theory, Medicare beneficiaries could face an unlimited amount of costs from co-pays, deductibles, and coinsurance alone. There are two options for Medicare Beneficiaries to limit their cost exposures. The first is to place a limit on the maximum annual out-of-pocket costs for Medicare bills, which requires either adding a Medigap/Medicare Supplement plan or replacing their original Medicare with a Medicare Advantage plan. Medicare Advantage plans (Part C) are all required by law to have out-of-pocket costs, which cap your yearly spending on covered, in-network services. Last year, in 2025, the highest allowed limit was $9,350 for in-network services and $13,300 for out-of-network services. If this seems high, there are plenty of Medicare Advantage plans with lower limits. Additionally, plans will change over time, and inflation has had a large impact over the past 2-3 years alone. Medicare Supplement (Medigap) plans protect by offering a variety of options. Some plans, like Plan G, offer very low maximums (limited to the Part B deductible, which is just $283 for the 2026 Plan Year, while others, like Plans K and L, have higher limits due to partial coverage. All the Medicare supplement plans offer more insurance and lower out-of-pocket costs than Medicare Advantage plans. For example, in the Southwest and Midwestern states, the average cost of Medigap Plan G is about $170 per month, or $2,040 per year. Once you add the $283 Annual Part B deductible, it caps your healthcare costs at $2,23.00 for the year, compared to the National Average of Medicare Advantage plan MOOPS, which is now over $5,000 for In-Network costs alone. PLEASE REFER TO THIS EXAMPLE AS IT SHOWS MONTHLY MEDICARE COSTS WITH A MEDICARE SUPPLEMENT PLAN G Photo Of Braden Medicare Insurance's 2026 Monthly Medicare Cost Estimate Worksheet Poster MORE ABOUT MAXIMUM MEDICARE OUT-OF-POCKET COSTS When you first enroll in Medicare, most people start with Medicare Part A  (In-Patient Hospital Services) and Medicare Part B , outpatient (All Of Your Out-Patient Healthcare Costs, including Durable Medical Equipment (DME), and Out-Patient Surgery Center services).  It is possible to get Medicare Part A months or years before Part B. Still, these are the two parts of Medicare required before deciding on a Medicare Supplement/Medigap plan or Medicare Advantage plan (Medicare Part C). Original Medicare does not have an annual maximum out-of-pocket limit.  It was never intended to be a stand-alone, full-coverage option for seniors. Therefore, there is no cap on Medicare out-of-pocket spending in Original Medicare. Simply put, this means that yourng your Medicare out-of-pocket costs can be unlimited in theory. WHAT MAKES UP THESE OUT-OF-POCKET COSTS? Out-of-pocket costs or out-of-pocket expenses include deductibles, copayments, and coinsurance. These medical expenses can add up quickly without a maximum limit. The only way to place a maximum out-of-pocket on your financial risk for covered health services is to either purchase a Medicare supplement Plan or a Medicare Advantage Plan. For those who qualify, Medicare beneficiaries can access savings programs that are available through Medicare to help manage out-of-pocket costs, including premiums, deductibles, copayments, and even costs related to prescription drugs. MEDICARE SUPPLEMENT ANNUAL OUT-OF-POCKET LIMITS With 12 Medicare Supplement Plans to choose from, there are some with limits and some with no limits at all. Please refer to the 2026 Medicare Supplement Comparison Chart below to distinguish the intricacies of each plan. Photo Of Braden Medicare Insurance's 2026 Medicare Supplement Side-By-Side Comparison Chart Here are the Top 5 Most Popular Medicare Supplement/Medigap Plans since 2020: Plan G Plan N Plan F Plan C High Deductible Plan G For example, the out-of-pocket maximum for Plan G equals the Medicare Part B deductible ($283 for 2026), a “hard” fixed maximum out-of-pocket .  The out-of-pocket maximum for high-deductible Medigap plans equals their annual deductible ($2,950 in 2026), again, a hard limit. However, your out-of-pocket maximum for Plan N is the Part B deductible plus office/ emergency room copays.  We have no way of knowing how many office visits you may have in any given year, but we can assume a reasonable number . You can be charged between $0 and $20 per doctor's visit, and $50 for a Hospital Emergency Room Visit if you are not admitted. Because it is not a set amount, we refer to these as a soft maximum out-of-pocket amount. For 2026 , the out-of-pocket maximum for Plan K is $8,000; for Plan L, it is $4,000 .   The out-of-pocket maximum only refers to medical services approved or accepted by Medicare and does not include any services or procedures not covered by these supplement plans. You might notice that, when you look closely at the table, most Medicare supplement Plans show 100% coverage for the major benefits. MEDICARE PART B COVERAGE For example, Medicare Part B coinsurance or copayment.  That is the 20% that Medicare Part B does not cover. You have 100% coverage.  Everything is covered until you reach Plans K and L. Medigap Plan K has only 50% coverage.  Medigap Plan L has only 75% coverage.  These coinsurance and copayment amounts apply to a wide range of medical expenses and medical services , including doctor visits, outpatient care, durable medical equipment, and covered drugs. IN-PATIENT HOSPITAL PART A COVERAGE Look at Part A hospital coinsurance.  With no supplement, you have 60 days of coverage before you start paying a daily copay.  That copay is covered 100% by a Medicare supplement plan, except for Plans K & L.  Plan K only covers 50%.  Plan L covers 75%.  Hospital costs, such as room and board, medications administered during your stay, and other inpatient services, are included in these expenses. SKILLED NURSING FACILITIES (SNF) Medicare Part A covers the first 20 days at 100%, with the consumer paying a daily copay for days 21 through 100, for a total of no more than $17,360. That’s the maximum for 2026.  Skilled nursing facility costs , including daily care and rehabilitation services, are subject to these copays depending on your coverage. If you have Medicare supplement Plan A or Plan B, you will pay whatever Medicare doesn’t pay, including skilled nursing facility costs. Which means if you spend 100-days in a skilled nursing facility you will pay up the maximum of $17,360.   If you have any supplements other than supplement plans K and L, you have 100% coverage.  100 days of skilled nursing care cost you nothing out-of-pocket. Zero. ($0). PARTIAL COVERAGE PLANS So, the reason Medicare supplement Plans K & L have a maximum out-of-pocket cost is that they offer only partial coverage for major services.  The consumer has significant financial exposure to medical bills because they do not have 100% coverage for these major services, which is where catastrophic coverage could help mitigate that risk .  Without a set maximum out-of-pocket limit for those two plans, the consumer would have unlimited financial exposure, which could result in an excessive financial burden. Think of the annual maximum out-of-pocket costs as only referencing the benefits that are covered at either 50% or 75% by these two plans. Another way to describe this is simply with a question.  How can a consumer have any financial risk if the Medicare supplement is paying 100% of the Medicare bill? So Many Professionals Got This Wrong! THE TWO THINGS MANY PEOPLE GET WRONG WHEN IT COMES TO MEDICARE MEDICARE DOES NOT COVER LONG-TERM CARE First, Medicare is not Long-term Care.   Long-term care needs are not even considered on this benefit table. For example, your Skilled Nursing Care benefits end after 100 days. At 101 days of Skilled Nursing, you have no Medicare benefits and no Medicare supplement benefits. It doesn’t matter whether these supplement plans have zero coverage for Skilled nursing, like Plans A and B, 100% coverage, like Plans C, G, and N, or just 50% or 75% coverage, like Plans K and L. At day 101, your Medicare coverage is depleted. In addition, after you use your initial 90 days of inpatient hospital care, Medicare provides up to 60 additional ‘lifetime reserve days’ that can be used over your lifetime for extra hospital coverage. Once these are used, you must pay all costs out of pocket. Medicare coverage is structured around ‘benefit periods’: a benefit period begins the day you are admitted as an inpatient to a hospital or skilled nursing facility and ends after you have been out for 60 consecutive days. Each benefit period resets the deductible and coinsurance requirements, and multiple benefit periods can occur within a year, which may increase your out-of-pocket costs for inpatient care. A new benefit period begins after you have been out of the hospital or skilled nursing facility for 60 days, and each new benefit period resets certain costs and coverage terms. You are on your own unless you have Long-Term Care Insurance. That is where your Long-Term Care insurance policy will begin. WHAT IS COVERED? Second, and this is key, the maximum out-of-pocket cost limit only applies to what the Medicare supplement covers.  Only costs for covered services are counted toward the out-of-pocket maximum, meaning that expenses for any covered service under the supplement plan, including those services that Medicare covers, are included, while non-covered services are not. For example, the maximum out-of-pocket cost shown for Plan K is $8,000 for 2026.  But that $8,000 is only applicable to what the supplement plan covers, excluding the annual deductible.  It does not cover the Part B deductible. That’s an additional expense not included in the maximum out-of-pocket.  It doesn’t cover Excess Charges.  If you have Excess Charges, they are in addition to the maximum out-of-pocket. Now let’s apply that information to Medicare Supplement Plans A and B.  For Medicare services that Plan A or Plan B covers, they pay 100% of the Medicare bills that Original Medicare does not pay .  The maximum out-of-pocket cost only references the portion of Medicare services covered by the supplement.  There is no maximum annual out-of-pocket cost listed because the benefits they cover are covered at 100%.   There is simply no supplemental insurance for Skilled Nursing. That means you have a maximum out-of-pocket of $0.00 for the benefits it covers.  It just doesn’t cover as much as the other plans. There are inconvenient holes in the coverage. WHAT IS THE MAXIMUM-OUT-OF-POCKET FOR PLAN G? The maximum out-of-pocket for Plan G is the Medicare Part B deductible ($283 for 2026). Medicare Supplement Plan G covers all inpatient and outpatient Medicare expenses not paid for by Medicare. Coverage is based on the Medicare-approved amount for each service, meaning Plan G pays costs that are Medicare-approved after you meet your deductible. Medicare covers hospital stays, doctor visits, and other health services, while Plan G fills in the gaps for expenses not fully covered by Medicare. Your only expense is the annual Part B deductible. There is also no annual or lifetime cap on the benefits you receive. DOES PLAN G HAVE A DEDUCTIBLE? No, regular Plan G does not have a deductible.  However, you must pay the annual Medicare Part B deductible, which is $283 for 2026, unless you have a plan through preferred provider organizations that may include coverage for prescription drugs.  In addition, the b monthly premium is a separate, recurring cost for outpatient coverage and is not included in the out-of-pocket maximum.  The high-deductible version of Plan G has a $2,950 deductible for 2026.  That is also its maximum out-of-pocket. Well, we have to exclude Foreign Travel because Medicare itself does not cover emergency healthcare for foreign travel, as stipulated in the Inflation Reduction Act .   That is simply an extra benefit provided by the supplement. Medicare Supplement Plan G covers 100% of every Medicare service . The only Medicare service it does not cover, whether inpatient or outpatient, is the annual Medicare Part B deductible.  That is $283 for 2026.    That’s it.  If you have a Medicare supplement Plan G, your maximum out-of-pocket financial risk for 2026 is $283, which does not include any prescription drug coverage. If you were to list a maximum out-of-pocket, the way this table is designed, it would be zero.  But considering real life, your maximum out-of-pocket will be the Medicare Part B deductible**.**  This is a heck of a lot less than the financial exposure you have with Medicare supplement Plans K and L.  In fact, it is the lowest maximum out-of-pocket financial risk available to a consumer under Medicare. Considering real-life costs rather than the limits of this table, let us look at the maximum out-of-pocket costs for the other popular Medicare supplements, including potential drug costs . WHAT IS THE MAXIMUM-OUT-OF-POCKET FOR PLAN N? When a Medicare supplement does not cover the Part B Excess Charges, like Medigap Plan N  and Medigap Plan D , for example, we presume the consumer will avoid excess charges. It’s very easy to do. However, beneficiaries should be aware that they will still need to pay out of pocket for costs such as copays and deductibles. Please see my video on Best Medicare Supplement Plans  for a detailed explanation of how easy it is. DOES PLAN N HAVE A DEDUCTIBLE? No, Plan N does not have a deductible.  However, you will have to pay the annual Medicare Part B deductible, which is $283 for 2026. The monthly premium is a separate, recurring cost that is not included in your out-of-pocket maximum. DOES PLAN N HAVE ANY CO-PAYS? Yes.  There is a $20 copay for office visits that involve diagnosis or evaluation.  There is a $50 copay for emergency room visits that do not result in a hospital admission.  These copays are part of the plan’s cost-sharing structure, which determines how much you pay out-of-pocket for covered services. Urgent Care and Telehealth visits can be billed as an office visit.    There is no copay for physical therapy or chemotherapy office visits. WILL PLAN N COVER MEDICARE PART B EXCESS CHARGES? No.  Only Plan G and Plan F will pay Part B excess charges.  However, excess charges are easy to avoid using Medicare’s online physician lookup tool. When you receive medical services, Medicare pays its approved portion of the costs first, and you are responsible for the remaining expenses, such as the Part B deductible and any applicable copays. With the presumption that excess charges will be avoided, the Medicare Supplement Plan N  maximum out-of-pocket will be the amount of the Medicare Part B deductible plus any of the copays you pay for office visits.  The maximum is $20 for an office visit and $50 for a hospital emergency room visit. For a detailed comparison of these costs and coverage options, see Medicare Supplement Plan N vs Plan G . You may not know the exact number of office visits you will have in a year, but for all practical purposes, that cost, including Part D cost-sharing, will likely be less than the Part B deductible. In case you were not aware, not all office visits qualify for the $20 copay.  For details, please see my video on Best Medicare Supplement Plans, linked above and below my left shoulder. The maximum out-of-pocket limit for a Medicare supplement Plan N  is among the lowest available in Medicare.    For all practical purposes, it will be a number less than twice the Medicare Part B deductible and certainly much, much lower than Medicare supplement Plans K and L. MEDICARE SUPPLEMENT HIGH-DEDUCTIBLE PLAN G AND PLAN F What about the high-deductible Medicare supplements ?  That’s easy.  The maximum out-of-pocket  is equal to the deductible.  That deductible is $2,950 for the year 2026.  It increases each year with increases in the Consumer Price Index -U, rounded to the nearest $10 increment WRAPPING THINGS UP I hope you found this article easy to read and understand, and, more importantly, that it answered any questions you may have had regarding Medicare Out-Of-Pocket Costs, Deductibles, Co-Insurance, and Co-Pays. If you still have questions or would like any more information about Medicare, Medicare Supplement/Medigap Plans, or Medicare Advantage and Medicare Part D Prescription Drug Plans, please feel free to reach out to me anytime. You can call me at (480) 225-1393 or email me directly at mike@bradenmedicare.com .

