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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!

MICHAEL T. BRADEN JANUARY 16, 2026 MEDICARE NEWS Picture of Braden MEdicare Insurances WISeR Poster, the new Pilot program of Medicare aimed at reducing Waste, Fraud, and Abuse in Medicare. If you have Medicare or plan to sign up soon, you may have heard about a new program called WISeR. This new, voluntary pilot program currently operates in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. It is expected to run from January 1st, 2026, through December 31st, 2031. It seems like a week goes by without hearing about some form of Waste, Fraud, or Abuse in America, particularly in government programs. Well, to the government's credit, CMS (Centers for Medicare and Medicaid Services) is launching WISeR. The Medicare WISeR Model is a quality assurance program created by CMS to review a limited set of medical services that have historically been prone to misuse. The voluntary program is being tested in six states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) through 2031. Medicare Advantage plan enrollees are not affected. WISeR DEFINED WISeR : W - Wasteful I - Inappropriate S - Service R - Reduction WiseR is a pilot program created by the Centers for Medicare & Medicaid Services, or CMS. It acts as a quality check to ensure treatments are necessary and appropriate, while also reducing fraud and waste. Picture of Braden Medicare Insurance's Waste and Inappropriate Service Reduction Model. HOW WILL THIS WISeR PILOT BE IMPLEMENTED? The premise of this new program is to use advanced technology, including artificial intelligence (AI) and machine learning, hand-in-hand with physicians and other healthcare professionals to review a select group of medical services before the procedures can be approved and performed. I am sure your first thought is, "Why are they messing with my Medicare?" right? Well, the simple truth is that the goal of the WISeR program is to identify, root out, and eliminate Waste, Fraud, and Abuse in certain services identified beforehand, before they are rendered. Honestly, the goal is not to deny care; rather, it is to make sure every Medicare beneficiary receives safe and appropriate treatment. WHY IS MEDICARE (CMS) STARTING THE WISeR PROGRAM NOW? The WISeR program is for beneficiaries who have chosen Original/Traditional Medicare Fee-for-Service and a primary healthcare provider. Currently, healthcare providers are paid based on the volume of services they provide. While the vast majority of doctors and healthcare providers have your best interests at heart, this payment structure can sometimes create situations that lead to misuse or fraud. Misuse usually takes the form of prescribing unnecessary tests, suggesting unnecessary treatments, or recommending unnecessary procedures. This is fraud and abuse by a healthcare professional, potentially padding their wallets by receiving payments for unnecessary care. Records provided to CMS by the Medicare Payment Advisory Commission show that Medicare spent nearly $6 billion in 2022 alone on services considered to have little or no clinical benefit. Now that Medicare has the option and support for enhanced technology, WISeR is focused on speeding up the review process while also identifying cases where certain recommended or suggested treatments may not be the best or correct course of action, based on the beneficiary's current health status. IS MEDICARE GOING TO REVIEW EVERY THING MY DOCTOR TELLS ME? The WISeR Model focuses on a small group of services previously identified by Medicare as having a history of waste, fraud, or abuse. Some of these examples include electrical nerve stimulator implants that are not FDA-approved, skin and tissue substitutes, and other unnecessary arthroscopic procedures involving the knee when the issue is simply osteoarthritis. and knee arthroscopy for knee osteoarthritis. These particular services were carefully selected based on medical research, Medicare coverage rules, and reports indicating misuse. The goal of WISeR is to identify areas where previous fraud, waste, and abuse have been documented. Medicare does not want to lessen. Emergency and hospital-only services are excluded  from this program, along with services that would increase the patient’s risk if delayed.   WHO CONDUCTS THE WISeR REVIEWS FOR CARE? The WISeR pilot focuses on a select group of services, so if you’re recommended for one of these services, the technology will help determine whether it meets Medicare’s coverage requirements. Including the technology, determinations for approval of recommended procedures are made with a licensed, expert clinician, using established, evidence-based medical standards. Medicare's goal is to streamline this process to make it faster and easier than your normal prior authorization process. CMS has set a goal to complete all Prior Authorizations within 72 hours. The other benefit of this new model is that it will greatly reduce paperwork for providers and ensure that Medicare beneficiaries receive appropriate care. Drawing of the new CMS Pilot program RiseR, showing a Physician entering data into his computer. RISeR is designed to use Doctors and Advanced Technology to identify and eradicate Fraud, Waste and Abuse with certain Medicare processes and procedures. IS EVERYONE AFFECTED BY THE NEW MEDICARE WISeR PILOT PROGRAM? It is important to mention that the WISer plan will not change any aspect of your Medicare Advantage plan. You will continue to receive coverage and any required prior authorizations through your Medicare Advantage Insurance carrier just as you normally would. For beneficiaries who receive their benefits from Original Medicare in the six "test states" it is possible that some of your services subject to review, depending on whether your provider or state applies to participate in the pilot program. IF I LIVE IN ONE OF THESE STATES WILL MY COVERAGE OR MY MEDICARE PLAN CHANGE? No, it is important that we do not get concerned about your plan. Your plan will not change. period. The WISeR model does not change your current Medicare coverage. You can still visit any doctor or supplier that accepts Original Medicare. The amount Medicare pays for covered services also stays the same. HOW DOES WISeR AFFECT THE CARE YOU RECEIVE? After January 15, 2026, if your doctor recommends one of the listed services, there may be an additional step to confirm medical necessity. While you and your doctor still make the decisions, CMS aims for WISeR to serve as an added layer of protection against potential fraud. This step ensures that medical decisions are supported by evidence and comply with Medicare’s coverage policies. WHAT THE NEW MEDICARE WISeR PROJECT HOPES TO ACCOMPLISH The Medicare WISeR Model represents an effort to increase transparency and protect both the patient and taxpayer dollars. By reducing wasteful spending on unhelpful or sometimes even harmful services, Medicare can focus its resources on care that makes a difference in people’s lives. WRAPPING THINGS UP The goal of the Medicare WISeR Model is to add a review step for certain high-risk services to confirm they’re medically appropriate for your specific situation. Wiser will leverage advanced technology in collaboration with licensed medical practitioners to improve processes and reduce the risk of waste, fraud, and abuse. There will be no disruption or changes to your current Medicare Health plan, regardless of whether you live in one of these pilot states or not. Your premiums and benefits will not be affected by the WISeR program.

Michael T. Braden August 27, 2025 Medicare Part D HOW TO COMPARE PART D PLANS TO SAVE MONEY ON PRESCRIPTION MEDICATIONS Choosing the right Medicare Part D Prescription Drug plan can significantly reduce your medication costs. With numerous options available, it’s essential to know how to compare plans effectively. This guide will help you navigate the complexities of prescription drug coverage plans, focusing on key factors that impact your savings and health. HOW TO COMPARE PART D PLANS TO SAVE MONEY ON PRESCRIPTION MEDICATIONS HOW TO COMPARE MEDICARE PART D PRESCRIPTION DRUG PLANS Prescription drug coverage plans are designed to help cover the cost of medications prescribed by your doctor. These plans vary widely in terms of premiums, copayments, formularies (the list of covered drugs), and pharmacy networks. Understanding these differences is crucial to selecting a plan that fits your needs and budget. Premiums : The monthly fee you pay for the plan. Copayments and Coinsurance : Your share of the cost when you fill a prescription. Formulary : The list of drugs covered by the plan, often divided into tiers with different cost levels. Pharmacy Network : The pharmacies where you can use your plan benefits. When comparing plans, look beyond the monthly premium to consider other factors. A plan with a low premium but high copayments for your medications might cost more overall. Conversely, a plan with a higher premium but lower drug costs could ultimately result in savings for you. OW TO COMPARE MEDICARE PART D PRESCRIPTION DRUG PLANS THE RIGHT WAY Use The Medicare Plan Comparison Tool To Effectively Compare Medicare Part D Prescription Drug Plan Prices and The Cost of your Prescription Medications: List Your Medications : Write down all the medications you currently take, including dosage and frequency. Check Formularies : Review each plan’s formulary to see if your medications are covered and at what cost tier. Estimate Annual Costs : Calculate your total yearly expenses, including premiums, copayments, and coinsurance. Consider Pharmacy Options : Ensure your preferred pharmacy is in the plan’s network to avoid extra fees. Look for Extra Benefits : Some plans offer additional perks, such as mail-order services or discounts on specific medications. Using online tools and resources can simplify this process. For example, the medicare part d plans website offers comparison tools that allow you to enter your medications and see side-by-side plan costs. ARE THERE ANY INCOME THRESHOLDS TO ENROLL IN A MEDICARE PART D PRESCRIPTION DRUG PLAN? Medicare Part D provides prescription drug coverage for eligible individuals, but your income can affect your costs. If your income exceeds certain limits, you may pay an additional amount called the Income-Related Monthly Adjustment Amount (IRMAA). Income Thresholds : These are based on your tax return from the previous two years. IRMAA Amounts : The higher your income, the higher your monthly premium adjustment. Reporting Changes : If your income decreases, you can report it to potentially reduce your IRMAA. Understanding these limits helps you anticipate your total costs and plan accordingly. If you qualify for extra help due to low income, you might be eligible for programs that reduce or eliminate premiums and copayments. Picture of Prescription Medications Stocked on SHelves in a Pharmacy. BEST PRACTICES FOR GETTING THE MOST OUT OF YOUR MEDICARE PRESCRIPTION DRUG PLAN Saving money on prescription drugs requires a strategic approach. Here are some practical tips: Review Plans Annually : Drug prices and plan formularies change yearly. Reassess your plan during open enrollment. Use Generic Drugs : Generics are typically less expensive and equally effective. Consider Mail-Order Pharmacies : They often offer lower prices and convenient delivery. Ask About Discounts : Some pharmacies and drug manufacturers offer savings programs. Check for State Assistance Programs : Some states provide additional help with prescription costs. By staying informed and proactive, you can reduce your out-of-pocket expenses significantly. CHOOSE THE RIGHT PLAN FOR YOU, NOT THE BEST PLAN FOR DON NEXT DOOR Selecting the best prescription drug coverage plan depends on your unique health needs and financial situation. Consider the following: Medication Needs : Prioritize plans that cover your essential drugs at a reasonable cost. Budget : Balance premiums with expected out-of-pocket costs. Pharmacy Access : Choose plans that include your preferred pharmacies. Additional Benefits : Look for plans offering extra services that matter to you. Remember, the goal is to find a plan that offers the best overall value, not just the lowest monthly premium. By carefully comparing prescription drug coverage plans and understanding the factors that influence costs, you can make informed decisions that save you money and ensure access to the medications you need. Utilize available resources and tools to streamline the process, and regularly revisit your choices to adjust to any changes in your health or finances.