Michael T. Braden March 15, 2026 Retirement I was up late one night reading, and The Shawshank Redemption was on TV. I wasn't really paying attention to the movie, but I turned just in time to see Morgan Freeman's character, "Red," say it was time to "get busy living, or get busy dying" . And for whatever reason, that phrase struck a chord with me, unlike the other 30 times I had heard it. I have been a Medicare Broker and Certified Medicare Planner for the past 11 years, and I constantly chat with my friends and clients about what they plan to do once they retire. Some like to travel, some want to play golf, and many want to chill and enjoy time with friends and family. One of my friends said the day after he formally retired, he went to Rocky Point and threw every watch he owned into the sea. I started wondering: what are the most common driving forces among people once they decide to quit working full-time? For many, the biggest influence on their decision was their spouse or their family. Oftentimes, people bury themselves in work to mask the pain and hurt of losing someone near and dear to them. And it is harder to imagine being joyful in retirement. But I found this exercise interesting and wanted to share it with you, hoping that some of you will find it interesting and share it with others. After all, as crazy as the world has become, finding joy and sharing happiness with others sure beats the heck out of watching the evening news most nights! Photo of Braden Medicare Insurance's Key Happiness Factors For Seniors In Retirement Poster COMMON DENOMINATORS FOR HAPPINESS IN RETIREMENT BE AT PEACE WITH YOURSELF AND THE WORLD Every night we say our prayers in our own way. And if you recite the Our Father prayer, we ask others to "forgive us our trespasses, as we forgive those who trespass against us" . Being able to shake the Etch A Sketch of life so there is a clean slate for the rest of our lives is not easy, but it is rewarding. It gives us clarity and allows us the opportunity to start the next chapter of our lives. For everyone, you do you !. Follow your faith, love your family, and let the foundation you built your house on be your guiding principles as you move forward on your new path................ Retirement, Your Golden Years, whatever you want to call it, it is the next chapter in life, and you do with it what you want, but to quote a song by LeeAnn Wommack, "When you have the chance to sit it out or dance, I hope you dance" ! HAPPINESS IN RETIREMENT STARTS WITH GOOD HEALTH More people than you realize put off surgeries and procedures until they retire, thinking they will save some money, but more importantly, they will not be worried about taking time off work. Make sure you have an excellent health plan that fits your needs. And, as hard as it is, try to visualize what you want your health plan to look like, not at age 65, but when you are 70, 80, and beyond. It is often easier said than done, but once you have completed this step, you can take the rest of your steps without looking over your shoulder. INDEPENDENCE Did you know that over 75% of seniors between 64 and 74 years of age say they are generally happy to very happy compared with just 51% of those between 25-35 who felt the same way. Seniors feel more alive and fulfilled when they have freedom and independence, live on their own, and do not need supervision. We have all seen that at a certain point in the circle of life, the aging process can take a toll on our capabilities. Things we didn't think twice about can suddenly go away. And for many seniors, these issues often lead to the need for assistance, additional care, and attention, which has the effect of intruding negatively on our lives. I know it is easier said than done. Still, if we all attack these pitfalls with the attitude and inner strength to IAO (Improvise, Adapt, and Overcome) instead of settling, it's amazing what we can still accomplish. FAMILY TIES There is plenty of research linking a sense of belonging to living a longer, healthier, and happier life. Most typically, individuals who live with one or more loved ones have markedly better social skills, peace, and happiness than those who live alone. Relationships, at all levels, enable seniors to have higher satisfaction quotients because they provide emotional support, caregiving, and a sense of belonging. Home is always where your heart is, and there is always no place like home............................... SOCIALLY ADVENTUROUS It should surprise no one that human beings are social creatures. Some of us crave it; most of us tolerate it, but either way, you cannot deny that the more stimuli we get from others, especially as we continue to age, become more important, and, unfortunately, more complicated, the older we get, and in particular, when we notice more of our friends struggling with their health. Being on solid financial ground is a catalyst for many people to afford and enjoy a healthy social life, which increases their happiness. Additionally, individuals with strong family ties, friendships, and a sense of belonging in their community experience higher life satisfaction and reduced loneliness. Seniors with active social lives report higher levels of retirement happiness, primarily due to emotional support and a sense of purpose. HAVING A STRONG FINANCIAL FOUNDATION Being free from financial worries and having the means to enjoy a productive retirement won’t surprise anyone when it comes to retirement happiness. Furthermore, it comes as no surprise that individuals who control and are in control of their own finances are generally viewed as warmer, calmer, more and happier people. If you build your Retirement home on a strong, sound foundation, you are free to enjoy life without being a worrywart. And, on the other side of the coin, there is plenty of research and evidence suggesting that people who constantly worry about Health, Healthcare, and day-to-day finances have a much lower HI (Happiness Index). VOLUNTEERING & GIVING BACK Everyone who freely volunteers their time and or resources to others or to a noble cause feels better about life, themselves, humanity, and the world in general. Anyone who has ever helped someone else will usually attest that volunteering delivers enormous satisfaction, while keeping them grounded and allowing them to reflect on how positive and successful their lives have truly been, as they enjoy the selfless joy of helping others. ACCESS TO QUALITY HEALTHCARE Did you know that individuals/retirees who have access to quality healthcare have a life expectancy of 2-5 years longer than those who do not have access to quality healthcare in retirement? Whether you live in a city, a suburb, or have a nice, quiet place in the country, people are happier when they are healthy. They are calm and unafraid of what may be waiting around the corner, if they are well and properly insured. Here are a few fun facts that everyone should acknowledge: More people over 55 (42%) consider themselves physically active. Fewer than 30% of the population consider themselves physically active. Adding a modest 10 minutes of physical activity a week increases your happiness levels. Psychological Studies show a direct correlation between longevity and regular physical activity. Physically active seniors have been shown to have higher levels of self-esteem and greater longevity compared with those who are not. CARPE DIEM...............SEIZING EACH DAY Do what you have never done. Check items off your Bucket List. Learn how to paint, learn how to garden, take a pottery class, and put a pot or vase that you make on display in your house. Make a small Garden or Herb Garden at home. Take up photography. Experiment, let your hair down, and commit to learning something new every week. Get better at computers, re-establish your golf game, start playing tennis again, or experiment with Pickleball. Join a cooking club or book club. Volunteer at Church, Give Back by volunteering to teach at a local school. Write a book; it's easy to self-publish it on Amazon. Embrace the internet, and discover so many things at your fingertips. Keep challenging yourself to learn. The quest for knowledge is as invigorating as a morning bike ride in the fall. Drive a racecar, go in a Hot Air Balloon, go on a rafting trip, and learn a few survival techniques. STAYING MENTALLY ENGAGED & CHALLENGED Exactly what stimulates a senior's mind is a subjective matter. For some, it might involve completing word puzzles or quizzes. For others, it might mean managing a local group or running charitable events. Whatever mental stimulation looks like, evidence suggests it improves cognitive function. Activities that challenge the brain – such as learning new skills – are linked to improved happiness. Keeping the mind engaged contributes to a more fulfilling and enjoyable life while also helping to slow cognitive decline. Put some word apps on your phone or tablet. Read at least one chapter per day of a book. CARING AND INTERACTING WITH PETS Perhaps the #1 way to increase happiness and self-confidence is to share your life and home with a pet when you are a senior. In fact, nearly 50% of all seniors have at least one pet. From daily walks to constant companionship, studies have shown that owning pets can lead to increased fitness levels, reduced stress, and enhanced mental well-being, especially by helping keep feelings of isolation and loneliness at bay. Lastly, this should come as no surprise to anyone, but many seniors admit that their furry friends strongly influence their retirement decisions, including where to live. Having that connection is beautiful. Companionship, trust, and loyalty are all admirable traits, and we get them all back in spades from the pets we love, and often from the pets that make us whole, whether we realize it or not!

Michael T. Braden March 5, 2026 MEDICARE 101 Picture of Braden Medicare Insurances' Do I Have To Enroll In Medicare If I Am Not Retiring Yet Poster ARE YOU PLANNING TO WORK PAST AGE 65? THE QUINTESSENTIAL $64,000 QUESTION: WHEN SHOULD YOU ENROLL IN MEDICARE? Many individuals choose to continue their careers well past their sixty-fifth birthday. If you are among this active group of older adults, you might wonder exactly when you should enroll in Medicare. This is an extremely important question, and it relies heavily on your current healthcare coverage. You must carefully evaluate your unique situation to avoid unnecessary costs and ensure continuous medical protection as you transition into this new phase of your life. Photograph of Braden Medicare Insurances' The Quintessential $64,0000 Question: When Should You Enroll In Medicare? Poster MEDICARE AND EMPLOYER HEALTH COVERAGE IF YOU PLAN ON WORKING PAST 65 When you have health insurance through your employer or your spouse’s employer, that coverage must coordinate directly with Medicare. The company's size is the most critical factor in this coordination. If the employer has twenty or more employees, the group health plan pays first, and Medicare pays second. In this specific scenario, you might choose to delay Medicare Part B to save on monthly premiums. However, if the company has fewer than twenty employees, Medicare pays first. You must enroll in both Part A and Part B to avoid massive gaps in your healthcare coverage, as the employer plan will only act as secondary insurance. Understanding how Medicare eligibility and enrollment rules  work alongside employer coverage can help you avoid unexpected costs or coverage gaps. WHAT ARE YOUR OPTIONS FOR ENROLLING IN MEDICARE? You have several distinct choices when you turn sixty-five. You can enroll in both Part A and Part B, regardless of your current employment status. Because Part A is premium-free for most individuals who have worked at least ten years in the United States, it is generally recommended that you enroll in Part A immediately. Part A covers inpatient hospital stays and skilled nursing facility care. Photo of Braden Medicare Insurances' The Four Parts Of Medicare Poster You can then decide to safely delay Part B, which covers outpatient medical services, if your current employer coverage is officially considered creditable. When evaluating long-term coverage options, many beneficiaries eventually explore Medicare Supplement plans  to help cover expenses that Original Medicare does not fully pay. POINTS TO PONDER IF YOU ARE WORKING PAST AGE 65 You must compare your employer's health plan against what Medicare offers. Look closely at your monthly premiums, annual deductibles, and maximum out-of-pocket costs. Employer group plans often have high deductibles that you must fully satisfy before your coverage begins. You typically may have to continue to pay 20% co-insurance even after you meet your deductible. In many cases, transitioning to Original Medicare and pairing it with a robust Medicare Supplement policy provides far more comprehensive and predictable coverage than a standard employer group plan. Medicare Supplement plans eliminate the high out-of-pocket limits typically found in corporate insurance. BE AWARE OF THE RISKS IF YOU CHOOSE TO DELAY YOUR ENROLLMENT Delaying your enrollment in Medicare is not a problem, but you do need to be aware of the risks, and make sure you understand the rules laid out by Medicare so you can avoid needless and unnecessary penalties . If you postpone enrolling in Medicare Part B without having creditable active employer coverage, you will face a permanent late enrollment penalty. This penalty increases your Part B premium by ten percent for every full twelve-month period you could have had Part B but did not sign up. Additionally, you might experience a dangerous gap in your medical coverage while you wait for the next General Enrollment Period to open. Many retirees later add supplemental coverage, such as Medigap/Medicare Supplement Plan N or Plan G , to reduce the out-of-pocket costs left by Original Medicare. HSA's AND MEDICARE Have you been contributing to a Health Savings Plan at work? If so, you need to be aware of this. The Internal Revenue Service dictates that you cannot contribute to a Health Savings Account once you are enrolled in any part of Medicare, including the premium-free Part A. To avoid tax penalties, you must stop all contributions to your account at least six months before you apply for Medicare or Social Security benefits. WRAPPING THINGS UP We always advise clients to start planning several months before their sixty-fifth birthday. Speak with your human resources department to understand exactly how your current plan works with Medicare. Once you decide to transition to Medicare, securing a Medicare Supplement plan is the most comprehensive health plan that not only protects your health but also protects your finances in retirement. A Medicare Supplement plan steps in to pay the substantial deductibles and coinsurance that Original Medicare leaves behind, giving you total peace of mind and the absolute freedom to see any doctor, anywhere in the US, who accepts Medicare. If you have any questions concerning Medicare or how to best move forward with getting started with Medicare, please ask your Medicare Broker. Or, if you have not already chosen a local Medicare broker, please feel free to contact us anytime, and we will be happy to answer any questions you have. You can call me anytime at (480) 225-1393, email me directly at mike@bradenmedicare.com , or by filling out a contact form on our website at www.bradenmedicare.com .