Michael T. Braden February 3, 2026 MEDICARE 101 There are many well-intentioned individuals who seem to think they know everything about Medicare. You might even know someone who fits that description! However, when it comes to Medicare, the choices you make are crucial for your future healthcare. It would be a shame to rely on hearsay or myths that aren't true. Photo of a Medicare Couple with a notepad and Pen, with the words Medicare Myths written on a clipboard that has a stethoscope wrapped around it. In today's article, I want to tackle the most common Medicare myths head-on. It’s important to know the truth before making decisions that can’t be undone. THE BIGGEST MEDICARE MYTHS MEDICARE IS FREE TO EVERYONE I wish this were true, but it is another Medicare Myth! The reality is that Medicare is not free. Not everyone automatically qualifies for it either. MEDICARE HAS FIVE PARTS Many people believe there are five parts to Medicare, including Medicare Part A, Part B, Part C, Part D, and Part M (Medigap). This is false! There are actually four parts to Medicare: Medicare Part A : Covers hospitalization costs and expenses. Medicare Part B : Covers outpatient expenses, such as doctor visits, lab work, imaging, outpatient surgery, and durable medical equipment. Medicare Part C : This refers to Medicare Advantage Plans. Medicare Part D : Covers prescription medications. MEDICARE PART A COVER LONG-TERM CARE This is incorrect. Medicare Part A covers inpatient hospitalization, skilled nursing care, hospice care, and some in-home health visits. However, it does not cover long-term care, custodial care, or nursing home care. YOU MUST HAVE PAID MEDICARE TAXES FOR 10 YEARS OR MORE TO RECEIVE MEDICARE BENEFITS This is a common misconception. Individuals can qualify for premium inpatient hospitalization and skilled nursing care, as well as free Medicare Part A, if their spouse has at least 40 quarters of Medicare taxes paid. You might even qualify if you or your spouse worked fewer than 40 quarters, but you’ll need to pay a monthly premium for Medicare Part A. MEDICARE ADVANTAGE PLANS MUST COVER EVERYTHING JUST LIKE ORIGINAL MEDICARE DOES This is a myth! Medicare Advantage plans are offered by private, for-profit insurance companies. While most Medicare Advantage plans include prescription drug coverage, they are not required to cover everything exactly as Original Medicare does. For instance, these plans often have copays, coinsurance, and maximum out-of-pocket costs that members must meet. They also have specified networks of doctors and are typically only covered in your home county. YOU MUST ENROLL IN MEDICARE PART D False! No one is required to enroll in a Medicare Part D Prescription Drug plan. However, if you don’t enroll promptly, you may face penalties that last indefinitely. ORIGINAL MEDICARE DOES NOT COVER ROUTINE DENTAL OR VISION, BUT MEDICARE SUPPLEMENT PLANS DO This is misleading. Medigap plans cannot cover anything that Original Medicare does not cover by law. ALL MEDICARE SUPPLEMENT AND MEDIGAP PLANS OF THE SAME LETTER PROVIDE THE SAME LEVELS OF COVERAGE FOR THE SAME PRICE This is not true. While Medicare Supplement/Medigap Plans are standardized, meaning each lettered plan has the same coverage benefits across all 50 states, the costs can differ by state. Factors such as age, sex, and the state's rating methods can/do affect pricing. YOU MUST BE A US CITIZEN TO RECEIVE MEDICARE BENEFITS This is false! You only need to be a U.S. citizen or a permanent legal resident for five years. You must also be 65 years old or older and eligible for Social Security benefits, or permanently disabled and receiving disability benefits for at least 2 years. Additionally, those with permanent kidney failure requiring dialysis or a kidney transplant, or those diagnosed with ALS (Lou Gehrig's Disease), may also qualify. MEDICARE SUPPLEMENT/MEDIGAP PLANS HAVE NETWORKS JUST LIKE MEDICARE ADVANTAGE PLANS This is incorrect. Since a Medigap plan works alongside Original Medicare, you can see any doctor and receive services at any hospital in the U.S. and its territories that accept Medicare Assignment. YOU MUST ENROLL IN MEDICARE PART B WHEN YOU TURN 65, OR YOU WILL RECEIVE A PENALTY This is partially true. Yes, there is a penalty if you miss your Medicare Part B enrollment deadline. However, the penalty is 10% for each year between when you were first eligible and when you finally enroll in Medicare Part B. This penalty will be added to your monthly Medicare Part B premium for as long as you are covered under Medicare Plan B. THE MEDICARE "EXTRA HELP" PROGRAM PROVIDES FINANCIAL ASSISTANCE FOR HOSPITAL COSTS This is false. The Medicare Part D Low-Income Subsidy (LIS) "Extra Help" assists with costs for Medicare Prescription Drug plans only, including premiums, deductibles, and co-payments. MEDICARE SAVINGS PLANS HELP YOU SAVE MONEY OVER ORIGINAL MEDICARE This is misleading. A Medicare Savings Program is a state-mandated program that can pay all or part of your Original Medicare premiums and out-of-pocket expenses if you have limited income and resources. over 95% of Medicare Beneficiaries do not qualify for these plans. OTHER MEDICARE FACTS THERE ARE NO OUT-OF-POCKET MAXIMUMS WITH ORIGINAL MEDICARE That’s right! There is no yearly limit on out-of-pocket expenses for Medicare. This is why anyone enrolling in Original Medicare is strongly urged to consider purchasing a Medicare Supplement (Medigap) plan. EVERY MEDICARE PART D PRESCRIPTION DRUG PLAN HAVE MONTHLY PREMIUMS, DEDUCTIBLES, AND CO-PAYMENTS Those who enroll in a Medicare Part D Prescription Drug plan pay monthly premiums, an annual deductible, and cost-sharing for their medications. These costs can vary by plan, prescription, and the pharmacies you use. IF YOU DO NOT CHOOSE AND ENROLL IN A MEDICARE SUPPLEMENT OR MEDIGAP PLAN WITHIN SIX MONTHS OF ENROLLING IN MEDICARE PART B, YOU CAN BE TURNED DOWN FOR COVERAGE IF YOU HAVE A PRE-EXISTING CONDITION If you don’t purchase a Medigap policy within six months of enrolling in Medicare Part B, you could be denied coverage due to a pre-existing condition. IF YOU HAVE CREDITABLE MEDICAL COVERAGE, MEDICARE ALLOWS YOU TO POSTPONE ENROLLING IN MEDICARE PART B Having creditable medical coverage (coverage that is equal to or better than Medicare's offerings through an employer's group health plan) can allow you to postpone enrolling in Medicare Part B. This only applies to individuals working for companies with more than 20 employees. If your employer has fewer than 20 employees, you must enroll in Medicare when you turn 65. Everyone should enroll in Medicare Part A as soon as they turn 65. YOUR MEDICARE SUMMARY NOTICE (MSN) ALERTS YOU TO ERRORS AND/OR SIGNS OF FRAUD It’s a good habit to review your Medicare Summary Notice (MSN) for any errors or signs of fraud. Keep track of your medical appointment dates and save all receipts and statements from your healthcare providers to compare them with anything listed on your MSN. WRAPPING THINGS UP I hope you enjoyed this article highlighting Medicare myths versus Medicare facts. If you have any questions about what we covered today or any other Medicare-related topics, please feel free to reach out to me anytime. You can email me at mike@bradenmedicare.com , text or call me at (480) 225-1393, or simply visit our website at www.bradenmedicare.com anytime, 24/7. 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Michael T. Braden December 10, 2025 Medicare 101 Braden Medicare Insurance' Poster Showing The Four Parts Of Medicare In Colorful Blocks WHAT IS MEDICARE? Medicare is a federal health insurance program that provides essential health coverage to people aged 65 and older, as well as specific younger individuals with disabilities or End-Stage Renal Disease . Administered by the Centers for Medicare & Medicaid Services (CMS), Medicare offers a range of coverage options to help beneficiaries access the health services they need. Medicare is divided into several Parts, each covering different types of services. These include hospital insurance, medical insurance, Medicare Advantage plans, and prescription drug coverage. Understanding how these Parts work together  is crucial for Medicare beneficiaries to make informed decisions about their healthcare coverage. To help you compare plans and determine the best Medicare coverage for your needs, online tools such as the Medicare Plan Finder are available onTo help you compare plans and determine the best Medicare coverage for your needs, online tools such as the Medicare Plan Finder are available on Medicare.gov . These resources allow you to review coverage options, compare costs, and evaluate benefits side by side. It’s essential to take time each year to review your current plan and make any necessary changes, ensuring you always have the coverage that best fits your health needs. Whether you’re new to Medicare or reviewing your options for the upcoming year, staying informed and using available resources can help you find the right plan and maximize your benefits. UNDERSTANDING THE FOUR PARTS OF MEDICARE Medicare Is Easier To Understand And Navigate Once You Understand How All Of The DIfferent Parts Of Medicare. This ABCD's Of Medicare Poster Should Help Bring Clarity To Your Knowledge Of Medicare Medicare is made up of several parts, each offering different types of coverage to meet your health insurance needs: Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services. Most people do not pay a premium for Part A if they or their spouse paid at least 10 years of Medicare taxes while working. Medicare Part B provides coverage for physician visits, outpatient care, preventive services, and certain medical supplies. Part B requires a standard monthly premium, which may vary based on your income. Medicare Part C (Medicare Advantage) combines the benefits of Parts A and B and is offered by private insurance companies approved by Medicare. Medicare Advantage plans often include additional benefits such as vision, dental, and hearing coverage, and may have different