Michael T. Braden February 19, 2026 MEDICARE ADVANTAGE In today's article, I wanted to take a few minutes to teach you about a different type of Medicare Advantage plan that not many people seem to know about: Medicare Special Needs plans and Medicare Critical Special Needs Plans. Whether you're getting ready to enroll in Medicare or want to understand your options better, learning about Medicare Special Needs and Critical Special Needs plans is important. Even if it doesn't pertain directly to you, you may have a friend or family member who would find this information practical and useful. Picture of Braden Medicare Insurances' Medicare Special Needs Plans Poster As a CMP (Certified Medicare Planner), I believe that Original Medicare with a Medicare Supplement is the best option to protect yourself and your finances from a Healthcare disaster, and to keep you in charge of your own healthcare decisions. But what happens if you start with a Medicare Advantage plan and you want to switch over to Original Medicare? It is usually not a problem unless you are denied coverage for a Medigap/Medicare Supplement policy because of a current or past health condition. Where do you go then, and what options do you have to acquire the best possible plan for your medical needs? WHAT IS A SPECIAL NEEDS PLAN? A Special Needs Plan (SNP) provides benefits and services to people with specific severe and chronic diseases, certain health care needs, or those beneficiaries who have Medicaid.  SNPs include care coordination services and tailor their benefits, provider choices, and lists of covered drugs (formularies) to meet best the specific needs of the groups they serve. SNPs can be HMO or PPO plan types, and they cover the same Medicare Parts A and B benefits as all Medicare Advantage Plans . However, SNPs often cover extra services for the special groups they serve. For example, if you have a severe condition, like cancer or congestive heart failure, Chronic Kidney Disease, or require Dialysis, Special Needs plans and Chronic Special Needs plans can offer more enhanced benefits and services than you can find with any "regular" Medicare Advantage plan. These plans frequently offer extended Hospitalization coverage, transportation to and from Doctors' Appointments, lower inpatient costs, and higher allowances for OTC and Healthy Food allowances. Remember , though, enrollment in a Special Needs plan or a Chronic Special Needs plan is contingent on you continuing to meet the conditions set forth by the plan's insurance company. WHO IS ELIGIBLE FOR A MEDICARE SNP (SPECIAL NEEDS PLAN)? You can join an SNP if you meet these requirements: You have Medicare Part A (Hospital Insurance)  and  Medicare Part B (Medical Insurance) . You live in the plan's  service area. .  You meet the eligibility requirements for one of the 3 types of SNPs: Dual Eligible SNP (D-SNP) Chronic Condition SNP (C-SNP) Institutional SNP (I-SNP) ELIGIBILITY REQUIREMENTS TO QUALIFY FOR A SNP PLAN Dual Eligible SNP (D-SNP) You’re eligible for both Medicare and Medicaid. D-SNPs contract with your state Medicaid program to help coordinate your Medicare and Medicaid benefits, depending on the state and your eligibility. Some D-SNPs, called "integrated D-SNPs," combine both your Medicare benefits and most or all of your Medicaid benefits and services through a single plan. Chronic Condition SNP (C-SNP)   You have one or more of these severe or disabling chronic conditions: Chronic alcohol and other dependence Certain autoimmune disorders Cancer (excluding pre-cancer conditions) Certain cardiovascular disorders Chronic heart failure Dementia Diabetes mellitus End-stage liver disease End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis) Certain severe hematologic disorders HIV/AIDS Certain chronic lung disorders Certain chronic and disabling mental health conditions Certain neurologic disorders Stroke Institutional SNP (I-SNP)  You live in the community but need the level of care a facility offers, or you live (or are expected to live) for at least 90 days in a row in a facility like a: Nursing home Intermediate care facility Skilled nursing facility Rehabilitation hospital Long-term care hospital Swing-bed hospital Psychiatric hospital Other facility that offers similar long-term health care services and whose residents have similar needs and health care status as residents of the facilities listed above Where are SNPs offered? Each year, different types of SNPs may be available in different parts of the country. Insurance companies decide where they’ll do business, so SNPs may not be everywhere in the U.S. FAQ's regarding SNP plans: Question: fee? plan's conditions of enrollment Answer: Do these plans charge a monthly premium ? Varies by plan. Some plans may charge a premium, in addition to the monthly Part B (Medical Insurance) premium. However, if you have Medicare and Medicaid, most of the costs will be covered for you. Contact your Medicaid office for more information. Do these plans offer Medicare drug coverage (Part D) ? Yes. All SNPs must provide Medicare drug coverage (Part D). Can I use any doctor or hospital that accepts Medicare for covered services? Varies by plan. Some SNPs require that you get your care and services from providers and facilities in the plan’s network (except for emergency care, out-of-area urgent care, or out-of-area dialysis). Some SNPs offer out-of-network coverage so that you can get services from any qualified provider or facility, but you’ll usually pay more. Do I need to choose a primary care doctor ? Varies by plan. If you have a primary care doctor or provider you like, ask the plan if you can keep them. Do I have to get a referral to see a specialist? Varies by plan. Referrals may be required for certain services but not others. What else do I need to know? D-SNPs, including integrated D-SNPs, can help coordinate your benefits between Medicare and Medicaid. What's an integrated D-SNP? If you’re interested in an I-SNP and live in a facility, check that the plan has providers that serve people where you live. C-SNPs can limit membership to a single chronic condition or a group of related chronic conditions. All SNPs use a care coordinator to help you stay healthy and develop a care plan with you. You can stay enrolled in a Medicare SNP only if you continue to meet the conditions set by the plan. If you're losing your plan because you no longer meet the plan's conditions, you may be eligible for a Special Enrollment Period to join another plan. When can I join another plan? Your plan can’t charge more than Original Medicare for certain services, such as chemotherapy, dialysis, and skilled nursing facility care. If your plan provides prior approval for a treatment, that approval must remain valid for as long as the treatment is medically necessary. Also, your plan can’t ask you to get additional approvals for that treatment. If you’re currently receiving treatment and switch to a new plan, you’ll have at least 90 days before the new plan can ask you to obtain a new prior approval for your ongoing treatment. Check with the plan you’re interested in for specific information. Grouping Chronic Conditions When completing the SNP application, MAOs may apply to offer a C-SNP that targets any one of the following: A single CMS-approved chronic condition (selected from the list above), A CMS-approved group of commonly co-morbid and clinically-linked conditions (described below), or An MAO-customized group of multiple chronic conditions (described below). CMS-Approved Group of Commonly Co-morbid and Clinically-Linked Conditions: A C-SNP may not be structured around multiple commonly co-morbid conditions that are not clinically linked in their treatment because such an arrangement results in a general market product rather than one that is tailored for a particular population.  C-SNPs are permitted to target a group of commonly co-morbid and clinically linked chronic conditions.  Based on CMS’s data analysis and recognized national guidelines, CMS identified five combinations of commonly co-existing chronic conditions that may be the focus of a C-SNP. CMS accepts applications for C-SNPs that focus on the following multi-condition groupings: Group 1:  Diabetes mellitus and chronic heart failure; Group 2:  Chronic heart failure and cardiovascular disorders; Group 3:   Diabetes mellitus and cardiovascular disorders; Group 4:  Diabetes mellitus, chronic heart failure, and cardiovascular disorders; and Group 5:  Stroke and cardiovascular disorders. For MAOs approved to offer a C-SNP targeting one of the above-listed groups, enrollees need only one qualifying condition for enrollment.  CMS will review the Model of Care (MOC) and benefits package for the multi-condition C-SNP to determine their adequacy in creating a specialized product for the chronic conditions it serves. MAO CUSTOMIZED GROUP OF CHRONIC CONDITIONS: MAOs may develop their own multi-condition C-SNPs for enrollees who have all qualifying, commonly comorbid, and clinically linked chronic conditions in the MAO's specific combination.  MAOs that pursue this customized option must verify that enrollees meet all qualifying conditions in the combination.  MAOs interested in pursuing this option for multi-condition C-SNPs are limited to groupings of the same 15 conditions selected by the panel of clinical advisors that other C-SNPs must select.  As with SNPs pursuing the Commonly Co-Morbid and Clinically-Linked Option described above, CMS will carefully assess the prospective multi-condition SNP application to determine the adequacy of its care management system for each condition in the combination and will review the MOC and benefits package. UNDERSTANDING CHRONIC CONDITIONS DEFINED BY MEDICARE Chronic conditions, such as diabetes , heart disease , or autoimmune disorders, demand consistent medical attention and specialized treatments. Under the Original Medicare program, you receive standard medical and hospital benefits to address these issues. However, Medicare Advantage plans, also known as Medicare Part C, take a different approach. They provide your Medicare benefits through private insurance companies approved by the federal government, often bundling medical and prescription drug coverage together under a single policy. Photo of Braden Medicare Insurances' Medicare Advantage Special Needs Plans & Chronic Special Needs Plans Poster MEDICARE ADVANTAGE SPECIAL NEEDS PLANS (SNPs) FOR CHRONIC CONDITIONS Within the Medicare Advantage system, there are Chronic Condition Special Needs Plans . These are frequently referred to as C-SNPs. These policies are designed exclusively for individuals with severe or disabling chronic conditions. The private insurance companies tailor the specific benefits, the provider networks, and the prescription drug formularies to meet the unique medical needs of the individuals enrolled in them. COVERAGE BENEFITS FOR CHRONIC CONDITIONS The coverage benefits for chronic conditions under a C-SNP might include specialized care coordination. Some plans offer access to specific health and wellness programs, discounted specialized equipment, or a targeted network of specialists who focus entirely on your exact condition. By law, they must cover everything that Original Medicare covers, but they package the delivery and administration of that care differently. COORDINATING CARE FOR BENEFICIARIES WITH SPECIAL NEEDS PLANS Care coordination is a major component of these private plans. Most Medicare Advantage policies utilize a strict network of doctors and hospitals, typically functioning as Health Maintenance Organizations (HMOs). You will usually need to select a primary care physician who manages your overall health. This doctor must provide an official referral before you are allowed to see a specialist. For individuals with complex chronic conditions, this means your care is closely tracked, and you must strictly adhere to the network rules to receive coverage. HOW TO EVALUATE ALL OF YOUR OPTIONS When evaluating your options, the costs to consider are high. Medicare Advantage plans often advertise low or zero-dollar monthly premiums, but you must pay copayments or coinsurance each time you utilize a medical service. If you have a chronic condition that requires frequent doctor visits, diagnostic tests, or hospital stays, these out-of-pocket expenses can accumulate rapidly. You will continue to pay these costs until you reach the annual maximum out-of-pocket limit set by the specific plan. HOW TO COMPARE AND CHOOSE THE BEST SNP OR C-SNP Choosing the right plan requires you to carefully review the provider directory and the drug formulary each year. You must ensure that your current doctors are in-network and that the plan’s formulary covers your necessary daily medications . However, many individuals managing chronic illnesses find that network restrictions quickly become burdensome when they are seeking the best possible specialized care outside of their local area. ENROLLMENT OPTIONS FOR SNP & C-SNP PLANS You can typically join or switch a Medicare Advantage plan during the Annual Enrollment Period  in the fall. If you are newly diagnosed with a qualifying severe condition, you might be eligible for a Special Enrollment Period . This allows you to join a Chronic Condition Special Needs Plan at other times during the year outside of standard enrollment windows. SOMETIMES ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT IS THE BEST PLAN YOU CAN HAVE FOR SPECIAL/CHRONIC NEEDS There are distinct pros and cons of Medicare Advantage for chronic conditions. The advantages include potentially lower monthly premiums and access to some tailored care coordination programs. The disadvantages include strict provider networks, the frequent need for prior authorizations  before receiving life-enhancing treatments, and unpredictable out-of-pocket costs for regular medical services. WRAPPING THINGS UP As we stated at the beginning of this article, we strongly believe that combining a Medicare Supplement Plan G with Original Medicare offers the best option  for quality healthcare. However, things change, premiums can become too expensive, or you may not qualify  for a Medicare Supplement if you did not enroll in one during your IEP (Initial Enrollment Period). If this happens to you or anyone you know, please advise them to look into Special Needs Plans or Chronic Special Needs plans. It has been our experience that targeted SPN and C-SPN plans are superior to regular, Medicare Advantage plans. Photo of Braden Medicare Insurance' Copy Of Michael Braden's Business Card Poster. Do not leave your future healthcare access to chance by choosing the path of least resistance today. Make a decision that protects your physical and financial health for the long haul. If you want to ensure predictable costs and access to the best possible care, we can help you find the right Medicare Supplement plan. I know Medicare can be very confusing, with a lot of moving parts. If you have any specific questions about Medicare Supplement (Medigap) Plans that this article did not address, please reach out to me. I want to make sure you get all the answers to your questions. You can email me directly at mike@bradenmedicare.com , text or call me at (480) 225-1393, or use the contact form on our website at www.bradenmedicare.com  anytime.

Michael T. Braden February 21, 2026 MEDICARE 101 Whether you are new to Medicare or a seasoned Medicare Beneficiary, there are times when Billing issues can pop up out of nowhere and rain on your parade. In today's article, we wanted to pull back the curtain and give you a better understanding of how Medicare Billing works, both with Original Medicare and with Medicare Advantage plans. Our goal is to inform you of the differences so you can know what to expect. YOUR FIRST INVOICE FROM MEDICARE Did you know that every Medicare beneficiary is responsible for paying for Medicare Part B? Regardless of whether you have chosen Original Medicare, Original Medicare with a Medicare Supplement, or Tri-Care, Tri-Care for Life, or Champ VA, you must be enrolled in Medicare Part B. For some individuals who qualify as Dual Eligible beneficiaries, meaning they qualify for both Medicare and Medicaid, their Part B payments may be covered by their state's Medicaid office. Once you are enrolled in a Medicare Health Plan and you are not yet enrolled in Social Security, your initial invoice from Medicare may be a shock to your system. We say this because you are new to Medicare and just starting out. Medicare always sends you a quarterly bill. So, for 2026, your first Medicare Part B bill won't be $202.90; it will be $608.70, as long as you have no IRMAA adjustments. This is a standard practice that Medicare has used forever, simply because they want to ensure they receive payment before the next billing cycle when possible. You can easily change this to automatic monthly billing by logging in to Medicare's website at www.Medicare.gov and enrolling in Medicare Easy Pay. With easy pay, you can choose an option to have your monthly Medicare Part B premium paid automatically, and you will not need to worry about juggling a quarterly bill in the future. Once you decide to enroll in Social Security in the future, you can choose to have your monthly Medicare Part B premiums automatically deducted from your Social Security check. THE #1 BILLING ISSUE WHEN STARTING WITH MEDICARE The Number One most common billing error when you first transition to Medicare from your employer's group insurance plan, COBRA, or your Private Insurance is that the doctor's office does not always cancel/remove your old insurance information from their systems/files. So, they often bill both your old insurance and Medicare, causing confusion and delays. It always gets sorted out, but it is entirely avoidable. We started completing a Patient Information Cover Sheet for each of our clients in order to eliminate most of these errors. We recommend emailing your current doctors a copy and bringing one with you to your next appointment. It is a good idea to follow this procedure anytime you add a new provider. Photo of a Sample Of Braden Medicare Insurance's Patient Information Cover Sheet Poster IF YOU HAVE ORIGINAL MEDICARE When you first visit your doctor after enrolling in Medicare, you have not met your Medicare Part B deductible amount of $283 (2026 Medicare Part B Deductible). Your doctor may collect this on behalf of Medicare, but they do not have to. Then, your doctor sends a copy of your invoice from your visit to Medicare for processing. Medicare receives the invoice, reviews your coverage, and then sends payment to the doctor on your behalf. If you are responsible for any part of the bill, Medicare will send you a Statement with your Monthly Explanation of Benefits Summary. If you have not yet set up your own Medicare account, it is recommended that you do so in the Medicare Member Portal. Then we advise all our clients to enroll in Medicare Easy Pay. You can write a check to Medicare or pay online through the Medicare Member Portal. IF YOU HAVE ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT When you first visit your doctor after enrolling in Medicare, you have not met your Medicare Part B deductible amount of $283 (2026 Medicare Part B Deductible). Your doctor may collect this on behalf of Medicare, but they do not have to. Then, your doctor sends a copy of your invoice from your visit to Medicare for processing. Medicare receives the invoice, reviews your coverage, and then sends payment to the doctor. Medicare will also end your Medicare Supplement carrier notice of the amount that they are responsible for, and then the Supplement also pays your provider. on your behalf. If you are responsible for any part of the bill, Medicare will send you a Statement with your Monthly Explanation of Benefits Summary. You are not responsible for paying anything up front. Medicare coordinates everything. If there is ever a question about your billing or payments, you should contact your Medicare Broker and/or Medicare directly at 1-800-MEDICARE. Medicare has customer service people who are friendly, well-trained, and helpful. If you ever need to call them, I am confident it will be a surprisingly nice and productive phone call. They are there to serve every Medicare beneficiary. IF YOU HAVE A MEDICARE ADVANTAGE PLAN If you have chosen a Medicare Advantage Plan (Medicare Part C), the process is slightly different. The provider's office will charge you any co-pays and/or coinsurance you are responsible for at the time of the appointment. Then, after they have collected your share, the provider sends the remaining balance of the bill to your Medicare Advantage Insurance carrier for payment. Oftentimes, payments can be delayed or refused if you did not receive Prior Authorization from your PCP and your Insurance carrier. If there are any questions, it is strictly between you, your Medicare Advantage Insurance company, and your provider. Medicare will not be able to assist you. WRAPPING THINGS UP We hope you found this article, "How Medicare Handles Your Billings," informative and helpful. If you ever have any questions about Medicare or your Medicare plan, we encourage you to reach out to your Medicare Broker. Brokers will always be there to assist you whenever called upon. If you self-enrolled in Medicare or an agent at the Insurance company's Call Center assisted you, please reach out to us, and we will do our best to answer your questions. As a Certified Medicare Insurance Planner, we know you have a lot to comprehend and take in as you transition into Medicare. We always encourage every client to look beyond the premiums and the information they see on television, on the radio, or in a flyer or brochure in their mailbox, and to imagine what they want their Healthcare Plan to look like and do for them5-15 years in the future. Things change, and what looks simple now may be difficult later, so do your best to set yourself and your loved ones up for success. Photo of Michael Braden's Business Card. Michael is the founder and owner of Braden Medicare Insurance Services. Please feel free to call, text, or email me anytime, or just fill out a contact form on our website.