costs and more limited provider networks. Medicare Part D offers prescription drug coverage through a variety of plans, each with its own list of covered drugs (formulary) and cost structure. Choosing the right Part D plan for you is essential for managing your prescription drug expenses. Medicare Supplement Insurance (Medigap) helps pay for out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Medigap plans can provide additional financial protection and peace of mind. Carefully review the benefits, costs, and services covered by each Part to ensure you select the appropriate combination of plans for your health and budget. ACCESSING THE MEDICARE PLAN FINDER TOOL The Medicare Plan Finder, available on Medicare.gov, is the official tool designed to help you compare plans for Medicare side by side. This user-friendly tool lets you enter your ZIP code and current prescriptions, then view costs and compare Medicare plans based on premiums, deductibles, and medication coverage. What the Medicare Plan Finder does not offer is the knowledge, experience, and expertise that you will find at Medicare Seminars Insurance Agency. Braden Medicare Insurance provides a more detailed explanation of your options and works with an experienced, independent, licensed Medicare Broker. Our Brokers have access to over 40 Insurance Companies, which gives you more options and better rates than from just one or two insurance companies. And perhaps the best part is that all of our services are provided at no cost to the consumer. We will be with you long after your policy begins, and we offer every client a complimentary review of your coverage each year, in advance of the Medicare Annual Enrollment Period (AEP). Totake advantage of our services, use the Contact Us form on our website at www.bradenmedicare.com, orcall or text us anytime at (480) 225-1393. We will spend the time you need to ensure you understand the pros and cons of your choices, including the insurance companies offering Medicare Part C or Medigap Plans in your local area. TAKE CHARGE OF YOUR OWN HEALTHCARE, YOU HAVE EARNED IT Before exploring the many Medicare coverage options, start by listing your healthcare needs and budget to create a clear picture of what coverage you’re looking for. Identify your daily medications, travel needs, and any chronic health issues to ensure that the plan covers all necessary services. Consider the need for frequent specialist visits or specific medications; these factors should be clearly outlined to avoid any surprises later. Chronic health conditions, for instance, typically require a comprehensive list of healthcare needs, including routine check-ups and specialist visits, which facilitates effective comparison with Medicare's more frequent medical visits and specialized care, significantly influencing the type of Medicare coverage required. Creating a comprehensive list of your healthcare needs, including routine check-ups and specialist visits, helps you compare Medicare options more effectively. The Medicare Plan Finder allows you to filter plans based on these specific needs, helping you make the most informed choice possible. HELP WITH UNDERSTANDING EACH OF THE DIFFERENT MEDICARE ADVANTAGE PLANS IN YOUR AREA Medicare Advantage Plans, also known as Part C, offer additional benefits beyond Original Medicare, including coverage for vision, dental, and wellness programs. When comparing these plans, it’s crucial to understand the different types available: HMO, PPO, and PFFS. Health insurance plans differ in terms of provider flexibility: HMO(Health Maintenance Organization) plans typically require that you use in-network providers for all non-emergency services, making it essential to check whether your preferred doctors are included. PPO(Preferred Provider Organization) plans offer more flexibility, allowing you to see out-of-network providers, though this may result in higher costs. PFFS (Private Fee-For-Service) plans offer greater flexibility in choosing healthcare providers but require specific payment terms to be followed. The Medicare Advantage Plan Finder helps you filter plans by HMO, PPO, or PFFS and evaluate extras such as fitness programs and telehealth services, ensuring you select a plan with the benefits you value most. LEARN HOW TO PROPERLY EVALUATE ALL OF THE MEDICARE SUPPLEMENT (MEDIGAP) PLANS Medicare Supplement Plans, also referred to as Medigap plans, are designed to cover costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. These plans are standardized across states, facilitating comparison of benefits and premiums across insurers. The Medicare Supplement Plan Finder allows you to: Filter plans by specific needs, such as coverage types and monthly premiums. Compare standardized Medigap plans that offer the same benefits regardless of the insurance company, thereby enabling direct premium comparisons. Review detailed summaries of each plan, including coverage for services like hospital stays and skilled nursing care. KNOWING HOW TO COMPARE MEDICARE PRESCRIPTION DRUG PLANS EFFECTIVELY Prescription drug coverage is a critical component of your Medicare plan, and that’s where the Medicare Part D prescription drug plan  comes in. The   Part D drug tool finder on Medicare.gov allows you to enter your medications and dosages to identify suitable plans that cover your prescription drug needs. Each Medicare Part D plan has a formulary that categorizes covered drugs into tiers, affecting cost-sharing. Generic medicines are typically placed in lower tiers and offer a more affordable alternative to brand-name drugs, thereby reducing out-of-pocket expenses. Verify whether your preferred pharmacies are in-network and review the formulary tiers to understand your out-of-pocket costs for any medications you take. REVIEWING THE ANNUAL COSTS AND THE OUT-OF-POCKET MAXIMUMS Understanding the financial implications of different Medicare plans is vital for setting a realistic budget. Users can view costs associated with each Medicare plan, including premiums, deductibles, and out-of-pocket expenses. It’s crucial to consider budget factors, such as premium increases and out-of-pocket costs, when evaluating Medicare options. In 2026, the out-of-pocket maximum for Medicare Advantage plans is capped at $9,250. Many insurance companies offer excellent options for under $5,500. Remember, the out-of-pocket cost cap in 2026 is $2,100. Regularly assess your health status and compare annual drug costs, out-of-pocket maximums, and total yearly costs, including deductibles and copayments, when choosing a Medicare plan. BE SURE TO CHECK THAT ALL OF YOUR HEALTHCARE PROVIDERS ARE IN THE NETWORK FOR ANY PLAN YOU ARE CONSIDERING When considering an Advantage Plan, you will want to confirm whether your healthcare providers are in the plan’s network. Online tools can help you verify whether specific doctors are included, so don’t neglect to use those resources to understand your options better. Many Medicare Advantage plans have a limited provider network, which affects access to specialists or facilities. Out-of-network services often incur higher costs, so check network availability beforehand. WHAT ARE MEDICARE STAR RATINGS? Star Ratings help consumers assess the quality of Medicare Advantage and Part D plans, thereby influencing their healthcare choices. Contracts with higher Star Ratings often reflect better customer satisfaction and health outcomes. Approximately 42% of Medicare Advantage plans scored four stars or higher in the 2024 ratings, indicating greater consumer trust and stable performance. Plans with longer tenure in the program tend to achieve higher Star Ratings, suggesting that experience correlates with performance. FREQUENT MISTAKES YOU SHOULD UNDERSTAND AND REMEMBER . Navigating Medicare can be complex, and making the wrong choices, even unknowingly, can lead to coverage gaps or unnecessary costs. Below are some common mistakes Medicare beneficiaries should avoid : Not enrolling in Medicare Part B when first eligible   can result in higher monthly premiums and delayed access to critical medical services. Failing to review and compare Medicare Advantage or Part D drug plans during the Annual Election Period may result in missing better coverage options or lower costs. Plans and benefits can change each year, so it’s essential to review your choices annually. Not understanding the differences between Original Medicare and Medicare Advantage plans  can lead to selecting a plan that doesn’t fit your health needs or lifestyle. Delaying enrollment in a Medicare Supplement plan (Medigap)  can increase your costs or make it harder to qualify, especially if your health changes. Overlooking prescription drug coverage needs  when choosing a Medicare plan can result in unexpected out-of-pocket expenses for your medications. To avoid these pitfalls, stay informed about your options, review your coverage regularly, and consult trusted resources, such as licensed agents, for guidance. Taking these steps can help you identify the appropriate Medicare plan and protect your health and finances. ASSISTANCE, CARE, SUPPORT, AND UNDERSTANDING WHENEVER YOU NEED IT Agents and brokers assist individuals with Medicare enrollment and eligibility assessment, guiding them to select CMS-approved plans tailored to their needs in each state. In-person assistance is available for eligible beneficiaries who prefer direct guidance during the enrollment process. This personalized support can significantly improve understanding and the selection of the appropriate plan. KEEPING YOU AHEAD OF THE CURVE THROUGHOUT THE YEAR Medicare policies, benefits, and costs can change from year to year, making it essential for beneficiaries to stay up to date. The official Medicare website (medicare.gov) and the Medicare Handbook are excellent resources for learning about the latest updates to Medicare coverage, costs, and enrollment periods. Licensed insurance agents and brokers can also provide valuable support, helping you understand your options and guiding you through the enrollment process. The Medicare Annual Election Period, which runs from October 15 to December 7, is the ideal time to review your Part D or Advantage plans, compare new options, and make any necessary changes to your coverage. By staying informed about Medicare changes and regularly reviewing your coverage, you can ensure you’re getting the most out of your benefits while minimizing your out-of-pocket costs. Proactive management of your Medicare plan helps you maintain the health coverage you need and provides peace of mind for the year ahead. WRAPPING THINGS UP Navigating Medicare can be complex, but with the right tools and resources, you can find a plan that suits your needs and budget. From using the Medicare Plan Finder to understanding Star Ratings and seeking agent assistance, each step is crucial to making an informed decision. Note that the right Medicare plan can significantly impact your health and finances, so take the time to review your options carefully. Take charge of your healthcare today and ensure you have the coverage you need for a healthier tomorrow. Business Card For Michael Braden At Braden Medicare Insurance

Michael T. Braden January 6, 2026 MEDICARE 101 WHAT ARE MEDICARE EXCESS CHARGES Medicare provides healthcare to millions of Americans every day, and it is truly world-class. But, as good as Medicare is, it does not cover everything. When people first approach age 65, many realize they need to learn about Medicare. So they do research, attend seminars, and engage friends and family members in discussions. They learn about Premiums, Deductibles, Co-Insurance, Co-Payments, Medicare Advantage, and Medigap. But there is one important piece of the Medicare Puzzle they miss entirely: Medicare Excess Charges . While many beneficiaries are aware of deductibles and copayments, another hidden cost that often catches people off guard is what we call Medicare excess charges , specifically, Medicare Part B Excess Charges. Thankfully, there are options available to every Medicare beneficiary to avoid these potentially expensive add-on costs altogether and forever. This is where Medicare Supplement plans, or Medigap plans as some people refer to them, step in to help you. Both Medicare Supplement/Medigap Plan G and Plan F, specifically, Medigap Plan F and Plan G, protect you from these additional, unnecessary fees and costs. BY eliminating Medicare Part B Excess Charges, your medicare bills stay predictable, and you can rest easy without fear of having a big surprise Healthcare bill. Picture Of Braden Medicare Insurance's "What Are Excess Charges" Poster UNDERSTANDING MEDICARE EXCESS CHARGES So what are MEdicare Part B Excess charges, and how can you avoid them? Medicare excess charges are additional amounts a healthcare provider can charge a Medicare beneficiary. These Medicare Part B Excess Charges are over and above the amount Medicare has approved for health services. Medicare-approved amount for a service. These charges apply only to Medicare Part B  services. Most Part B Excess charges involve doctor office visits, Outpatient Care, and Durable Medical Equipment (DME). Around 93.6% of all physicians accept Medicare. When a doctor accepts Medicare, they are agreeing to honor Medicare's Fee Schedule. The largest majority of doctors who do not accept Medicare have traditionally been: Pediatricians. Psychologists. Psychiatrists. Naturopathic Doctors. Homeopathic Doctors. Doctors who specialize in "Alternative Therapies or Alternative Medicine, many of which are associated with taking a holistic, natural approach to Cancer Treatments. If you only received one Excess Charge, it may be manageable, but it still irritates you. And, if you have received a Cancer diagnosis, these Medicare Part B Excess Charges can add up, and they can easily become quite expensive for you. WHY SOME DOCTORS CHARGE MORE THAN MEDICARE Doctors, Physicians, and healthcare providers have one of three options for their relationship with Medicare. Participating Providers: These doctors accept “ assignment ,” meaning they agree to accept the Medicare-approved amount as full payment. They cannot bill you for excess charges. Non-Participating Providers: These doctors accept Medicare but do not accept assignment. They can choose to charge you up to 15% more than the Medicare-approved amount. Opt-Out Providers : These doctors have opted out of Medicare entirely. Medicare does not pay for their services, and you are responsible for the full cost. Excess charges originate from the second group: non-participating providers. They accept your insurance, but they require higher compensation than the standard Medicare reimbursement rates. HOW MUCH MORE CAN SOME DOCTORS CHARGE YOU? If you do not own a Medicare Supplement Plan F or Plan G policy, you are responsible for paying the full excess charge out of your own pocket. Consider a scenario where you require a surgery that has a Medicare-approved cost of $2,000. If your surgeon is a non-participating provider, they can add a 15% excess charge to that amount: Medicare Approved Amount: $2,000 Maximum Excess Charge (15%): $300 Total Bill: $2,300 Using the example above, Medicare would pay its required amount (80%) of the $2,000. Once Medicare has paid their 80% share, you would be responsible for your 20% share ($400) plus 100% of any/all Medicare Part B Excess Charges, which in the example we used is $300. Your total out-of-pocket cost for that single procedure would be $700. If you see the same specialist regularly, these costs canbecome an ongoing financial burden. WHICH MEDICARE SUPPLEMENT/MEDIGAP PLANS COVER EXCESS CHARGES? The best way to hedge your bet and protect yourself is to enroll in a Medigap or Medicare Supplement plan that will cover 100% of all Medicare Part B excess charges. Currently, two main plans offer this specific benefit: Medicare Supplement/Medigap Plan F Medicare Supplement/Medigap Plan G Both plans are excellent choices for comprehensive coverage, though eligibility rules differ between them. MEDICARE SUPPLEMENT PLAN G & PLAN F BOTH COVER MEDICARE EXCESS CHARGES Medigap Plan F has long been considered the “ gold standard ” of Medicare supplements because it covers 100% of the gaps in Original Medicare. When you have Plan F, you have zero out-of-pocket costs for Medicare-covered services. The plan pays your deductibles, your coinsurance, and yes, it pays 100% of any Medicare excess charges you incur. But there is a catch with Plan F: unless you were 65 prior to January 1, 2020, you are not eligible to enroll in Plan F. For those new to Medicare, or for anyone looking to save on monthly premiums, Medigap Plan G  is widely considered the best choice available today. Plan G provides nearly identical coverage to Plan F. It covers your Part A deductible, your Part B coinsurance, skilled nursing facility coinsurance, and it covers 100% of Medicare Part B excess charges. The only difference is that Plan G does not cover the Part B annual deductible ($283 in 2026). Once you pay that small deductible at the start of the year, your Plan G coverage operates just like Plan F, paying for all covered services for the rest of the calendar y ear. With Plan G, your monthly premiums are often significantly lower than Plan F. In many cases, the annual premium savings outweigh the cost of the Part B deductible, allowing you to keep more money in your pocket while still protecting you from Medicare Part B excess charges. WHAT IF YOU CHOOSE MEDIGAP PLAN N? If you choose a plan that does not cover excess charges, such as Plan N , you are accepting a certain amount of Financial risk. Medicare Supplement/Medigap Plan N is an excellent option for filling the gaps in Original Medicare coverage. The absolute best thing that those with a Plan N can do to avoid Medicare Part B Excess fees is to ask every doctor you have if they accept Medicare assignment. This is not always practical. In emergency situations, you cannot choose your provider. You might be taken to a hospital where the anesthesiologist or the on-call specialist is a non-participating provider. Without coverage, you will receive a bill for those excess charges weeks later. And those bills are not inexpensive. Additionally, if you happen to live in or travel to a state that does not prohibit excess charges (most states allow them), you are exposed to these costs. Having a plan like Plan F and Plan G eliminates the need to stress or worry about which doctor you see or where you travel within the United States. WHEN EXCESS CHARGES MATTER THE MOST Coverage for excess charges becomes critical when you need specialized care. Specialists, surgeons, and psychiatrists are statistically more likely to be non-participating providers than general practitioners. It also matters if you want to be the only person in charge of your own healthcare. With Plan G or Plan F, you can see any doctor in the United States who accepts Medicare. You do not need to ask if they accept the assignment because your insurance plan handles the difference. This peace of mind is invaluable when you are dealing with a health concern. WRAPPING THINGS UP Medigap Plan F is awesome, but most Medicare Beneficiaries who have had Plan F realize their premiums are typically $60-$100 a month higher than Plan G. And, that the convenience of Plan F automatically paying your deductible for you is nice, but the math just does not add up to Plan F being the best value. Medicare Supplement Plan G honestly is the new Platinum Standard for Medicare. Medical expenses are unpredictable, but your insurance coverage does not have to be. By choosing a Medicare Supplement plan like Plan G, you ensure that excess charges never impact your retirement savings. Picture of Michael Braden's Business Card, with rounded corners. If you still have questions about Medicare Part B Excess Charges, Plan F, Plan G, or Plan N, or anything else related to Medicare, please drop me a line or give me a call anytime. You can email me directly at mike@bradenmedicare.com , online at www.bradenmedicare.com , or by calling or texting me at (480) 225-1393.