Michael T. Braden March 2, 2026 MEDIGAP PLANS Many people understandably relate retirement to enrolling in Medicare and/or Social Security, as they are suddenly thrust into making important decisions that can shape not just their healthcare, but also their finances in retirement. In this article, we look into why we believe that Original Medicare with a Medigap/Medicare Supplement plan offers unmatched coverage and peace of mind in retirement. Photo of Braden Medicare Insurances' Why Medigap Plans Offer Unmatched Coverage and Peace of Mind in Retirement Poster Welcome to the next phase of your healthcare journey. Entering retirement and navigating your Medicare coverage can sometimes feel overwhelming, but securing the correct policy brings immense comfort to your daily life. As you review your options, you may wonder what insurance choice will best serve your long-term needs and protect your health. We are here to help you understand why Medigap Plans are celebrated nationwide for providing exceptional peace of mind. PEACE OF MIND IS IMPORTANT Peace of mind is more than just a comforting phrase. In healthcare, it means knowing you have robust protection against unexpected medical bills and total control over your personal medical decisions. It means you can focus on healing and enjoying your retirement rather than worrying about coverage gaps or hidden insurance fees. Original Medicare is a wonderful foundation, but it leaves you responsible for deductibles, copayments, and 20% coinsurance for outpatient services—a Medicare Supplement plan steps in to cover those exact gaps, granting you true security. STABILITY WITH PREDICTABLE COSTS BRINGS FINANCIAL SECURITY One of the most significant stressors during retirement is the unpredictability of healthcare costs. A major medical event can quickly deplete your hard-earned savings if you rely solely on Original Medicare. Medicare Supplement plans, which are also known as Medigap, provide financial predictability by capping or eliminating your out-of-pocket expenses for covered services. By paying a stable monthly premium, you shield your budget from surprise medical bills. This financial security allows you to plan your retirement budget with absolute confidence, and you will never need to keep a "Rainy Day Fund" . Photo of Braden Medicare Insurances' If you fail to plan, you are planning to fail Poster FREEDOM OF CHOICE Your relationship with your doctor is incredibly personal. When you enroll in a Medicare Supplement plan, you are never restricted to a small local network of approved providers. Because these plans strictly supplement Original Medicare, your network is nationwide. You have the liberty to see any physician, specialist, or hospital in the United States that accepts Medicare patients. Furthermore, you do not need to obtain a referral from a primary care doctor before scheduling an appointment with a specialist. SIMPLICITY ALLIGNED WITH MEDICARE Dealing with complicated insurance claims and prior authorizations can be exhausting. Many private health plans require the insurance company to approve a treatment before you can receive it. Medigap Plans and Medicare Supplement plans eliminate this administrative obstacle. They follow the rules set by the federal government. If Medicare approves a medical service, your Medicare Supplement plan will automatically pay its designated share. The private insurance carrier cannot override or deny a claim that Medicare has already approved. This simplicity allows you and your doctor to make medical decisions quickly and without interference. LIFESTYLE AND TRAVEL FLEXIBILITY Retirement is the perfect time to explore new hobbies, visit family across the country, or spend your winters in a warmer climate. A Medicare Supplement plan travels with you seamlessly. Your healthcare coverage is just as effective in another state as it is in your hometown. Additionally, many Medigap/Medicare Supplement plans offer foreign travel emergency benefits , providing an extra layer of protection if you decide to vacation internationally. COMPARING MEDICARE ADVANTAGE AGAINST MEDICARE & MEDIGAP (MEDICARE SUPPLEMENT) PLANS Photo of Braden Medicare Insurances' Pros & Cons of Original Medicare vs Medicare Advantage Poster When evaluating your choices, it is crucial to understand the difference between Medigap/Medicare Supplement plans and Medicare Advantage plans. Private insurance companies manage Medicare Advantage plans and typically require you to use specific HMO  or PPO networks. If you see a doctor outside of their network, you may face outrageous out-of-pocket costs, or your plan may choose not to cover the service at all. Medicare Advantage plans also frequently require specialist referrals and prior authorizations. Conversely, Medigap plans place a premium on personal choice , giving you the independence to determine your own healthcare path . While Medicare Advantage plans might advertise lower upfront premiums, Medicare Supplement policies offer the best long-term value with predictable back-end costs, nationwide access, and no network restrictions. FLEXIBILITY TO CHOOSE WHERE YOU RECEIVE CARE As individuals manage their health over the years, securing reliable access to exceptional medical facilities becomes increasingly vital. Medical advancements are progressing at an incredible pace, and complex conditions often require specialized equipment and expert teams found only at top-tier medical institutions. You never want to find yourself needing critical care, only to discover that your insurance plan restricts you from visiting the premier facility in your area. Selecting the correct coverage ensures you can prioritize your health and well-being without worrying about arbitrary boundaries. Perhaps the most glaring difference between Medicare Supplement plans and Medicare Advantage plans lies in how they compensate and control healthcare providers. Medicare Advantage plans most often operate within a strict network of healthcare professionals and hospitals. For example, if you visit a hospital outside your plan's network, you might be responsible for the entire bill. Whereas Medicare Supplement (Medigap) plans provide complete open access to hospitals. With a Mediga (Medicare Supplement) policy, you have the freedom to visit any doctor or hospital in the United States, and in all US Territories that accept Original Medicare. There are no networks with Original Medicare. ACCESS TO TEACHING HOSPITALS AND PREMIER HOSPITAL FACILITIES NATIONWIDE When facing a life-threatening or other severe diagnosis, such as cancer or a complex heart condition, you may want to ensure you have the best care from the best doctors available. For many Medicare beneficiaries, this includes treatment at a major medical center or a well-respected teaching hospital. But most Agents never disclose that most top hospitals choose not to participate in Medicare Advantage networks; these facilities simply do not have the time or want the aggravation caused by the administrative hurdles, bottlenecks, delayed payments, and the low reimbursement rates that are quite common with Medicare Advantage plans. Medicare Advantage plans might lock you out of the most advanced care available, and it is completely within their right, because you agreed to abide by their networks when you enrolled in one of their plans. However, Medicare Supplement (Medigap) plans completely remove this barrier. If the premier teaching hospital accepts Medicare, your Medicare Supplement plan will be accepted there, granting you access to the finest medical minds in the country. OVERCOMING REFERRALS, PRIOR AUTHORIZATIONS, AND ADMISSION HURDLES Perhaps the most exasperating part of healthcare today is being told you need to halt or delay your treatment until your insurance company approves your treatment plan. Just about every Medicare Advantage plan frequently requires referrals to see specialists and prior authorizations for hospital admissions. In fact, recent analysis from the Kaiser Family Foundation demonstrated that Medicare Advantage insurers made well over 50 million prior authorization determinations last year alone, leading to millions of denials and delayed treatments. Medicare Supplement plans operate differently. They do not require referrals or prior authorizations. Your doctor makes the medical decisions, rather than an insurance company, allowing you to be admitted and treated promptly. Simply stated, Original Medicare operates under the standard that if your Doctor accepts Medicare, and your doctor attests that treatment is medically necessary, then it is approved. This is a far cry from the circus aspect of jumping through hoops with Medicare Advantage. CARE AFTER YOUR HOSPITAL DISCHARGE We all understand that Recovery does not always end when you are discharged from the hospital. Many patients require a stay in a SNF (Skilled Nursing Facility) or an inpatient rehabilitation center. Medicare Advantage plans heavily manage this post-acute care, dictating which specific facilities you can use and strictly monitoring the length of your stay. They often push for early discharges to save costs. With a Medicare Supplement plan, you and your physician determine the appropriate length of your stay and the best facility for your rehabilitation, ensuring you heal completely and holistically before returning home. HOSPITAL ACCESS WHEN YOU ARE TRAVELING Many individuals enjoy traveling or spending parts of the year in different states, and many beneficiaries have homes in multiple states. Are you aware that, with Medicare Advantage plans, your coverage is generally limited to the county you have listed as your primary address? For millions of Americans, finding appropriate hospital care while traveling can result in massive out-of-network bills. But, Medigap (Medicare Supplement) plans travel with you. So whether you are visiting family in Boston or spending the winter in the Carolinas, your coverage remains identical. You are free to receive care at any hospital that accepts Medicare from coast to coast. And, any facility that accepts Original Medicare will also happily accept every MEdicare Supplement (Medigap) plan. WRAPPING THINGS UP We hope this article was thought-provoking and informative for you. At Braden Medicare Insurance, our mission is to teach and inform Medicare Beneficiaries about their options when choosing the right health care plan in retirement. As a CMP (Certified Medicare Planner), we know how important it is to get the right plan for you, your family, and your lifestyle. If you still have questions about which Medicare option is best for you, please give us a call anytime. We would be honored to assist you in any way we can. You can reach us at (480) 225-1393, email us at mike@bradenmedicare.com , or visit us 24/7 on our website at www.bradenmedicare.com .

Michael T. Braden February 11, 2026 MEDICARE 101 Picture Of Braden Medicare Insurance's Getting Care In A Disaster Or Emergency Poster When a health crisis strikes, your primary focus should be on recovery, not whether your insurance will cover the bill. Medical emergencies change everything because they remove your ability to plan. You do not have the time to research in-network facilities, compare out-of-pocket costs, or wait for approvals. You need immediate, life-saving care. Understanding how your coverage handles these unpredictable moments is vital for your peace of mind and your financial security. MEDICARE'S DEFINITION OF WHAT MEDICAL EMERGENCY CARE IS To understand your Medicare emergency care coverage, it is beneficial to know how the Centers for Medicare and Medicaid Services defines an emergency. An emergency medical condition is one with acute symptoms of sufficient severity, including severe pain. It means that a prudent layperson, with an average knowledge of health and medicine, could reasonably expect that a lack of immediate medical attention would result in serious jeopardy to their health, serious impairment to bodily functions, or serious dysfunction of any bodily organ. In situations like this, Original/Traditional Medicare guarantees you have access to care, no matter what Plan you have. TRANSPORTATION AND AMBULANCE COVERAGE In a crisis, a fast response is critical. Medicare Part B covers ground ambulance transportation to the nearest appropriate medical facility when traveling in any other vehicle could endanger your health. In some severe cases, Medicare even covers emergency air ambulance transport. However, this coverage is subject to the Part B deductible and a 20% coinsurance. Picture Of Braden Medicare Insurance's Medicare Covers Emergency Transportation Poster If you have a Medigap/Medicare Supplement   plan, it will step in and cover the 20% coinsurance. This helps immensely, leaving you with virtually no out-of-pocket expense for the ride. If you happen to have coverage under Medicare Part C, and you choose a Medicare Advantage plan, you will likely be responsible for the Emergency transportation Co-Insurance, specified in your plan's Summary of Benefits (SOB). EMERGENCY CARE AT A HOSPITAL During a medical emergency situation, you can visit any hospital emergency room in the United States, and your Medicare Advantage plan must cover the care, even if the hospital is outside of your plan's network. However, once your condition stabilizes, the situation changes. If you have a Medicare Advantage plan and you are admitted to an out-of-network hospital, your Insurance provider will likely require you to transfer to a hospitalin your plan's network . for the duration of your hospital stay. However, if you have Original Medicare with a Medigap or Medicare Supplement plan, you have the freedom to stay at any hospital that accepts Medicare, anywhere in the country, without having to deal with any annoying network restrictions. MEDICARE EMERGENCIES AND PRIOR AUTHORIZATION Perhaps the most common worry for Medicare beneficiaries in an emergency is whether they need permission to receive treatment. You will be relieved to know that true emergencies never require prior authorization. Even a Medicare Advantage plan cannot deny emergency room care because you did not get approval first. They are obligated to heed the advice and actions of the physicians treating you during a crisis. Butas a reminder, once the immediate emergency subsides, Medicare Advantage plans typically require you to adhere to their Prior Authorization protocols for all subsequent care, treatments, surgeries, or extended hospital stays. It is quite rare for Original Medicare and Medicare Supplement plans rarely require prior authorization, allowing your doctors to proceed with necessary post-emergency care without administrative delays. YOUR PAYMENT RESPONSIBILITIES IF YOU HAVE A MEDICAL EMERGENCY Financial exposure is a significant factor when comparing your options. With Original Medicare alone, you are responsible for the Part A deductible if you are admitted, plus the Part B deductible and 20% coinsurance for emergency room services and doctors. A Medicare Supplement plan is designed to pay these remaining balances. For instance, a Plan G will cover your Part A deductible and your Part B coinsurance, making your out-of-pocket costs highly predictable. Alternatively, Medicare Advantage plans usually charge a set copayment for an emergency room visit, which is often waived if you are admitted to the hospital within a specific timeframe. While this seems straightforward, the costs of the actual hospital stay, out-of-network fees once stabilized, and subsequent copayments can quickly add up until you reach the plan's annual out-of-pocket maximum. FOLLOW-UP & SPECIALIST CARE POST EMERGENCY Recovery does not end when you leave the emergency room. You will likely need follow-up appointments, physical therapy, or consultations with specialists. If you have a Medicare Advantage plan, you must ensure these specialists are within your local network. You might also need to obtain a referral from your primary care physician before you can schedule the visit. A Medicare Supplement plan shines in this area. It allows you to schedule a follow-up visit with any specialist in the United States who accepts Medicare. You do not need referrals or worry about networks, giving you uninterrupted access to the best care available for your specific condition. EMERGENCY COVERAGE IF YOU ARE OUT OF YOUR COVERAGE AREA Many beneficiaries enjoy traveling or spending parts of the year in different states. It is important to understand what happens if you have to deal with a Medical emergency while you are away from home. If an out-of-state medical emergency occurs, the insurance coverage you have with your carrier determines what happens next. Medicare Advantage networks are typically confined to a specific geographic region; normally, the county you live in. While your emergency room visit is covered out-of-state, your follow-up care is generally not included. This means you might have to return home to your network to receive in-network coverage for your recovery. On the other hand, if you have Traditional/Original Medicare with a Medigap plan, your plan travels with you. Since there are no networks with Original Medicare, your Medigap policy is accepted by any provider nationwide that accepts Original Medicare. Additionally, many Medicare Supplement plans offer a foreign travel emergency benefit that covers 80% of billed charges (up to $50,000) for certain medically necessary emergency care services outside the United States after a small deductible. We recommend that, whenever you travel to another country, you purchase comprehensive health insurance as a guest/visitor. This insurance is very reasonable and delivers complete peace of mind. Photo of Braden Medicare Insurance's What Is Covered if you have a Medical Emergency while traveling outside of the US Poster. MEDIGAP PLANS VS MEDICARE ADVANTAGE (MEDICARE PART C) IN EMERGENCIES As part of the evaluation process, when you are considering what type of Medicare plan fits you and your family the best, it is vital to know what happens in the case you have a health emergency. It goes without saying that we all hope and pray that this does not happen to you or your loved ones. And when you compare and contrast Medicare Part C (Medicare Advantage plans) with Original Medicare and a Medicare Supplement/Medigap plan, it is crystal clear that Original Medicare, with a Medicare Supplement, offers the best option for any Medicare beneficiary. While it may sound good to have an All-In-One Health plan, only Original Medicare with the added protections of a Medigap/Medicare Supplement plan prioritizes your freedom of choice and offers the absolute best option for keeping your medical costs in line and keeping you away from a catastrophic financial emergency. WRAPPING THINGS UP At Braden Medicare Insurance Services, we hope you found this article helpful and informative regarding what every Medicare Beneficiary should understand about Medicare and Medical Emergencies. We understand this is not a conversation anyone looks forward to having, but if Medical Emergencies occur, proper, prior planning really does prevent poor performance. If you have any questions about anything related to Medicare Coverage in Emergency situations, or about anything Medicare related, we invite you to contact us for additional information. We are committed to assisting every beneficiary who contacts us. Whether it is just answering a few questions or assisting you with enrolling and evaluating Medicare plans, we are here if you need us, and there is never a charge for our help, advice, or information. You can email us at mike@bradenmedicare.com or call us at (480) 225-1393 anytime. There is also a wealth of information on our website, www.bradenmedicare.com .

Michael T. Braden March 7, 2026 MEDICARE ADVANTAGE Picture of Braden Medicare Insurances' Pulling Back The Curtain On Medicare Advantage Plans Poster PULLING BACK THE CURTAIN ON MEDICARE ADVANTAGE PLANS Welcome to the Braden Medicare Insurance Blog. I think today's article will be interesting and informative for anyone approaching their Medicare eligibility window (IEP), as well as for anyone who is currently a Medicare Beneficiary. I began my career as an Independent Medicare Broker over 10 years ago. I am stating this to illustrate that we help anyone who needs help with Medicare. I am absolutely committed to being a great listener, an understanding teacher, and a bulldog when it comes to defending my clients and doing whatever I can to keep them safe and financially whole throughout their retirement years. I take pride in helping and serving others. Picture of the National Society Of Medicare Planners Logo Some people are attracted to Original Medicare, while others like the flexibility of Original Medicare. Still, they want the security of adding a Medigap (Medicare Supplement) policy to strengthen their Original Medicare plan. Then some people are attracted to Medicare Advantage Plans (Medicare Part C or All-In-One plans). I have many clients who have Special Health Needs, and some have Chronic Health Issues. I highly recommend SPN and C-SPNP for anyone with specific needs and health challenges. Therefore, in the spirit of full disclosure, out of all of my clients, here is what my clients have chosen for their Medicare coverage: 2% Have Original Medicare by itself. 6% Medicare Advantage Special Needs (SPN) or Chronic Special Needs Plans (C-SNP), 14% Have Medicare Advantage Plans. 78% Have Original Medicare With A Medicare Supplement/Medigap policy. And out of this group, 19% Have Plan F, 2% Have Plan C, 55% have Plan G, 22% have Plan N, and 2% Have High Deductible Plan G (HDG). BEAUTY IS IN THE EYE OF THE BEHOLDER Finding the BEST Medicare plan is not nearly as important as finding the BEST option for you, as an individual, and for your family. I hope everyone who reads this article will commit to investing a little time in researching and learning about Medicare so you can make the best, well-informed plan choice for you. Please resist the outside noise, like your brother-in-law saying he has this guy at work who is on Medicare and loves his plan, or the woman who cuts your neighbor's hair saying her Sister in Missouri swears by her plan. I will attest to anyone who asks me for my opinion that Original Medicare, coupled with a Medicare Supplement/Medigap Plan G, is the absolute best option, as it offers the most comprehensive coverage and is the top No-Brainer Medicare combination available. However, for myriad reasons, Original Medicare, with or without a Medicare Supplement policy, is not the best choice for many people. And, there are just as many fans and advocates of Medicare Advantage plans. That is great, I am a fan and will support any Medicare Advantage plan that is the best option for a particular Medicare Beneficiary. DON'T BE PENNY WISE AND POUND FOOLISH Picture of Braden Medicare Insurances' Don't Be Penny Wise & Pound Foolish Poster. Many times, when people are new to Medicare, they are typically in good health, so they often think they can get by on the cheap and get a Medicare Advantage Plan, thinking they can save money for a few years. Maybe a novel concept, but I have honestly witnessed bad things happen that left people unable to get a Medicare Supplement policy in the future because of something they did not expect. Insurance is what we pay to have someone else take on the risk. In the case of Medicare and a Medicare Supplement, this is to pay the 20% of Medicare costs that Medicare does not cover. SOME OLD QUOTES & SAYINGS STILL RING TRUE TODAY Picture of Braden Medicare Insurances' A Bird In Hand Is Worth Two In The Bush Poster Everyone has one chance to enroll in any Medicare plan they desire during their IEP (Initial Enrollment Period) for Medicare. So if you are looking forward and trying to imagine what you want your Health Care and your Healthcare coverage to look like in your 80s and 90s, there is no good reason not to get a Medicare Supplement/Medigap plan of your choice when you first enroll in Medicare. Once you have a Medigap/Medicare Supplement policy, it can never be taken away from you. You can rest easy knowing you will have consistent, predictable costs, and that after your modest Part B deductible each year ($283 in 2026), all of your Medical Bills will be 100% covered. You can see any doctor and go to any Hospital you choose, anywhere in the US. You pick your own doctor, and there are no networks to deal with. The average Medicare Supplement Plan G premium for someone turning 65 in Arizona is $152 per month, or $1,824 per year. So if the average MOOP for a Medicare Advantage Plan is $6,000 or more, you can see the value in Medigap plans from a mile away. THE TOP REASONS PEOPLE SAY THEY CHOSE A MEDICARE ADVANTAGE PLAN IN 2024 COMPREHENSIVE COVERAGE IN ONE PACKAGE PREDICTABLE COSTS HELP YOU MANAGE BETTER MORE BENEFITS BEYOND BASIC MEDICARE COORDINATED CARE FOR A SEAMLESS EXPERIENCE PRESCRIPTION DRUG COVERAGE IS INCLUDED EXTRA PERKS WITH MOST PLANS FLEXIBLE PLAN OPTIONS POTENTIAL HEALTH SAVINGS DEPENDING ON YOUR NEEDS WHY MOST MEDICARE ADVANTAGE PLANS ARE NOT ALWAYS ALL THEY'RE CRACKED UP TO BE I am going to share some things with you that you may not know, might not understand, or perhaps have never heard of before. The purpose of sharing this information is to be transparent, in hopes that you are better informed about the inner workings of Medicare Advantage plans. Did you know that......................... You are not in control of Healthcare. You are a slave to your plan. They say what doctors are covered. Which hospital and SNF can you go to? How many Physical Therapy appointments can you, etc? You worked your entire life, so why are you willing to give up being in control of your own healthcare now? Most "Extra" Benefits are based on Quarterly Benefit Amounts? So the $1000 in Dental Benefits you thought you had is usually just $250 per Quarter. You have to use only dentists in your plan's provider directory. Plus, major work like Implants, Crowns, and root canals is typically not covered. To know exactly what is covered, you should constantly read and refer to your plan's Evidence of Coverage. You typically have a co-pay for everything with every Medicare Advantage HMO (Health Maintenance Organization) plan. An MRI will cost you $250-$400, and a Hospital Bed will cost $350-$450 per night for up to 7 nights. Every MAPD (Medicare Advantage Plan With Prescription Drugs) has a MOOP (Maximum Out-Of-Pocket) amount. The average for all MA and MAPD plans available nationwide in 2026 is just over $6,000. You may not need a referral to see a Specialist with a PPO (Preferred Provider Organization). Most MAPD Plans include a Health Club Membership. However, only about 20% of Medicare Advantage plan members use it regularly. You do not need a Medicare Advantage plan to get excellent Prescription Drug Coverage. The US Government (CMS/Medicare) pays $12,000 per year to every Medicare Advantage insurance company for each person enrolled in one of its plans! Now you know how they get the money to advertise and use all their Bait-and-Switch tactics. You are responsible for paying a 20% Co-Insurance for any Cancer Treatments (Radiation and Chemo), and in case you have not heard, those average $12-15K for each round of treatments. Your plan can deny coverage, require you to get Prior Authorization in advance for anything, require you to get 2nd, 3rd, or 4th opinions for anything, and there is nothing you can do about it. Medicare Part B Giveback Plans are misleading. They increase the MOOP and only return a small portion of the benefits of your premium. You have most other plans with more overall benefits and lower MOOP costs. The insurance companies know this, and they take advantage of you. In 2026, The Average MOOP for Medicare Advantage plans nationwide is over 6K! If you have a problem with a bill, it is ultimately your insurance company that decides which charges it will and will not cover. They can deny just about anything, for any reason, and there is nothing you can do about it. Medicare Advantage plans may not continue year after year. But every year, you need to pick a new MA/MAPD plan. If you like your plan, AWESOME, but it may not be around next year, and if that happens, you must pick a new plan. If your allowance for Eyewear (Prescription Glasses or Contacts) does not cover it, do not wait until October to go to the Optometrists. Why? Because your $250 benefit is really only $62.50 per quarter. The best thing to do is to try to beat the insurance company at its own game. So, on the last day of the quarter, use your benefits for the Optometrist appointment. Eye Exam. Then, use the first day of the new Quarter to pay for your benefits. If you have an HMO plan, you only have FULL Coverage in the county where you reside. Anytime you travel outside of your home county, you only have "Covered" Healthcare at an URGENT Care facility or in a Hospital Emergency Room. And as soon as they put you in a Hospital Room, you will be responsible for paying all out-of-network costs associated with your stay. Most Medicare Beneficiaries receive better care and more benefits if they qualify for a Medicare SPN (Special Needs Plan) or a C-SNP (Critical Special Needs Plan) than with a regular MAPD plan. Most Doctors, healthcare providers, and first responders often refer to Medicare Advantage plans as Medicare Dis-Advantage. WRAPPING THINGS UP Photo of Michael Braden's Business Card. Braden Medicare Insurance is a Licensed, Independent Medicare Broker and a CMIP (Certified Medicare Insurance Planner). We are based in Chandler, AZ, and are also licensed in California, Colorado, Florida, Indiana, Iowa, Michigan, Nevada, New Mexico, Ohio, Oregon, Pennsylvania, Texas, and Wisconsin. If you have any questions, would like a second opinion, or have a question about Medicare, please feel free to reach out to us anytime. We will never charge a penny for our time, knowledge, or expertise. Email us   @ mike@bradenmedicare.com , call or text us @ (480) 225-1393, or visit us on our website at www.bradenmedicare.com   anytime, 24/7 .