Michael T. Braden February 13, 2026 ENROLLING IN MEDICARE HOW YOUR MEDICARE DECISIONS MATTER Hi, and welcome to our latest Medicare Blog Article. Today, we are going to explain why the first choice you make when you first enroll in Medicare is essential to protecting your healthcare and your finances throughout your retirement. Photo Of Braden Medicare Insurance' We Only Get One Chance To Make A Good First Impression With Medicare Poster.pdf Remember the saying "You only get one chance to make a good first impression" ? Well, this phrase is certainly appropriate. Once you turn age 64, the sheer volume of information you receive can feel overwhelming. From Flyers, Brochures, Postcards, invitations to attend Seminars, and Dinner RSVPs, it can feel overwhelming. However, your initial Medicare enrollment decision is one of the most significant financial and healthcare choices you will make in retirement. While it might seem like a simple decision for the upcoming year, that first choice sets a trajectory that can significantly impact your access to care and your budget for decades to come. Understanding the long-term implications of this decision is vital to ensuring your future security. THINGS ALL NEW MEDICARE BENEFICIARIES NEED TO KNOW KNOWING & UNDERSTANDING ALL MEDICARE ENROLLMENT PERIODS Medicare operates on strict timelines. Most people are introduced to Medicare during their Initial Enrollment Period, a seven-month window surrounding their 65th birthday. This period is critical not just for signing up for Original Medicare (Part A and Part B), but also for choosing supplemental coverage. Picture Of Braden Medicare Insurance' Medicare's Initial Enrollment Period (IEP) Poster During this initial window, you have unique rights that do not last forever. Specifically, you have a one-time, guaranteed right to purchase any Medicare Supplement Insurance (Medigap) policy available where you live, regardless of your health status. This means insurance companies cannot deny you coverage or charge you more due to pre-existing conditions during this specific period. Once you receive your Medicare Supplement (aka Medigap Policy), your policy can never be taken from you, unless you fail to pay for your premiums for 90 Days. Medicare Supplements work seamlessly with Original Medicare to fill in the gaps left by Original Medicare. The most popular Medicare Supplement (Medigap) plans are Plan F, Plan G, Plan N, and High Deductible Plan G. Picture of Braden Medicare Insurance's Medicare Enrollment Periods Poster We have been a licensed, independent Medicare Broker and CMP (Certified Medicare Planner) for many years. Perhaps the biggest mistake we see new Medicare Beneficiaries make is failing to grasp the importance of the ramifications and potential fallout from their Initial Enrollment Period (IEP). Most of those new to Medicare have a bad habit of listening to advice from friends, family, and co-workers about their Medicare options instead of taking a little time to do their own research, or to not contract a local Medicare Broker to assist them. Most people consider their health very good at age 65, so they justify choosing a Medicare Advantage Plan (Medicare Part C) instead of investing in a Medicare Supplement plan. Everyone has to make their own decisions; unfortunately, all too often these decisions account only for today, without considering what they will want from their healthcare 5, 10, 15, or 20 years from now. MEDICARE PART C (MEDICARE ADVANTAGE) VS. MEDICARE SUPPLEMENTS It is common for individuals turning 65 to be in relatively good health. You might take a maintenance medication or two, but you likely feel active and vibrant. When you are healthy, a plan with low premiums and higher potential out-of-pocket costs might seem like an acceptable risk. When you view your first Medicare decision through a long-term lens, the value of securing a Medicare Supplement plan during your initial eligibility becomes clear. It is the only time you are guaranteed access to this type of comprehensive coverage without fear of medical underwriting. Look at it like this: Medigap/Medicare Supplement plans are preventive plans that protect you from serious financial risk, give you reasonable, predictable costs, and keep you in the driver's seat to steer the direction you want for your own healthcare. In choosing a Medicare Supplement plan, you are choosing Original Medicare. And having purchased a Medicare Supplement plan during your IEP (Medicare Initial Enrollment Period) guarantees you access to the most doctors and the best hospitals from coast to coast. In Arizona, for ages 65-68, a Medigap Plan G has an average premium of $160-$180. The numbers look like this: Your premiums would be around $2,000 for the year. You would have a Medicare Part B Deductible of just $283 for the entire year. And, all of your Hospitalization and Skilled Nursing stays are 100% covered. And, if that is not awesome enough, you are covered in all 50 States and all US territories. Your Maximum out-of-pocket expenses for healthcare (Not including any Prescription Medications) would be $2,300 - $2,500 per year. And there is no maximum in play with Medicare, which means that all medically necessary services and procedures for you are guaranteed for life, with no caps. And any future rate increases cannot be based on your claims history. Conversely, even though a Medicare Advantage plan (Medicare Part C) might look appealing today, the fact is that a Medicare Supplement plan is often the superior choice for long-term peace of mind. Now, looking at costs with a Medicare Advantage plan, most plans have a $0 monthly premium, and the average MOOP (Maximum Out-of-Pocket) amount for a Medicare Advantage Plan in 2026 is $5,700. The MOOP is the maximum you will pay out of pocket before your plan pays for all your costs for the remainder of the year. And, you have to go through all of the research every year, because every Medicare Advantage policy is only good for one year. There are co-pays and co-insurance for pretty much everything else, from Office Visit co-pays and referrals to $350 for an MRI, $395 per night for a Hospital stay, mandatory 20% co-insurance for Cancer Treatments, and restrictive networks. Also, with Medicare Advantage plans, you are only covered in the county where you live. If you travel, you are only covered for urgent care or Emergency services from a hospital ER. Lastly, the Mayo Clinic/Hospital, Barrow Neurological Institute, and most teaching hospitals nationwide do not accept Medicare Advantage plans. Remember the saying, " Nothing is as certain as change. Reality shows, and facts verify that most Medicare Beneficiaries develop more healthcare risks as they age, not less. A plan that works perfectly when you are healthy can become a financial burden when you become ill. Making your initial Medicare choice based solely on your current health, rather than your potential future health, is a common misstep. CHANGING HEALTH PLANS IN THE FUTURE IS NOT GUARANTEED Many beneficiaries assume they can easily switch Medicare plans whenever they wish. While you can change Medicare Advantage  plans annually during the Annual Enrollment Period  in the fall, s witching to a Medicare Supplement plan later in life is often far more complicated. If you choose a Medicare Advantage plan initially and decide five years later that you would prefer the stability of Original Medicare paired with a Medicare Supplement, you may face a significant hurdle called medical underwriting. Outside of your initial enrollment window, insurance carriers are permitted to review your medical history. They can decline your application or charge higher premiums based on your health conditions. This means that if your health declines after your initial enrollment, you might find yourself forced to your default tethered to a Medicare Advantage plan for life, simply because you will not qualify for a Medigap policy or Medicare Supplement plan. Some very common things that Medicare Supplement Underwriters can and do use to determine if someone is a good risk for a Medicare Supplemental policy. Let's look at common health conditions that can deny you approval for coverage: Having a Defibrillator. Past Cancer diagnosis and treatments, if within 4 years of diagnosis. Most cancers that are over 4 years old and in remission are okay. Insulin-Dependent Diabetic. Having been diagnosed with COPD. Having two or more overnight hospital stays within 12 months of your application. Having/Receiving Injections or Infusions for Arthritis. Being diagnosed with Kidney Disease. Heart Disease. Being prescribed certain medications. Having a "Pain Doctor". Needing Monthly Physical Therapy. Not completing the Activities of Daily Living unassisted. Being diagnosed with Atrial Fibrillation TAKE AN HONEST EVALUATION OF COST VS RISK WHEN IT COMES TO YOUR HEALTHCARE OPTIONS WITH MEDICARE The fundamental difference between your main Medicare options often comes down to a trade-off between upfront costs and backend risk. Medicare Advantage plans often feature low or zero-dollar monthly premiums, which is attractive. However, these plans come with a downside: co-payments, co-insurance, and out-of-pocket maximums that can reach thousands of dollars per year if you need significant care. Picture Of Braden Medicare Insurances Did You Know.........Poster Medicare Supplement plans, conversely, require a higher monthly premium, but they vastly reduce your exposure to unexpected medical bills. They fill the “ gaps ” in Original Medicare, covering costs like the 20% coinsurance for doctor visits. This allows for predictable budgeting, ensuring that a sudden illness does not deplete your retirement finances. Remember, the definition of Insurance is the cost it takes to reduce or eliminate healthcare risk and exposure, protecting you from Financial Catastrophe. ACCESS TO DOCTORS, CLINICS, AND HOSPITALS VARY BASED ON THE HEALTHCARE PLAN YOU CHOOSE Your first choice also dictates which doctors you can see. Medicare Advantage plans typically utilize HMO or PPO networks. You generally must receive care from providers within that network to receive the highest level of coverage, and you may require referrals to see specialists. If you choose Original Medicare paired with a Medicare Supplement, you have the freedom to see any provider nationwide who accepts Medicare. There are no networks and no referral requirements. This flexibility becomes increasingly important if you develop a complex condition requiring a specific specialist who might not be in a standard advantage network. WRAPPING THINGS UP 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 you have predictable costs and access to the best care possible, 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 13, 2016 Enrolling In Medicare HOW YOUR MEDICARE DECISIONS MATTER Hi, and welcome to our latest Medicare Blog Article. Today, we are going to explain why the first choice you make when you first enroll in Medicare is essential to protecting your healthcare and your finances throughout your retirement. Picture of Braden Medicare Insurance' Poster We Only Get One Chance to Make A Good First Impression with Medicare Poster Remember the saying "You only get one chance to make a good first impression" ? Well, this phrase is certainly appropriate. Once you turn age 