Michael T. Braden January 13, 2026 Medicare 101 It is common to have many Medicare-related questions running through your mind at any given time. However, finding answers to these Medicare questions may be more complex than expected. We get it, this is the driving force behind our mission and passion to educate and serve our clients. We've worked hard to provide everyone with this great guide to get you set up for success as you begin your Medicare Journey. Photo of Braden Medicare Insurances' Medicare Q & A Poster This Medicare Q&A article is rather lengthy, but we believe it is worth the read. In today's article, we wanted to provide you with the top questions we are asked by people approaching Medicare and those already enrolled in Medicare. Our goal is to help individuals by providing answers to the most frequently asked questions, so you are more informed and have more confidence in gathering Medicare information and in your Medicare Enrollment. MOST COMMONLY ASKED QUESTIONS ABOUT MEDICARE WHO IS ELIGIBLE TO APPLY FOR MEDICARE? To be eligible for Original Medicare, you must be a permanent legal resident ( green card holder ) or an American citizen who has lived in the United States for at least five years, and one of the following:  Age 65 or older  Under age 65 and receiving Social Security Disability Income for 24 months Diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis To enroll in Original Medicare, you may be required to reach out to your local Social Security office in some circumstances. IS MEDICARE FREE? For most, the Medicare Part A premium is $0 per month. However, if you do not qualify for zero-premium Part A, the premium can be as high as $565 in 2026. To qualify for zero premium, you must have worked at least 40 quarters (10 Years) paying Medicare taxes. If you did not meet this qualification, you would be required to pay the Medicare Part A premium. The standard Medicare Part B premium is $202.90 in 2026. This can increase based on income. This difference in premium reflects your I ncome R elated M onthly A djustment A mount (IRMAA). For example, if you and your spouse make $230,000 combined, you will each pay $244.60 per month in 2026. If you are subject to IRMAA, you will receive a determination letter from the Social Security Administration with your new monthly premium. DOES THE GOVERNMENT AUTOMATICALLY ENROLL EVERYONE IN MEDICARE? You will automatically be enrolled in Medicare at age 65 if you are receiving Social Security benefits or railroad retirement board benefits at least four months before you enroll in Medicare. However, suppose you are not receiving Social Security or Railroad Retirement Board benefits. In that case, you will need to contact your local Social Security office to enroll in Medicare up to three months before your 65th birthday. Photo of Braden Medicare Insurance's Medicare Initial Enrollment Period (IEP) for Medicare If you must contact your local Social Security office, you can sign up for Part A and Part B at the same time. Once you complete the application and provide the required documentation, you will begin receiving benefits on the first day of your 65th birth month. WHAT DO I DO IF I PLAN ON WORKING PAST AGE 65? While it is not mandatory, we recommend enrolling in Medicare Part A as soon as you become eligible if you qualify for premium-free Part A coverage. However, if you delay Medicare Part A, you will be able to enroll later during the Initial Enrollment Period (IEP) or a Special Enrollment Period (SEP) if you qualify. If you delay your initial enrollment into Medicare, you will be required to pay late enrollment penalties if you have not been covered under a Group Health Insurance Plan from an employer with more than 20 employees. If your employer offers creditable health coverage , you do not need to enroll in Medicare Part B if you are working past age 65. Creditable coverage is healthcare coverage that provides at least equal benefits to Original Medicare. Suppose you do not have creditable coverage and do not enroll in Medicare Part B when you first become eligible. In that case, you may have to pay the Medicare Part B late enrollment penalty as long as you have Medicare Part B. Remember that even if you have creditable coverage, it is essential to compare your current plan to Original Medicare with a Medigap plan and Part D. Often, combining these Medicare plans will provide you with the most comprehensive coverage possible. Are Medicare Supplement and Medicare Advantage the same thing? Medicare Supplement plans and Medicare Advantage plans are not the same thing. While both Medicare Supplement and Medicare Advantage plans bring additional benefits to Original Medicare, they work very differently. Original Medicare Covers Medicare Parts A (In-Patient Hospital Coverage) and Medicare Part B (Outpatient Health Care costs. Original Medicare is an 80/20 Health Plan, with Medicare covering 80% of all Medically Necessary services, and you are responsible for the remaining 20%. That is where the option of purchasing a Medicare Supplement comes in. Medicare Supplement plans, or Medigap plans as many refer to them, are designed to work hand-in-hand with Medicare to fill the gaps Original/Traditional Medicare does not cover. Photo of Braden Medicare Insurances' 2026 Medicare Part A Benefits Poster. Picture of Braden Medicare Insurances' 2026 Medicare Part B Benefits Poster There are 10 Medicare Supplement plans available, and these plans are standardized, meaning that each lettered Medicare Supplement plan has the same benefits in all 50 states. These plans are secondary to Medicare. Medicare Supplement (Medigap) plans pay after Medicare has paid its share. Medicare Supplement plans are the best way to have predictable costs, unmatched coverage, and convenience. In fact , for those who choose Original Medicare and A Medigap Plan G, it is the best Healthcare Coverage and best value you have ever had for comprehensive Health Insurance. Medicare Supplements have no networks, so you are free to see any provider and receive care at any hospital that accepts Medicare Assignment (Medicare's Fee Schedule). About 93.6% of all doctors accept Medicare nationwide. The main ones who do not are Pediatricians, Psychologists, Psychiatrists, Naturopathic doctors, and Homeopathic doctors . Photo of Braden Medicare Insurances' 2026 Medicare Supplement Comparison Chart Medicare Advantage plans, also known as Medicare Part C, on the other hand, become your primary coverage over Original Medicare. They often require you to follow a strict network of doctors and have higher out-of-pocket costs. However, everyone needs to understand that the majority of all Medicare Advantage plans only cover you in the county you live in. You can use Emergency Rooms or Urgent Care if you are traveling, but if you see a doctor or are admitted, you will likely pay Out-Of-Network costs for care. Medicare Advantage plans also have a 20% Co-Insurance for Chemotherapy and Radiation treatments. These additional benefits provided by Medicare Advantage plans often include dental, vision, hearing, and prescription drug coverage, as well as transportation assistance and gym memberships. However, not every plan or every carrier is required to offer these additional benefits. Additionally, with any Medicare Advantage plan, you need to read the fine print (the Explanation of Benefits). Because a plan may offer $1,000 in Dental Benefits, and you think that's good, but what they do not tell you is that they automatically break that down to $250 Per Quarter, and if you do not use these quarterly amounts, they usually will not roll over to the next quarter. IF I CHOOSE TO DELAY MY ENROLLMENT WHEN I TURN 65, HOW DO I ENROLL LATER? If you delayed Medicare coverage past age 65 with creditable coverage, you would need to contact Social Security to enroll in Original Medicare. The easiest way to do this is to enroll in Medicare using the Social Security Website at www.ssa.gov . Follow the Medicare Tab in the second column at the top of the homepage to enroll in Medicare. Since you have creditable coverage, you will receive a Special Enrollment Period to enroll in Medicare Part A and Medicare Part B benefits. From there, you can enroll in a Medicare Part D prescription drug plan and Medicare Part C or Medicare Supplement. However, if you delayed Medicare coverage without having creditable coverage, you would need to enroll in Original Medicare during the General Enrollment Period. This is an annual period that runs from January 1 to March 31. Remember, coverage does not begin until July 1 when you enroll during the General Enrollment Period. IS MEDICARE FREE? No, unfortunately, Medicare is not free for most beneficiaries. Some people who qualify for both Medicare and Medicaid (Dual Eligible Beneficiaries) may receive extra help in paying their Medicare premiums. Approximately 99% of all Beneficiaries do not pay for Medicare Part A. Everyone Must Be Enrolled in Medicare Part B to access their VA Benefits (CHAMP, VA Benefits, and TRICARE) . You must be enrolled in Medicare Part B to enroll in any Medicare Advantage plan. You must be enrolled in both Medicare Part A and Medicare Part B if you decide that Original Medicare is the right option for you and your family. For most, the Medicare Part A premium is $0 per month. However, if you do not qualify for zero-premium Part A, the premium can be as high as $518 in 2025 or $565 in 2026. To qualify for zero premium, you must have worked at least 40 quarters or ten years paying Medicare taxes. If you did not meet this qualification, you would be required to pay the Medicare Part A premium. The standard Medicare Part B premium is $202.90 in 2026. This can increase based on income. This difference in premium reflects your Income Related Monthly Adjustment Amount (IRMAA). For example, if you and your spouse make $230,000 combined, you will each pay $244.60 per month in 2026. If you are subject to IRMAA , you will receive a determination letter with your new monthly premium. ARE YOU ALLOWED TO CHOOSE A MEDICARE ADVANTAGE PLAN AND STILL GET A MEDICARE SUPPLEMENT POLICY? No, it is illegal to enroll in both a Medicare Supplement plan and a Medicare Advantage plan. If you were to enroll in both plans, neither would become your primary coverage, leading to a denial of services. This could leave you paying out of pocket for all your healthcare services, even with both coverages. To avoid this, it is illegal for an agent to enroll you in one plan if you are already enrolled in the other and do not have a valid way out of the plan. WILL I NEED TO RENEW MY MEDICARE EVERY YEAR? Original Medicare coverage is automatically renewable each year you are eligible. So, it is not necessary to renew your Medicare parts each year. Medicare Supplement plans work the same way; once you are accepted, the plan is automatically renewable as long as you continue to pay the monthly premiums. Premiums can and will increase over time, but once you have a Medicare Supplement or Medigap policy, it is yours for life, as long as your premiums are paid. Medicare Advantage plans are different. Some plans are available year after year, meaning if you are happy with the Medicare Advantage plan you chose, you can enroll in the same plan for the following Calendar Year. However, if you want to change plans, you can choose a new plan during the Medicare Annual Enrollment Period in the Fall, and your new plan will begin on January 1st. WHAT HAPPENS IF I RELOCATE? If you move to a new city or state, you will need to change your address with Social Security. Because Original Medicare is a federal program, benefits are the same nationwide. So, your benefits will not change. However, if you enroll in a Medicare Supplement or Medicare Advantage plan, you may be required to choose a new plan or pay a higher (or lower) monthly premium. ARE THERE DEDUCTIBLES WITH MEDICARE? Medicare Part A and Medicare Part B have deductibles and costs that change annually. For 2026, your Medicare Part A per-occurrence deductible is $1,736, with your Part B annual deductible costing $283. You must meet these deductibles before the respective Medicare part covers its portion of the services you receive. The Medicare Part A deductible is per occurrence, meaning you could pay that cost multiple times in one year. The Medicare Part B deductible, on the other hand, is annual. Thus, you will only pay it once per calendar year. The most popular Medicare Supplement plans will pay your Medicare Part A Deductible for you, but you will always pay your Medicare Part B deductible directly. Once you have met your Part B deductible each Calendar Year, Medicare will cover the remaining 80% of all costs. Medicare Advantage plans (Medicare Part C) often have an annual deductible that varies by plan. You will need to review your plan information to find your yearly deductible. If you have a Medicare Prescription Drug Plan, whether it is a Stand-Alone PDP plan or if you have Prescription Drug coverage from your Medicare Advantage plan (MAPD), you may also have a separate Part D deductible. For 2026, the maximum Part D Deductible is $615, a slight increase from the year prior. However, each plan can set its own deductible. DOES MEDICARE COVER PRESCRIPTION MEDICATIONS? Original Medicare does not cover prescription drugs. If you wish to have coverage for prescription Medications, you will need to enroll in a Stand-Alone Medicare Part D prescription drug plan. Medicare Part D helps cover the cost of prescription medications. Most Medicare Advantage plans also provide prescription drug coverage (MAPD) . If you are a veteran with VA Benefits, your VA Prescription Drug plan is considered creditable, so there is no need to have a separate Medicare Part D plan. If you do not enroll in Medicare Part D within 63 days of your Medicare Part B effective date, you may be subject to the Medicare Part D late enrollment penalty. This penalty is for those who delay Part D benefits without creditable coverage. You will be required to pay the additional cost as long as you have Medicare Part D. HOW CAN I CHANGE MY ADDRESS WITH MEDICARE? To change your address with Medicare, you must contact your local Social Security office and verify your identity. From there, they can change your address on file by answering a few simple questions and providing supporting documentation. If you have multiple addresses, you must provide your permanent residence. This is determined by where you spend most of your time throughout the year. WHAT HAPPENS IF MY MEDICARE CARD IS LOST OR STOLEN? Picture of Brand Medicare Insurances' Understanding Your Medicare Card Poster. If your Medicare card is lost or stolen, it is essential to report it to Social Security as soon as possible. To report a lost or stolen card and request a replacement, you can log into (or create) a My Medicare account through Medicare.gov . From there, you can print a temporary replacement card. To receive a new card in the mail, you will need to contact Medicare at 1-800-633-4227 . HOW DO I PAY FOR MEDICARE? There are three ways to pay for Medicare: If you are already receiving Social Security Benefits, your Monthly Medicare Premiums will be deducted from your Monthly Social Security Disbursement. Your initial Medicare Statement will be for 3 Months. After that, you can set up your Medicare Portal on the www.medicare.gov portal. Set up the Medicare Easy Pay option on the Medicare website at www.medicare.gov DOES MEDICARE PAY FOR DENTURES Original Medicare does not cover dentures. However, some Medicare Advantage plans may provide this benefit. If you would instead enroll in a Medicare Supplement plan or stick to Original Medicare, you can always enroll in a separate dental plan that offers coverage for dentures. These plans are designed to work with Medicare to create full-circle benefits for you. WILL MEDICARE PAY FOR HEARING AIDS Original Medicare does not cover hearing aids. However, some Medicare Advantage plans may provide this benefit. CMS does not deem hearing aids medically necessary, so the federal healthcare program does not cover them . If you need hearing coverage but do not want to enroll in a Medicare Advantage plan, there are several options. You can enroll in a stand-alone benefits plan that allows hearing coverage to work alongside your Medicare plan. MEDICARE WITH VA BENEFITS You do not need to enroll in Medicare if you have VA benefits. However, if you ever receive coverage outside of the VA system, you will need medical coverage to cover these costs. Remember, if you have VA coverage and delay Medicare Part B enrollment, you will have to pay the Medicare Part B penalty if you decide to enroll in Medicare coverage later in life. Once you enroll in Medicare, it pays primary, and the VA pays secondary. CAN MEDICARE DECLINE YOUR COVERAGE FOR HEALTH REASONS? Original Medicare, Medicare Advantage, and Medicare Supplement plans cannot drop you based on your health status. These plans are guaranteed renewable as long as you continue to pay the monthly premiums. Keep in mind that if you want to change plans, there may be health-related restrictions or roadblocks . Medicare Supplement plans can deny your application based on pre-existing conditions. Medicare Part D and Medicare Advantage plans do not review your health history. However, you can only apply during certain times of the year. WHAT CAN YOU DO IF YOU ARE STRUGGLING TO MAKE YOUR MEDICARE PREMIUM PAYMENTS? If you cannot afford your Medicare premiums, there are several assistance programs available to help cover these costs. First, you should visit your local Medicaid office to see if you qualify. If so, Medicaid will cover your monthly premiums and provide you with extra benefits. Additionally, several Medicare Savings Plans are available to help low-income earners. These plans help pay your Medicare premiums and out-of-pocket costs. HOW ARE MA HMO PLANS DIFFERENT FROM MA PPO PLANS? Medicare HMO and PPO  plans are both Medicare Advantage plans. HMO plans are the most restrictive, with tight networks and require referrals to see specialists. PPO plans are more lenient and have a more comprehensive network of doctors and hospitals you can utilize. HMO plans typically cost less than PPO plans. Both types of plans have restrictions and guidelines you must follow to receive care. IS THERE A NETWORK WITH ORIGINAL MEDICARE? Original Medicare does not have a typical network of doctors and hospitals. Instead, doctors and hospitals can opt in or opt out of accepting Medicare. In 2026, nearly 93% of doctors and hospitals nationwide will accept Medicare. When you enroll in a Medicare Advantage plan, you will have to follow the network of doctors who accept your plan. This is one of the downsides of enrolling in an Advantage plan. You lose the freedom to choose your care team thoroughly. However, with a Medicare Supplement plan, you can see any doctor nationwide. This is a bonus if you often travel or have dual residency. IS ENROLLING IN MEDICARE MANDATORY? Enrolling in Medicare coverage is not mandatory. So, you are not required to have coverage at any point. However, if you delay Medicare enrollment without creditable coverage, you may be required to pay late enrollment penalties that do not go away. Thus, it is often more cost-effective in the long run to enroll in Medicare coverage when you are first eligible. Medicare Part A is typically zero-premium for those who qualify, and delaying Medicare Part B can result in a significant penalty if you do not have creditable coverage. The Medicare Part B penalty adds 10% to the base premium for each 12-month period you go without coverage. CAN I CHANGE MY MEDICARE PART D PRESCRIPTION DRUG PLAN? If you enroll in Medicare Part D, you can enroll in a new plan once per year during the Annual Enrollment Period each fall. Medicare Part D plans do not require you to answer health questions, so you can enroll in any plan you wish during this enrollment period. Keep in mind, any changes made to your Medicare Part D plan during the Annual Enrollment Period go into effect on January 1 of the following year. Each year, Medicare Part D plan formularies change to reflect the needs of the majority of consumers. Your plan may change how it covers your specific drugs, and your copayments and deductibles may change each year. So, even if you are satisfied with your benefits, it is essential to review the upcoming year's changes and ensure your drugs will remain adequately covered. SWITCHING BACK TO MEDICARE FROM A MEDICARE ADVANTAGE PLAN If you have a Medicare Advantage plan and wish to switch to a Medicare Supplement (Medigap) plan, you may have to wait until the Annual Enrollment Period. Unlike Medicare Supplement plans, Medicare Advantage plans require you to enroll for one year unless you have a life-changing event that would allow you to leave the plan early. This means you cannot change plans whenever you wish throughout the year. Except for your first year on Medicare, Medicare Advantage plans are a 12-month term lasting from January to December. To change your plan for the upcoming year, you will need to enroll during the Annual Enrollment Period. By doing so, you must answer underwriting health questions to enroll in a Medicare Supplement plan. This means that your application for coverage may be denied depending on your answers to the health questions. DO MEDICARE BENEFITS CHANGE FROM YEAR TO YEAR? Original Medicare benefits do not change each year. However, the premiums, deductibles, and covered services may change each year. New prices are generally released in October and reflect changes for the upcoming year. Also, if there is a change in covered services, you will receive notice in advance that Medicare will no longer provide coverage. Medicare Advantage plan benefits do change every year. It is extremely important to review your plan changes each year during the Annual Enrollment Period . During this time, you do have the option to change your plan if you do not like the new changes for the year. Any changes made during this enrollment period will be effective on January 1st of the upcoming year. Medicare Supplement plans do not typically change yearly. However, the deductible and premium costs may differ each year. WRAPPING THING UP If you have additional Medicare questions or if you would like a friendly ear to talk to about anything related to Medicare, please feel free to contact me directly. At Braden Medicare Insurance Services, we genuinely love to help people, and there is never a charge for our services, our experience, or our time. You can call or text me at (480) 225-1393, email me directly at mike@bradenmedicare.com , or fill out our Contact Page on our website at www.bradenmedicare.com .