64, the sheer volume of information you receive can feel overwhelming. From Flyers, Brochures, Postcards, invitations to attend Seminars, and Dinner RSVPs, it can feel overwhelming. However, your initial Medicare enrollment decision is one of the most significant financial and healthcare choices you will make in retirement. While it might seem like a simple decision for the upcoming year, that first choice sets a trajectory that can significantly impact your access to care and your budget for decades to come. Understanding the long-term implications of this decision is vital to ensuring your future security. THINGS ALL NEW MEDICARE BENEFICIARIES NEED TO KNOW KNOWING & UNDERSTANDING ALL MEDICARE ENROLLMENT PERIODS Medicare operates on strict timelines. Most people are introduced to Medicare during their Initial Enrollment Period, a seven-month window surrounding their 65th birthday. This period is critical not just for signing up for Original Medicare (Part A and Part B), but also for choosing supplemental coverage. Photo of Braden Medicare Insurance' Medicare's Initial Enrollment Period Poster During this initial window, you have unique rights that do not last forever. Specifically, you have a one-time, guaranteed right to purchase any Medicare Supplement Insurance (Medigap) policy available where you live, regardless of your health status. This means insurance companies cannot deny you coverage or charge you more due to pre-existing conditions during this specific period. Once you receive your Medicare Supplement (aka Medigap Policy), your policy can never be taken from you, unless you fail to pay for your premiums for 90 Days. Medicare Supplements work seamlessly with Original Medicare to fill in the gaps left by Original Medicare. The most popular Medicare Supplement (Medigap) plans are Plan F, Plan G, Plan N, and High Deductible Plan G. Photo of Braden Medicare Insurance' Medicare Enrollment Periods Poster We have been a licensed, independent Medicare Broker and CMP (Certified Medicare Planner) for many years. Perhaps the biggest mistake we see new Medicare Beneficiaries make is failing to grasp the importance of the ramifications and potential fallout from their Initial Enrollment Period (IEP). Most of those new to Medicare have a bad habit of listening to advice from friends, family, and co-workers about their Medicare options instead of taking a little time to do their own research, or to not contract a local Medicare Broker to assist them. Most people consider their health very good at age 65, so they justify choosing a Medicare Advantage Plan (Medicare Part C) instead of investing in a Medicare Supplement plan. Everyone has to make their own decisions; unfortunately, all too often these decisions account only for today, without considering what they will want from their healthcare 5, 10, 15, or 20 years from now. MEDICARE PART C (MEDICARE ADVANTAGE) VS. MEDICARE SUPPLEMENTS It is common for individuals turning 65 to be in relatively good health. You might take a maintenance medication or two, but you likely feel active and vibrant. When you are healthy, a plan with low premiums and higher potential out-of-pocket costs might seem like an acceptable risk. When you view your first Medicare decision through a long-term lens, the value of securing a Medicare Supplement plan during your initial eligibility becomes clear. It is the only time you are guaranteed access to this type of comprehensive coverage without fear of medical underwriting. Look at it like this: Medigap/Medicare Supplement plans are preventive plans that protect you from serious financial risk, give you reasonable, predictable costs, and keep you in the driver's seat to steer the direction you want for your own healthcare. In choosing a Medicare Supplement plan, you are choosing Original Medicare. And having purchased a Medicare Supplement plan during your IEP (Medicare Initial Enrollment Period) guarantees you access to the most doctors and the best hospitals from coast to coast. In Arizona, for ages 65-68, a Medigap Plan G has an average premium of $160-$180. The numbers look like this: Your premiums would be around $2,000 for the year. You would have a Medicare Part B Deductible of just $283 for the entire year. And, all of your Hospitalization and Skilled Nursing stays are 100% covered. And, if that is not awesome enough, you are covered in all 50 States and all US territories. Your Maximum out-of-pocket expenses for healthcare (Not including any Prescription Medications) would be $2,300 - $2,500 per year. And there is no maximum in play with Medicare, which means that all medically  necessary  services and procedures for you are guaranteed for life, with no caps. And any future rate increases cannot be based on your claims history. Conversely, even though a Medicare Advantage plan (Medicare Part C) might look appealing today, the fact is that a Medicare Supplement plan is often the superior choice for long-term peace of mind. Now, looking at costs with a Medicare Advantage plan, most plans have a $0 monthly premium, and the average MOOP (Maximum Out-of-Pocket) amount for a Medicare Advantage Plan in 2026 is $5,700. The MOOP is the maximum you will pay out of pocket before your plan pays for all your costs for the remainder of the year. And, you have to go through all of the research every year, because every Medicare Advantage policy is only good for one year. There are co-pays and co-insurance for pretty much everything else, from Office Visit co-pays and referrals to $350 for an MRI, $395 per night for a Hospital stay, mandatory 20% co-insurance for Cancer Treatments, and restrictive networks. Also, with Medicare Advantage plans, you are only covered in the county where you live. If you travel, you are only covered for urgent care or Emergency services from a hospital ER. Lastly, the Mayo Clinic/Hospital, Barrow Neurological Institute, and most teaching hospitals nationwide do not accept Medicare Advantage plans. Remember the saying, " Nothing is as certain as change. Reality shows, and facts verify that most Medicare Beneficiaries develop more healthcare risks as they age, not less. A plan that works perfectly when you are healthy can become a financial burden when you become ill. Making your initial Medicare choice based solely on your current health, rather than your potential future health, is a common misstep. CHANGING HEALTH PLANS IN THE FUTURE IS NOT GUARANTEED Many beneficiaries assume they can easily switch Medicare plans whenever they wish. While you can change Medicare Advantage  plans annually during the Annual Enrollment Period  in the fall, s witching to a Medicare Supplement plan later in life is often far more complicated. If you choose a Medicare Advantage plan initially and decide five years later that you would prefer the stability of Original Medicare paired with a Medicare Supplement, you may face a significant hurdle called medical underwriting. Outside of your initial enrollment window, insurance carriers are permitted to review your medical history. They can decline your application or charge higher premiums based on your health conditions. This means that if your health declines after your initial enrollment, you might find yourself forced to your default tethered to a Medicare Advantage plan for life, simply because you will not qualify for a Medigap policy or Medicare Supplement plan. Some very common things that Medicare Supplement Underwriters can and do use to determine if someone is a good risk for a Medicare Supplemental policy. Let's look at common health conditions that can deny you approval for coverage: Having a Defibrillator. Past Cancer diagnosis and treatments, if within 4 years of diagnosis. Most cancers that are over 4 years old and in remission are okay. Insulin-Dependent Diabetic. Having been diagnosed with COPD. Having two or more overnight hospital stays within 12 months of your application. Having/Receiving Injections or Infusions for Arthritis. Being diagnosed with Kidney Disease. Heart Disease. Being prescribed certain medications. Having a "Pain Doctor". Needing Monthly Physical Therapy. Not completing the Activities of Daily Living unassisted. Being diagnosed with Atrial Fibrillation TAKE AN HONEST EVALUATION OF COST VS RISK WHEN IT COMES TO YOUR HEALTHCARE OPTIONS WITH MEDICARE The fundamental difference between your main Medicare options often comes down to a trade-off between upfront costs and backend risk. Medicare Advantage plans often feature low or zero-dollar monthly premiums, which is attractive. However, these plans come with a downside: co-payments, co-insurance, and out-of-pocket maximums that can reach thousands of dollars per year if you need significant care. Photo of Braden Medicare Insurance's Did You Know That Poster About Medicare Medicare Supplement plans, conversely, require a higher monthly premium, but they vastly reduce your exposure to unexpected medical bills. They fill the “ gaps ” in Original Medicare, covering costs like the 20% coinsurance for doctor visits. This allows for predictable budgeting, ensuring that a sudden illness does not deplete your retirement finances. Remember, the definition of Insurance is the cost it takes to reduce or eliminate healthcare risk and exposure, protecting you from Financial Catastrophe. ACCESS TO DOCTORS, CLINICS, AND HOSPITALS VARY BASED ON THE HEALTHCARE PLAN YOU CHOOSE Your first choice also dictates which doctors you can see. Medicare Advantage plans typically utilize HMO or PPO networks. You generally must receive care from providers within that network to receive the highest level of coverage, and you may require referrals to see specialists. If you choose Original Medicare paired with a Medicare Supplement, you have the freedom to see any provider nationwide who accepts Medicare. There are no networks and no referral requirements. This flexibility becomes increasingly important if you develop a complex condition requiring a specific specialist who might not be in a standard advantage network. WRAPPING THINGS UP Photo of Braden Medicare Insurance' Poster of Michael Braden's Business Card 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 you have predictable costs and access to the best care possible, 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 1, 2026 MEDICARE ENROLLMENT Picture of a Man Looking at a Guide to a Maze Inside Of A Medicare Card Border As advanced as the United States is in many areas of society and innovation, we have never developed a foolproof mechanism for teaching individuals about Medicare, and specifically, when and how to enroll in Medicare. Something that most Medicare beneficiaries learn the hard way is that the federal government does not notify them when it is time to enroll in Medicare. They expect you to know how to apply for Medicare  and when and how to proceed with the process, based on your timeline. Medicare still has a strong reputation for having many moving parts and numerous rules to understand, making it overwhelming and confusing.  The more people understand about Medicare, what it is and how it works, the less daunting the process of enrolling in Medicare becomes . By following this Map to Medicare Enrollment article, you will be more confident in your knowledge of Medicare, become more familiar and confident with the Medicare enrollment process, and have a better foundation for your healthcare coverage in retirement. WHAT IS MEDICARE Most people do not realize that Medicare is the National Health Insurance program for Americans 65 years of age and older, as well as those who have been granted a full-time disability by the Social Security Administration. Medicare is not for the Poor or Homeless. Medicaid is health insurance for individuals whose income is below national guidelines, and for those who need extra help. Medicare is the best option for individuals when they reach age 65. And, most people can keep their current Employer Group Health Insurance after they turn 65 (As long as their employer has over 20 employees). Then, they can easily enroll in Medicare once they finally decide to retire. DOES EVERYONE WHO APPLIES FOR MEDICARE GET MEDICARE? As a general consensus the majority of people qualify for Before you start trying to figure out how to enroll in Medicare, you first want to ask when you can sign up for Medicare. You’d think the questions “How old do you have to be to qualify for Medicare?” or “What is Medicare eligibility age?” would be easy to answer. However, the criteria can be more complex than you’d expect. Generally, most people become qualified for Medicare when they turn 65. However, there are exceptions for those with certain disabilities or medical conditions. If you are under 65, receiving Social Security Disability Insurance (SSDI) for at least 24 months, or have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you can qualify for Medicare before 65. UNDERSTANDING THE FOUR PARTS OF MEDICARE Braden Medicare Insurance's Poster with Colorful Blocks SHowing The Four Parts Of Medicare Trying to figure out how to apply for Medicare is a key step when starting your Medicare journey, but understanding how Medicare works should also be at the forefront of your to-do list. Knowing these parts and how they cover your healthcare services will make the Medicare process easier when selecting the most suitable coverage for your healthcare needs in retirement. Once you understand the basics, you can ask more directly related questions, such as “When can I get Medicare?” or “Where do I sign up for Medicare?” These are the different parts of Medicare, each covering different areas of your healthcare services: MEDICARE Part A Medicare Part A provides coverage for your inpatient hospital, skilled nursing facility care, hospice care, and certain home health care services. Part A comes from the federal government. MEDICARE Part B Part B covers outpatient medical services, such as doctor visits, preventive services, lab work, and physical therapy. Like Part A, Part B comes from the federal government. MEDICARE Part C Another name for Medicare Part C is Medicare Advantage . These plans are managed through private insurance companies. A Medicare Advantage plan includes Part A and Part B benefits and often additional coverage, such as prescription drug insurance and dental and vision benefits. MEDICARE Part D Medicare Part D covers the prescription medications you’d pick up at the pharmacy. You enroll in a Part D plan through a private insurance carrier to help cover the cost of drugs. STEP-BY-STEP ENROLLMENT GUIDE When starting the Medicare enrollment process, the steps can vary depending on your circumstances. For Example: If you’re already receiving Social Security benefits at least four months before your 65th birthday month, you do not need to worry about how to apply for Medicare at 65 because you will be automatically enrolled in Medicare Parts A and B . Your Medicare card should arrive a few months before your birthday month, and your benefits will become effective on the first of your 65th birthday month (unless your birthday starts on the 1st). If you’re not receiving Social Security benefits, you’ll apply for Medicare through the Social Security Administration (SSA) during your Initial Enrollment Period. This enrollment process can be completed online, by phone, or in person at your local SSA office. If you become eligible for Medicare but delay your enrollment, you can qualify for a Special Enrollment Period (SEP) or the General Enrollment Period (GEP), depending on your circumstances. If you are receiving Social Security Disability Income benefits for at least 24 months, you qualify for Medicare. THE MOST COMMON MEDICARE BENEFICIARIES MAKE WHEN ENROLLING IN MEDICARE Once you realize the transition to Medicare might be more complicated than expected, the right question to ask yourself is, “How do I correctly apply for Medicare. " There are some common missteps you want to avoid as they could lead to coverage gaps or financial penalties: If you miss your Initial Enrollment Period (IEP) and do not have creditable employer coverage, you could face permanent late enrollment penalties. Although technically voluntary, not enrolling in a Medicare Part D prescription plan when you become eligible could mean a lifetime financial penalty. As we previously stated, Medicare has four main parts, but there are many Medicare  plans  as well. Understanding the concepts and differences between Original Medicare, Medicare Advantage, and Medicare Supplement plans will help prevent confusion when selecting your coverage. YOU MISSED YOUR MEDICARE ENROLLMENT DEADLINE. NOW WHAT DO YOU DO? If something happens, and you miss your Medicare enrollment deadline, don’t panic. You can still enroll in Medicare during the yearly General Enrollment Period or, if you qualify, a Special Enrollment Period (SEP). One qualifying reason for a SEP could be the loss of employer-sponsored health coverage. HELP WITH DETERMINING WHICH MEDICARE OPTION IS BEST FOR YOU AND YOUR FAMILY When it comes down to choosing your Medicare plan, there are multiple factors to consider before a final decision. Consider your health and which benefits are most important to you. Compare costs, such as monthly premiums, deductibles, copayments, and coinsurance. Are you okay with a provider network? Do you want access to a wide range of healthcare providers? Consider all of these factors when evaluating which route you want to take. MEDICARE FAQ Picture of two Red Adirondack Chairs sitting on a dock on a lake, with the caption of Medicare Q & A WHERE DO I HAVE TO GO TO ENROLL IN MEDICARE?    The most common way to apply for Medicare is online through Social Security’s website, following the instructions. You can also call Social Security or visit your local SSA office.     WHEN IS THE BEST TIME TO APPLY FOR MEDICARE?   Picture of a Red, White, and Blue Medicare Initial Enrollment Period Chart You can apply as early as three months before your 65th birthday month during your 7-month Initial Enrollment Period (IEP). Your IEP begins three months before your 65th birthday and ends three months after it (unless your birthday falls on the first of the month). When you apply during the three months before your 65th birthday month, your Medicare benefits become active on the first of your birthday month.     WHAT IS THE BEST WAY TO ENROLL IN MEDICARE? Medicare beneficiaries will apply through the Social Security office.  Apply for Medicare online through Social Security’s website .   Picture of a computer monitor showing how you can enroll in Medicare using the SSA.gov website.   IS MEDICARE EXPENSIVE?   The cost of Medicare typically changes annually. Medicare Part A is premium-free for most people because they have enough work credits and paid Medicare taxes over the years. Everyone pays a monthly premium for Part B (unless you qualify for Medicaid). The standard Part B premium in 2026 is $202.90. But the final determination on what you will pay for your Medicare premiums is made by the Social Security Administration based on your income. If your income is higher, you pay more for your Part B and D premiums. The costs can vary for specific plans since the rest of your Medicare plan options come from private insurance carriers. Check out our Medicare costs page to learn more .     CAN I ENROLL IN MEDICARE PART A WITHOUT ENROLLING IN MEDICARE PART B?   If you plan to delay Medicare Part B, you can sign up for Part A only on the Social Security website. And, since 99% of people pay no premiums for Medicare Part A, it makes good common sense to enroll in Medicare Part A as soon as you turn 65.     WHAT'S THE BEST WAY TO ENROLL IN MEDICARE PART B?  If you have Part A already but need Part B, select “Part B only” when on the SS website or go to sign up for Medicare Part B only . However, if you are applying for Part B because you qualify for a SEP, you will submit CMS form L564 in addition to your Part B application.     STEPS TO TAKE IN ORDER TO RECEIVE YOUR MEDICARE CARD   Once you apply for Medicare and your application is approved, you will receive your card. Social Security may take some time to process your application. Therefore, it may be several weeks before you receive your card. You should also be able to check your SSA account to see if your Medicare number is available.     ARE YOU ALLOWED TO KEEP YOUR CURRENT HEALTH PLAN WHEN YOU ENROLL IN MEDICARE?   Depending on your coverage, it may be considered primary or secondary to Medicare. You would need to contact your current plan directly to understand how it would coordinate with Medicare. If your current coverage is through the ACA, you would need to cancel it once you have Medicare. These two do not coordinate.     WHAT ARE THE DIFFERENT ENROLLMENT PERIODS AVAILABLE WITH MEDICARE?  The Annual Election Period (October 15 – December 7) allows beneficiaries to make changes to their Medicare Advantage or Part D plans.     Photo of Braden Medicare Insurance's Poster showing the Medicare Enrollment Periods. WRAPPING THINGS UP Hopefully, you can better understand  how to qualify for Medicare and navigate the enrollment process. Once you are armed with the correct information about Medicare, you will be in a better position to make informed decisions to ensure you have the right Healthcare plan for you and your family. In my opinion, the absolute best thing anyone can do when it comes time to learn about Medicare is to work with a licensed, independent Medicare Broker. WHY WORKING WITH A MEDICARE BROKER MAKES THE MOST SENSE: There is no charge to you for working with a Medicare Broker. Brokers deal with Medicare every day, not just once in a lifetime. Brokers know all of the rules and regulations that the normal American will never know or understand. You can do a quick GOOGLE search and find Medicare Brokers Close To Me. Then call 2-3 of these Medicare Brokers and interview them. See what they sound like, are they educated in Medicare? Are they open or arrogant? Do they push one option over others? Do they create pressure on you or make you feel uneducated? Ask them how many companies they are contracted with. Ask them whether they have a website and provide their email address . A reputable broker should have an email that matches their webpage. Ask them to give you an overview of Medicare and what options you have. Ask them if they have BBB Accreditation. Any broker worth their salt will be happy to assist you and answer all of your questions. Brokers choose this career because they are service-oriented and genuinely enjoy helping others. Picture of Michael Braden describing that he is not only a highly respected Medicare Broker, but he is also a Certified Medicare Planner.