Michael T Braden January 7, 2026 Medicare Part C HOW DO YOU FIND THE BEST MEDICARE ADVANTAGE PLAN? Looking for the highest-rated Medicare Advantage plans for 2026? In this article, you’ll find detailed comparisons to help you choose the right plan for your healthcare needs, highlighting the best options based on star ratings, comprehensive benefits, and member satisfaction. The best-rated Advantage plans have the most extensive networks coverage and positive member experiences. Picture of Braden Medicare Insurance's How Do You Find The Best Medicare Advantage Plan Poster. WHAT TO LOOK FOR WHEN INVESTIGATING MEDICARE ADVANTAGE PLAN OPTIONS Medicare uses a "STAR" Rating System to identify plans that receive the highest ratings for Member satisfaction. Look for plans with trusted names in the Healthcare industry. Please don't select a plan just because your friend or neighbor mentions it; do your homework to ensure any plan you consider is the right one for you and your healthcare needs, and that it's available where you live. Ensure that all your doctors are members of the plan you are interested in. Verify that all your prescription medications are covered by any plan you consider . Look at the MOOP, MOOP stands for Maximum Out-Of-Pocket expenses for a particular plan. Your MOOP is the total exposure you have. If/when you reach your MOOP, your plan will cover your healthcare costs for the remainder of the calendar year. Verify that the hospitals you prefer are in your plan's network. It is a good reminder for anyone interested in a Medicare Advantage plan to know that they typically only cover you in the county you reside in. Medicare Advantage plans do not travel with you. You can go to an Urgent Care or to a hospital emergency room if you are away from home, but if you need to see a doctor, you will likely have to pay out-of-network rates for healthcare services. BEST MEDICARE ADVANTAGE PLANS Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies and are all-in-one plans that cover hospital insurance, hospital stays, doctor visits, and medical expenses. Medicare Advantage Plans Advantage plans combine the same basic benefits as Medicare Parts A and B and often include additional services such as vision, dental, or wellness programs. Most Medicare Advantage plans include Prescription Drug coverage, but not all of them do. This is why many people refer to MA (Medicare Advantage plans) and MAPD (Medicare Advantage plans with Prescription Drug coverage) as All-In-One plans. They’re designed to offer a comprehensive healthcare alternative to Original Medicare. The best Advantage plans have higher Star Ratings , which are an essential tool for comparing the quality of different Advantage plans. Selecting the top Medicare Advantage plan also requires evaluating additional factors , such as plan availability, benefits, location, and monthly premiums. These factors help determine whether a potential plan is suitable for the beneficiary. DID YOU KNOW THAT THERE ARE DIFFERENT MEDICARE ADVANTAGE PLANS FOR DIFFERENT NEEDS Picture Of Braden Medicare Insurance's Medicare Advantage Plans Poster. Medicare Advantage plans cater to various healthcare needs, so it is really vital that you choose the best plan that meets your own, specific healthcare and lifestyle needs. The majority of Medicare Advantage plans offer benefits and coverage for services not included in Original Medicare, such as routine physical exams and dental care. This additional coverage can be a game-changer for those who require more comprehensive healthcare services. Advantage plans generally cover medically necessary services, which are essential for diagnosing or treating health conditions. Elective or non-essential procedures, such as cosmetic surgery or long-term custodial care, are not considered medically necessary and are typically not covered. For those with Special Needs or beneficiaries with Chronic Heart and/or Kidney Disease, you will always find lower premiums, lower MOOP, and more robust extra benefits, including travel benefits, and lower hospital co-pays by choosing Medicare Advantage SPN (Special Needs Plans) and C-SNP (Chronic Special Needs Plans) plans. Advantage plans with higher Star Ratings (4+ stars out of 5) often receive quality bonus payments from the government, encouraging quality improvement and allowing plans to offer richer benefits , such as lower costs or extra perks, which, in turn, attract more beneficiaries. Designed to offer superior service and coverage, these plans are ideal for those who prioritize quality and comprehensive care. Picture of Braden Medicare Insurance's Medicare Star Ratings Poster. Medicare uses Star Ratings in Order to Distinguish Good Medicare Advantage Plans from Bad Medicare Advantage Plans. MEDICARE ADVANTAGE PLAN TYPES Advantage plans  come in a variety of options, each designed to meet different healthcare needs and preferences. Health Maintenance Organization (HMO) plans are a popular choice for many beneficiaries. With an HMO plan, you typically select a primary care physician and must use a specific network of providers for your care, except in emergencies. This structure helps keep costs predictable and often results in lower premiums. Preferred Provider Organization (PPO)   plans offer more flexibility than HMOs, allowing you to see both in-network and out-of-network providers, which is ideal for those who want more freedom in choosing healthcare providers. However, you’ll typically pay much less when staying within the plan’s network. Private Fee-for-Service (PFFS) plans let you visit any doctor or hospital that accepts the plan’s payment terms, giving you more control over your healthcare choices, as there is no primary care provider requirement and no referrals needed to see a specialist. These plans also often include additional benefits, such as drug coverage or vision, with costs and premiums varying by provider and location. Special Needs Plans (SNPs)  are in-network plans tailored for Medicare beneficiaries with specific health conditions or financial needs, providing specialized care and targeted benefits for typically lower costs, oftentimes with $0 premiums and copays, making them ideal for managing complex health needs. With so many options available from private insurers, it’s important to compare the different types of Advantage plans to find the one that best fits your unique lifestyle and healthcare needs. IMPORTANT ITEMS TO LOOK OUT FOR AND COMPARE WHEN SELECTING ANY MA PLAN Evaluating the network of doctors and hospitals is critical when selecting a Medicare Advantage plan. The plan’s network determines which doctors and hospitals are covered and directly impacts beneficiaries’ out-of-pocket expenses and access to care. SIZE AND ACCESSIBILITY OF THE PLANS NETWORKS Advantage plans with extensive networks offer a wider variety of provider options, ensuring that enrollees have access to the healthcare services they need. Plans with broad networks often offer greater flexibility in referrals and specialist visits, particularly beneficial for individuals with chronic conditions or complex health needs. Choosing a Medicare Advantage plan with a large , diverse network can enhance the quality of care and improve health outcomes for beneficiaries. COMPARE WHAT IS COVERED IN-NETWORK & OUT-OF-NETWORK Your costs will always be lower if you use IN-Network providers and visit only IN-Network Care Facilities. Using the in-network Advantage plan generally results in lower out-of-pocket costs than seeking care from out-of-network providers. Accessing out-of-network services often leads to higher costs and reduced coverage. Medicare Advantage beneficiaries should carefully evaluate their plan’s network to understand which providers and services are covered, avoid surprise charges, and ensure they receive the full range of benefits available to them. If you are unsure, either contact your Broker or call the plan directly. Lastly, you need to review and compare both the Summary Of Benefits (SOB) and the Evidence Of Coverage(EOC). Note, every MA and MAPD Plan has a 20% Co-Insurance for Chemotherapy and Radiation Treatments for Cancer. COSTS THAT ARE ASSOCIATED WITH ALL MEDICARE ADVANTAGE PLANS Money matters, and what you spend out of pocket for healthcare is perhaps even more important for most people than what your plan covers. Healthcare costs should be a big factor when choosing a Medicare Advantage plan. The providers (Doctors/Clinics/Hospitals/SNFs) set premiums and deductibles, which can vary by location and plan network. Beneficiaries should consider other potential expenses that can vary significantly across Medicare Advantage plans, such as copayments and coinsurance for services like doctor visits, specialist appointments, hospital stays, and prescription drugs. It’s important to note that while several Medicare Advantage plans feature $0 monthly premiums, these savings are often offset by higher copays or deductibles from the insurance company . Therefore, evaluating the total expected healthcare expenses based on your anticipated medical needs is crucial for determining which plans would fit you best. PREMIUMS & DEDUCTIBLES Many Medicare plans offer $0 monthly premiums, making them an attractive choice for many enrollees. However, while these $0 premiums often lead beneficiaries to expect low overall costs, it is important to consider all associated expenses, including deductibles and coverage limits, when comparing plans. Beneficiaries must also maintain their Medicare Part B premium to remain enrolled. This monthly premium is set at $202.90 for 2026. OUT-OF-POCKET COSTS Medicare Advantage out-of-pocket spending limits  vary by plan. Examining these maximums alongside premiums, copayments, and deductibles is vital when assessing different plan options . These costs can greatly affect your overall healthcare expenses, so choosing a plan that fits your budget and needs is essential. ADDITIONAL "EXTRA" BENEFITS Advantage plans frequently include additional coverage for services beyond what Original Medicare covers, such as prescription drug coverage, dental, vision, and hearing care, and fitness and wellness programs. Many Medicare Advantage plans also include over-the-counter benefits, such as allowances for OTC medications and health products. Emergency care coverage, both within the United States and internationally, is often included as an added benefit in many plans. PRESCRIPTION DRUG COVERAGE (PART D) Most Advantage plans integrate prescription medication coverage into the plan itself. This addition ensures that necessary medications are covered, reducing the overall cost burden for beneficiaries. For more details on Medicare coverage for diabetics, including medication, supplies , and prevention programs, see our comprehensive guide . Picture of Braden Medicare Insurance's Poster Showing Medicare Part C (Medicare Advantage Plan) DENTAL, VISION, AND HEARING BENEFITS Advantage plans can vary widely in their dental, vision, and hearing care benefits  based on the plan provider. Many plans offer preventive dental services such as cleanings and exams, which are not typically covered under Original Medicare . However, the specific coverage details, benefits, and out-of-pocket charges can vary significantly depending on the insurer and particular plan.  GYM MEMBERSHIPS & HEALTH AND WELLNESS PERKS Most Medicare Advantage plans these days include a gym membership, along with other health and wellness programs. These plans can include coaching, nutrition counseling, and support for chronic disease management. These perks contribute to the overall value of the plans by promoting a healthier lifestyle and helping beneficiaries achieve better health outcomes. HIGHEST RATED MEDICARE ADVANTAGE PLANS BY STATE There are well over 4,000 Medicare Advantage plans across the United States. And since Medicare Advantage plans are designed to cover you only in the county you live in, it makes sense that not every plan is available in every county. Leading insurance companies such as Humana, Aetna, and United Healthcare offer some of the highest-rated Medicare Advantage plans nationwide . Humana is known for its broad plan availability, a wide array of supplemental benefits, and low or $0 premiums. AETNA Aetna stands out for its comprehensive coverage and additional benefits , such as dental and vision care, which contribute to its high customer satisfaction ratings. Aetna PPO Plans also have interstate coverage in most areas of the country. UNITED HEALTHCARE/AARP United Healthcare is recognized for its broad national presence, robust provider networks, and innovations, such as capped drug costs, that significantly reduce members' out-of-pocket expenses . HUMANA Robust benefits and a large availability of plans nationwide. The Humana Gold Plans are among the best-reviewed plans nationwide. When searching for the best Medicare Advantage plan in your area, it’s essential to research and compare the options that are available to you. Look for plans that offer the right balance of coverage, costs, and customer satisfaction. By evaluating the highest-rated Medicare Advantage plans in your state, you can find the one that meets your financial and lifestyle requirements. STAR RATINGS AND MEMBER EXPERIENCE REVIEWS Star ratings for Medicare Advantage plans assess quality based on member surveys and provider data, with an average star rating indicating the overall performance. These ratings, provided by the Centers for Medicare & Medicaid Services (CMS), range from 1 to 5 stars, with 5 stars representing the highest level of quality and member satisfaction. High star ratings often correlate with better plan benefits, lower out-of-pocket costs, and superior customer service. Beneficiaries are encouraged to consider star ratings as a key factor when selecting a good Medicare Advantage plan, as these ratings provide valuable insights into the plan’s overall quality and reliability. STRONG CUSTOMER SERVICE AND SUPPORT Excellent customer service and support are key factors to consider when choosing a Medicare Advantage plan. Many insurance companies understand the importance of helping members navigate their Advantage plans and access the care they need. For instance, Aetna provides a 24/7 customer support hotline and online chat service, ensuring that help is always available. UnitedHealthcare offers a suite of user-friendly online tools and resources, making it easier for members to manage their health insurance and find information about their coverage. When evaluating Advantage plans, consider the level of customer support each insurance company offers. Responsive service can make a significant difference in your experience, from resolving billing questions to helping you find in-network providers. Choosing an Advantage plan from a company known for strong customer service can give you added peace of mind throughout your healthcare journey. Lastly, ask any company you are considering where their Call Centers are located. This matters, and in my experience, US-based Member Services are superior to those abroad, such as in the Philippines, India, and Pakistan. MEDIGAP VS MEDICARE PART C When considering your health insurance options, it’s important to understand the differences between Medicare Advantage plans and Medicare Supplement (Medigap) plans . Advantage plans, provided by private insurers, replace Original Medicare and often include additional benefits such as dental and vision care, prescription drug coverage, and gym memberships. These plans may offer lower monthly premiums but typically have higher potential out-of-pocket expenses. In contrast, Medicare Supplement plans are designed to work alongside Original Medicare, helping cover out-of-pocket costs such as deductibles, copays, and coinsurance. While Medicare supplement plans can reduce your share of medical expenses, they do not include extra benefits like dental or vision care, and you’ll still need to enroll in separate plans for these coverages. If you’re interested in switching from Medicare Advantage to Medicare Supplement Insurance , there are specific steps and timelines to consider. Choosing between a Medicare Advantage plan and a Medicare Supplement plan depends on your individual healthcare needs, budget, and preferences. If you value additional benefits and an all-in-one plan, Advantage may be the right choice. If you prefer the flexibility of Original Medicare with supplemental coverage for out-of-pocket expenses, a Medicare Supplement plan could be a better fit. Be sure to compare the options from various insurance companies to find the best solution for your situation. PLUSSES AND MINUSES OF MEDICARE ADVANTAGE Medicare Advantage offers a range of benefits, but it’s important to weigh both the advantages and potential drawbacks before enrolling. One of the main benefits of Advantage is the potential for lower out-of-pocket costs, especially for those who stay within the plan’s network. Many advantage plans also include valuable extras like dental and vision, prescription medication coverage, and fitness benefits, making it easier to budget for your healthcare expenses. However, there are many limitations to consider. Advantage plans often have restricted provider networks, which means you’ll need to choose from a list of in-network providers to keep your costs down. If you choose to see out-of-network providers, you could face higher out-of-pocket fees. Some plans also require prior authorization for certain services, which can delay care or add extra steps to the process. Remember, you are always at the mercy of your insurance company to approve services and procedures; they are always in control of your healthcare, not you. By understanding the pros and cons associated with Medicare Advantage, you can make an informed decision and select the plan that best supports your health and financial goals. MEDICARE ENROLLMENT PERIODS Picture of Braden Medicare Insurance's Medicare Enrollment Periods Poster. Enrollment periods determine when individuals can enroll in or change their Medicare plans. These timeframes are crucial for selecting the right plan at the right time, whether you go with Advantage or Medigap. WRAPPING THINGS UP To summarize, the best 2026 Medicare Advantage plans offer a range of options that are designed to meet diverse healthcare needs. To make an informed decision about the right plan for you, it is vital that you determine what you want from your Healthcare: Do you want to travel in retirement? Do you want to be in charge of your Healthcare choices and decisions, or are you willing to leave that up to an insurance company? Make sure you are working with an Independent Medicare Broker. It is important that you can verify that any/all of your doctors are in a plan's network before enrolling in that plan. With Medicare Advantage, you need to choose a new plan every year. That is a lot of time, and it is also a reason why there are so many complaints from Medicare beneficiaries about getting the runaround from their Insurance carrier to obtain 2nd, 3rd, or even 4th opinions. Remember that most extra Benefits are not as advertised. For example, $1,000 In Dental Benefits is not actually $1,000 because that $1,000 is divided by four, so your benefit is actually only $250 per quarter, and there is usually no carryover of unused benefits. CONTACT US If you have any comments or questions about this article, please feel free to contact me by phone or text at (480) 225-1393 or by email at mike@bradenmedicare.com . You can also learn more about us and reach out to us by visiting our contact page at www.bradenmedicare.com .

Michael T. Braden February 20, 2026, Medicare Supplement Plans Medicare Supplement Plans, or Medigap Plans as they are commonly referred to, are the best way to protect yourself from catastrophic Medical Bills in retirement. There are 12 separate plans to choose from, and they work alongside Original Medicare. Original Medicare is an 80/20 Healthcare Plan. The government (Medicare) pays for 80% of your healthcare after you have met the $283 Medicare Part B deductible. That leaves you, the Medicare beneficiary, to cover the remaining 20%. Medicare Supplement/Medigap Plans can cover all or a portion of this 20%, depending on where you live and which plan you choose. In this article, we will discuss what Medicare Supplement Plans are, which plans are the most popular, what factors go into determining what the monthly premiums are, how to compare plans, some helpful insider tips for how to compare plans, what information to look for, and how to stay ahead of premium increases in retirement. Curious about the cost of Medicare supplement plans? The monthly premium for any Medicare supplement plan will vary widely from state to state and from one insurance company to another. In addition, monthly premiums will change annually. Most Insurance companies have taken larger-than-necessary premium increases over the past 2-3 years. Overall, we can expect an increase every 2-3. Over time, Plan N has averaged 3-5% increases, Plan G has averaged 4-7%, and Plan F has averaged 6-9%. There is no single article that provides you with accurate, timely information on the premium rates and plans available to you today. The only way to get an accurate picture of the cost of Medicare Supplement plans is to request free quotes from us at Braden Medicare Insurance or from a licensed, independent Medicare Broker in your area. Medicare brokers work with many different insurance companies, giving you more choices while keeping your interests in mind. Image for 2026 Medicare Supplement Plans from Braden Medicare Insurance featuring a blue stethoscope on top of Application Forms WHAT THINGS FACTOR INTO MEDICARE SUPPLEMENT PLAN PREMIUMS? Monthly premiums for Medigap plans vary significantly based on factors such as plan type, age, location, and health status, underscoring the need for careful comparison. It is important to remember that not all plans are available in all states, and that rates will vary from state to state based on various factors. Medicare Supplement/Medigap plans are standardized, meaning that each individual, lettered Medicare Supplement plan has the same benefits in all 50 states. Rates will vary from state to state based on six main factors: Your Age Your Sex Your Location The Rating Method Used in Your State Do you Use Tobacco Are You Height/Weight Appropriate? MEDICARE SUPPLEMENT/MEDIGAP MONTHLY PREMIUMS One of the first things you’ll notice when exploring Medigap plans is the wide range of monthly premiums, including the average. These premiums can vary significantly, often ranging from as low as $ 50 to several hundred dollars, depending on the plan type, your location, and the private insurance companies you select. This variability can be attributed to several factors, including the specific Medigap plan selected, the beneficiary’s age, location, and health status. For instance, a Plan K might offer lower premiums but require more cost-sharing from the beneficiary. In contrast, a Plan G, with its comprehensive coverage, might come with a higher premium. It’s important to remember that while lower premiums might seem attractive initially, they often come with higher out-of-pocket costs when you need care or higher future premiums. Therefore, balancing the monthly premium with the expected healthcare needs is crucial. This is where understanding the specifics of each plan and how it aligns with your health and financial situation becomes pivotal. DEDUCTIBLES WITH MEDICARE SUPPLEMENT PLANS Deductibles are another critical component of Medigap plans that beneficiaries need to consider. For those opting for high-deductible plans like Plan F and Plan G: The high-deductible Plan G and Plan F are the only supplement plans with deductibles. Other plans have no deductible, but may not cover the Medicare deductible. In 2026, the deductible for these high-deductible options is set at $2,950 (see the 2026 Medicare Supplement Plan Comparison Sheet  for more details). The deductibles for both HDG and HDF plans are based on the Rate of Inflation, so they change each year slightly, based on the Consumer Price Index (CPI). I am running a few minutes late; my previous meeting is running over. Medicare will pay their 80% share of approved services once you have met the $283 Annual Part B Deductible. Your Supplement will not pay until you reach the annual deductible amount of $2,950. After that, your Supplement will pay their 20% share for the rest of your Medicare-approved services through December 31st each Calendar Year. Beneficiaries must cover the Medicare Part B deductible of $283 in 2026 and the minimum of $2,950 (which includes the $283) before their High-Deductible plan begins paying. At this point, the plans will act as Regular Plan G or Plan F , but the monthly premiums are 60-75% lower than those for Regular Plan G and Plan F. High-deductible options offer some flexibility, especially for beneficiaries who are relatively healthy and do not anticipate high medical expenses. These plans are available in certain states, offering a viable high-deductible option for cost-conscious beneficiaries. However, it’s essential to weigh the potential savings in monthly health insurance premiums against the risk of high out-of-pocket costs in the event of unexpected medical needs, especially if you are looking to maintain the same premium when choosing a Medicare supplement plan. MEDICARE CO-INSURANCE & CO-PAYS Coinsurance and copayments are crucial components of Medigap plans, referring to the share of medical costs beneficiaries pay out of pocket after meeting deductibles. Medigap plans play a crucial role in covering these costs, thereby reducing the financial burden on beneficiaries. For example, after meeting the deductible, a Medigap policy can cover coinsurance costs, significantly lowering out-of-pocket expenses. Different Medigap plans offered by supplemental insurance companies provide varying levels of coverage for these expenses, including medical bills. For instance, Medigap Plan N covers most Part B services but requires copayments for certain office visits (Office Visit Costs range from $0 - $20, depending on which code the provider uses; many clients pay $0). The best plan for you is the one that offers the quality of care and coverage you desire at the lowest monthly premium. The most popular Medicare Supplement plans in the United States are: Plan G Plan F Plan N Plan C HDG Original Medicare covers 100% of Chemotherapy and Radiation for Cancer Treatment, whereas Medicare Advantage Plans require a 20% Copay for both. OUT-OF-POCKET COSTS & OUT-OF-POCKET LIMITS Out-of-pocket limits are a safeguard that can provide beneficiaries with peace of mind by capping their annual healthcare expenses. In 2026, the out-of-pocket limit for Medicare Supplement Plan K is $8,000, while for Plan L it is $4,000. These limits are designed to protect beneficiaries from catastrophic costs by ensuring that, once the limit is reached, the plan pays all remaining covered service costs for the rest of the year. Plan K and Plan L have different cost-sharing structures before reaching these limits. The only difference is that Plan K requires beneficiaries to cover 50% of the costs for covered services, whereas Plan L requires only 25%. These differences affect overall out-of-pocket expenses, so consider how much you’re willing to pay before the plan covers all costs. These out-of-pocket limits are subject to annual adjustments based on inflation and health care cost estimates, reflecting the dynamic nature of healthcare expenses. Monitoring these adjustments with the guidance of insurance commissioners helps new beneficiaries stay informed about their potential financial responsibilities. THINGS THAT INFLUENCE MEDIGAP PREMIUMS Several factors influence the cost of Medicare Supplement plans, and understanding them can help beneficiaries make more informed choices . Key factors include: Age Gender Residential area Smoking status For instance, premiums can vary widely by location, with different markets showing different price ranges. Tobacco use is another critical factor, often resulting in higher premiums due to the associated health risks. Additionally, the specific Medigap plan selected plays a significant role in determining overall premium costs . Plans with more comprehensive coverage typically come with higher premiums, while those with cost-sharing options may offer lower premiums but higher out-of-pocket costs. State regulations also impact how much insurers can charge for Medigap policies, particularly for beneficiaries under age 65. This regulatory landscape can vary, so it’s essential to be aware of the rules in your state when selecting a Medigap plan. Insurance companies may also set premiums differently depending on these factors. COMPARE MEDIGAP PLANS SIDE-BY-SIDE Braden Medicare Insurance's 2026 Full Color, side-by-side Medicare Supplement Comparison Sheet Comparing   different Medigap plans  is crucial for finding the one that best meets your needs . Plan G, for instance, is popular for its comprehensive coverage, paying for the Part A deductible and all cost-sharing for Part A and B services, except the Part B deductible. In contrast, Plan N  covers most Part B services but requires copayments for certain office and emergency visits. Some Medigap plans offer additional coverage, including supplemental coverage for: Vision Dental care Long-term care: Innovative benefits such as: Hearing coverage 24/7 nurse phone lines are also available in some plans, offering added value. However, it’s essential to regularly review your healthcare needs to ensure you’re selecting the most appropriate Medigap insurance plan or Medigap policy as your situation changes. Plan G’s popularity is evident , with 39% of policyholders selecting it in 2023, indicating its favorable balance of cost and coverage. However, plans with greater benefits often come with slightly higher premiums, so you should carefully assess your healthcare needs and budget. When choosing a medicare supplement plan , understanding these differences is key . RATING METHODS FOR MEDICARE SUPPLEMENT PLANS Understanding the premium rating methods insurers use helps beneficiaries anticipate future costs. There are three main rating methods for Medigap plans: community-rated, issue-age-rated, and attained-age-rated. In community-rated plans, premiums are set based on geographic location, ensuring the same monthly premium for everyone in that area, regardless of age; in issue-age-rated plans, premiums are set based on age at enrollment; and in attained-age-rated plans, premiums are set based on age at enrollment . Issue-age-rated policies set premiums based on the applicant’s age at enrollment, preventing increases solely due to aging. In contrast, attained-age-rated policies determine premiums based on the insured’s current age, leading to higher costs as they age . Knowing which method your insurer uses can help you predict how your premiums might change over time. HOW YOU CAN LOWER YOUR MEDIGAP COSTS Reducing Medigap costs requires strategic planning and smart choices. Selecting the right Medigap plan or medigap policy that aligns with your healthcare needs and budget is an effective strategy. If Plan G is too expensive, consider alternatives like the High-Deductible Plan G or Plan N, which offer lower premiums. Avoiding late enrollment penalties and shopping around for the best rates annually can also lead to significant savings. Various discounts are available for Medigap premiums, including those associated with preventive services: Household discounts Online application discounts Automatic/electronic funds transfer/prepayment discounts Multi-policy discounts. Taking advantage of these paid discounts can help manage your overall health care expenses more effectively. MEDICARE ADVANTAGE VS MEDICARE SUPPLEMENT PLANS Braden Medicare Insurance's Drawing Showing A Road With a Highway Sign Denoting One Exit for Medicare Advantage plans, and Another Exit for Medicare Supplement plans. When comparing Medicare Advantage plans and Medicare supplement plans , cost is a key factor to consider. Medicare Advantage plans typically have lower monthly premiums than Medigap policies, and some may even offer $0 premiums. However, these plans come with network restrictions and may require copayments or coinsurance for certain services, which can increase out-of-pocket costs depending on your health needs. On the other hand, Medicare Supplement plans generally have higher monthly premiums but offer more predictable costs by covering many deductibles, copayments, and coinsurance that Medicare Advantage plans may not fully cover. Medigap policies allow beneficiaries to see any provider that accepts Medicare, providing greater flexibility. If you are considering switching from Medicare Advantage to Medicare Supplement Insurance , there are specific enrollment periods and processes to be aware of. Ultimately, the choice between a Medicare Advantage plan and a Medicare Supplement plan (Medigap policy) depends on balancing monthly premium costs with potential out-of-pocket expenses, your preference for provider choice, and your overall health care needs. For many people, a Medicare Advantage plan suits them. However, if you ask any Broker or Healthcare Professional, they may refer to Medicare Advantage as Medicare DIS-ADVANTAGE, which should tell you all you need to know. Lastly, in Arizona, Barrow Neurological Institute and the Mayo Clinic both accept Original Medicare and Medicare Supplement/Medigap plans. But neither of them accepts any Medicare Advantage plans. This is the same for 99.9% of all of the renowned "Teaching" hospitals across the country. ADDITIONAL OR EXTRA BENEFITS COST YOU IN THE LONG RUN While additional benefits in Medigap plans can be attractive, they often come with higher premiums. Only a small percentage of Medigap plans offer extra benefits like vision, dental, and hearing, and they cover only a limited number of enrollees. Most beneficiaries who have access to these additional benefits typically choose a comprehensive plan, such as Medicare Supplement Plan G. Please do not be suckered into purchasing a Medicare Supplement from an insurer that offers a free Gym Membership. I am all for staying active, but you will leave more money on the table doing this than just purchasing a membership at the Fitness Center/Gym where you live. Here is some information that I am sure no one has ever mentioned to you. Did you know that AARP Medicare Supplements have a declining discount, so it is great when you first enroll, but then the discount drops 1-2% per year, while premiums increase, which is not a healthy recipe for your wallet. And you have to have an AARP Membership to apply, which costs an additional $16 per year. These additional benefits can complicate the decision-making process and may not always be clearly communicated to beneficiaries. Weighing the added costs against the potential benefits helps determine whether these extra coverages are worth the higher premiums and provide more coverage, offering the same benefits and full benefits. ENROLLING IN A MEDICARE SUPPLEMENT PLA N Enrolling in a Medicare supplement plan  involves understanding the timing and conditions for enrollment . If you’re looking for a guide on signing up for Medicare Part D , see how to sign up for Part D Medicare . If you are wondering whether you must enroll in Medicare if you live abroad , consult our detailed resource: The enrollment window  begins the month you turn 65 and enroll in Medicare Part B. This window lasts for six months. During this open enrollment phase, individuals can select any Medigap policy without medical underwriting. Guaranteed issue rights allow individuals to purchase Medigap plans outside the open enrollment period under specific conditions. Retirees should consider switching Medicare supplement plans during open enrollment to obtain better rates or coverage that best fits their current needs. Based on my experience over the past 11 years, the combination of Original Medicare/Traditional Medicare and a Medicare Supplement Plan G is the best, most complete, and most comprehensive healthcare available! WRAPPING THINGS UP I know Medicare can be very confusing, with a lot of moving parts. If you have any specific questions about Medicare Supplement (Medigap) Plans that this article did not address, please reach out to me. I want to make sure you get all of the answers to all of your questions. You can email me directly at mike@bradenmedicare.com , text or call me at (480) 225-1393, or use the contact form on our website at www.bradenmedicare.com anytime. Based on my experience over the past 11 years, the combination of Original Medicare/Traditional Medicare and a Medicare Supplement Plan G is the best, most complete, and most comprehensive healthcare available!