Photo showing a shadow figure changing a Medicare Advantage Billboard to read "Medicare DisAdvantage" Michael T. Braden January 29, 2026 Medicare Advantage MEDICARE ADVANTAGE PLANS OFTEN HAVE HIGHER COSTS THAN YOU WERE TOLD BY AN AGENT When you turn 64-1/2, your mailbox usually begins to overflow with flyers, postcards, brochures, and other advertising/marketing materials for Medicare plans. Many of these flyers promise $0 Premiums, a cornucopia of extras, and a bundle of extra benefits that seem too good to be true. While Medicare Advantage plans can offer an alternative to Original Medicare, they often can seem too good to be true, and once you get a bill, you realize that you are not getting what you thought you signed up for. Understanding how these expenses are generated is the first step in protecting your savings in retirement. It is crucial that you take a deeper dive and look beyond the premium and understand the potential out-of-pocket expenses that can accumulate throughout the year. For those seeking predictable costs and peace of mind, Medicare Supplement plans often provide a more stable financial solution. THE TRUTH HIDDEN IN MEDICARE ADVANTAGE PLANS Surprise costs in Medicare Advantage plans generally arise because of how these plans are structured. Unlike Original Medicare, which is a fee-for-service program managed by the federal government, Medicare Advantage plans are managed care policies sold by private insurance companies. These carriers agree to manage your care in exchange for a flat fee from Medicare. To make a profit, they often implement strict cost-control measures. This means they limit which doctors you can see and require approval for specific procedures. If you step outside their rules, even accidentally, you become responsible for a significant portion of the bill. This structural difference is the primary reason beneficiaries often face unexpected expenses, unlike the comprehensive coverage offered by Medigap   plans. NOBODY TOLD YOU ABOUT OUT-OF-NETWORK COSTS One of the most significant financial shocks comes from receiving care outside of your plan’s network. Medicare Part C Plans ( Medicare Advantage ) typically operate as HMOs or PPOs, restricting you to a specific list of doctors and hospitals. In an HMO, you generally have no coverage for non-emergency out-of-network care, meaning you must pay 100% of the cost. Even with a PPO, seeing a provider outside the network results in significantly higher copayments or coinsurance. This contrasts sharply with Medicare Supplement plans, which allow you to see any doctor in the United States who accepts Medicare, ensuring you are never penalized for choosing the best provider for your health needs. THE REPROCUSSIONS FROM HAVING TO CHASE DOWN PRIOR AUTHORIZATIONS Another hidden hurdle is the requirement for prior authorization . Before you can receive specific tests, surgeries, or therapies, your doctor must ask the insurance plan for permission. If the plan denies the request or delays approval, you face a difficult choice: wait for the appeal process while your health suffers or pay for the treatment entirely out of pocket. These administrative barriers do not exist with Medicare Supplement plans, where medical necessity is determined by your doctor and Medicare, not an insurance company administrator looking to cut costs. CO-PAYMENTS AND REFERRALS CAN ADD UP QUICKLY While a zero-dollar premium sounds appealing, the “pay-as-you-go” model of Medicare Advantage can quickly become expensive. You will likely be charged a copayment for every single medical appointment. Specialist visits are particularly prone to high copays, often ranging from $40 to $50 or more per visit. If you have a chronic condition that requires seeing a cardiologist, endocrinologist, or other specialists frequently, these copays add up rapidly. In comparison, a Medicare Supplement plan can cover these “gaps,” leaving you with little to no cost at the time of service. UNFORESEEN CHANGES WITH PRESCRIPTION MEDICATIONS Prescription drug coverage is often bundled into Medicare Advantage plans, but this convenience can backfire. Plans can change their formularies and the list of covered drugs every single year. A medication that was in a low-cost tier one year might move to a higher tier the next, drastically increasing your copay. Furthermore, if your specific drug is removed from the formulary, you may have to pay the full retail price or go through a lengthy exception process. NOT REALLY UNDERSTANDING YOUR MOOP Marketing materials frequently highlight the Maximum Out-of-Pocket   (MOOP) limit as a safety net. However, this safety net is often set much higher than many beneficiaries realize. For 2026, the maximum out-of-pocket limit for in-network services can reach $9,250. This means you could potentially pay over nine thousand dollars in copays and coinsurance before the plan covers 100% of your costs. For many seniors, this amount is far beyond their means. Medicare Supplement plans typically result in far lower annual out-of-pocket expenses, providing proper financial protection. LIMITS AND STRUCTURE OF THE EXTRA ADDED BENEFITS The dental, vision, and hearing benefits touted by Medicare Advantage plans often come with strict limitations. The coverage is frequently capped at a low dollar amount, such as $1,000 or $1,500 per year, which does not cover major procedures like root canals, crowns, or high-quality hearing aids. Additionally, these benefits are often restricted to a tiny network of dentists and optometrists. You may find that your preferred dentist does not accept the plan, rendering the benefit useless unless you switch providers. URGENT CARE BILLING IS NOT THE HOSPITAL EMERGENCY ROOM Finally, billing confusion between emergency room and urgent care visits can lead to expensive surprises. If you visit an emergency room for a condition the plan later deems “non-emergent,” the plan may downgrade your coverage, leaving you with a higher bill. Conversely, if you go to an urgent care center that is out-of-network while traveling, you might not be covered at all. Medicare Supplement plans travel with you nationwide , providing consistent coverage whether you are at home or visiting grandchildren in another state. PEACE OF MIND IS PART OF FEELING HEALTHY AND PROTECTED Navigating the complexities of Medicare does not have to be a guessing game. While Medicare Advantage plans may initially appear attractive, the potential for surprise bills can disrupt your retirement budget. Medicare Supplement products offer a robust alternative, providing predictable costs, freedom of choice, and comprehensive coverage that lets you focus on your health rather than your wallet.

Michael T. Braden, November 7, 2025 MEDICARE SUPPLEMENTS Photo of Prescription Tablets and $100 Bills with the caption "What are the benefits of Medigap insurance?" When those new to Medicare first enroll in Medicare, they are mainly focused on the cost of their premiums, what their deductibles are, whether or not all of their favorite doctors and hospitals are in their network, and how in the world they are ever going to remember everything about Medicare! Medicare Supplement plans, also known as Medigap, are designed to fill the gaps left by Original Medicare . Still, for many people, the benefits of having a Medigap/Medicare Supplement Policy are sadly never made clear to them, especially if they self-enrolled or worked with a Medicare Agent/Broker who wasn't as thorough or detailed as they should have been. Many of the most important aspects of Medicare Supplement/Medigap plans are oftentimes hidden in the plan's fine print. These benefits do not just save you money; they can save you thousands during a serious medical event. Understanding these overlooked features helps you appreciate the true value of your policy and why a Medigap plan offers confidence and peace of mind, knowing you are well covered beyond basic healthcare. NO CO-PAYS OR CO-INSURANCE One of the most immediate benefits of a MEDIGAP or MEDICARE SUPPLEMENT Plan/Policy is the full coverage of your Medicare Part B charges. Under Original Medicare, you are responsible for 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment. There is no cap on this 20%, meaning if you have a $100,000 surgery, you could owe $20,000. Most Medigap plans cover this entire 20% cost for you. This means that after you meet your annual Part B deductible ($283 for 2026) , you can relax and rest assured that you will not be on the hook for unexpected Medical procedures or emergency health issues. ENHANCE PART A BENEFITS THAT EXCEED ORIGINAL MEDICARE Hospital stays can be costly, and Original Medicare has limits. Part A covers your hospital costs for the first 60 days of a benefit period after you pay a deductible. However, if your stay extends beyond that, you begin to pay a daily coinsurance amount that increases significantly over time. Medicare Supplement plans provide a crucial safety net here. They cover the Part A coinsurance for days 61-90 and your Lifetime Reserve Days for days 91-150. Even more importantly, once you have exhausted all your Medicare hospital benefits, Medigap plans provide coverage for an additional 365 days of inpatient hospital care during your lifetime. This extended coverage is a benefit we hope you never need, but it is invaluable if you do. Photograph of Braden Medicare Insurance's 2026 Medicare Supplement Plan Comparison Chart GREATER BENEFITS FOR SKILLED NURSING FACILITIES Recovering from a serious illness or injury often requires time in a Skilled Nursing Facility (SNF). Medicare Part A covers the first 20 days in full, but from day 21 through day 100, there is a daily coinsurance charge. For 2026, this daily cost is $217. That daily fee adds up quickly—over $6,500 for a month-long stay. Medigap plans protect your savings by covering the coinsurance amount in full. This allows you to focus on your rehabilitation and recovery rather than worrying about a mounting daily bill. COVERING PART B EXCESS CHARGES Some doctors and providers do not accept Medicare Assignment , meaning they do not agree to accept the Medicare-approved amount as full payment. By law, these providers can charge you up to 15% more than the Medicare-approved rate. These are called “excess charges.” If you have a Medicare Supplement Plan F or Plan G, the plan pays 100% of these excess charges for you. You can see any doctor who accepts Medicare, even if they do not accept assignment, and you will not see a bill for that extra 15%. This benefit significantly widens your access to specialists and top-tier medical centers. COVERAGE FOR BLOOD TRANSFUSIONS Original Medicare only pays for blood transfusions starting with the fourth pint of blood in a calendar year. You are financially responsible for the first three pints, which can be surprisingly expensive. Now, raise your hand if you knew that the cost for a Pint of Blood averages $200 - $300! I think most people are shocked the first time they see charges for Blood after Surgery or after a Hospital Stay. Thankfully, every Medicare Supplement/Medigap plan covers the first three pints of blood, making sure that you, the Medicare Beneficiary, are not stuck with a hefty bill. 20% CO-PAYS FOR MEDICAL EQUIPMENT (DME) Durable Medical Equipment (DME) includes items like wheelchairs, walkers, CPAP machines, and hospital beds. Under Original Medicare Part B, you typically pay 20% of the cost for this equipment. Because DME can be costly, that 20% share can be a burden. Your Medicare Supplement plan steps in to pay this coinsurance, making essential equipment affordable and accessible when you need it most to maintain your independence at home. CONSISTENT COSTS FOR YOUR BUDGET Perhaps the most “overlooked” benefit is not a specific medical service, but a financial one: predictability. With a Medigap plan, you know exactly what your costs will be. You pay your monthly premium, and in return, you have little to no out-of-pocket expenses for covered services. This predictability makes retirement budgeting much easier. You do not have to set aside a large “rainy day” fund for medical copays or surprise bills because your insurance is doing the heavy lifting for you. OVERSEAS EMERGENCY BENEFITS Medical emergencies often happen when we are least prepared. Whether it is a sudden need for emergency care while traveling abroad – which many Medigap plans cover up to a lifetime limit of $50,000 – or protection against unexpected “excess charges” from a specialist, these plans are designed to handle the surprises. By filling the financial gaps left by Original Medicare, a Supplement plan serves as a shield against catastrophic costs that could otherwise derail your retirement finances. COMPANIES MAY OFFER ADDITIONAL BENEFITS While the government standardizes the medical benefits of Medigap plans, private insurance carriers often compete for your business by offering extra perks. These can include “household discounts” if you and a spouse both enroll, or memberships to gym networks like SilverSneakers , Renew Active, and Silver & Fit, or Active & Fit . Some carriers also offer add-on packages for vision, dental, and hearing coverage, which are not covered by Original Medicare or standard Medigap plans. It is always worth asking what “extras” are available when you compare quotes.