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Michael T. Braden, August 27, 2024 THE FOUR PARTS OF MEDICARE Braden Medicare Insurance Poster Describing The Four Parts Of Medicare. BACKGROUND OF MEDICARE IN AMERICA   Medicare is the national health insurance program for everyone in the United States aged 65 and older . Medicare is part of the United States Department of Health and Human Services. Everyone enrolls in Medicare through the Social Security Administration. Once they are approved and enrolled in a Medicare Plan, their Healthcare is managed by Medicare. Some Americans with disabilities may be eligible for Medicare before age 65 . President Harry S. Truman first envisioned Medicare; however, it did not become law until 1965 , when President Lyndon B. Johnson signed it into Law. Harry and Bess Truman were the first two Medicare Beneficiaries in the United States. Today, Medicare has 4 Parts (A, B, C & D) Medicare is the most extensive Health Program in the United States.  It serves over 64 million Americans, and for all of the Medicare jokes you may have heard, Medicare really is FANTASTIC healthcare, and you get to customize how you want your Medicare to work for you.  Original Medicare has always consisted of Two Parts, Medicare Part A and Medicare Part B, since Lyndon Johnson signed it into law.  Then, under Bill Clinton, Medicare introduced the third part of Medicare, Medicare Part C. Initially referred to as Medicare Choice at the time, it later became known as Medicare Advantage.    Lastly, George W. Bush added the final component of Medicare, Medicare Part D, which covers Prescription Drug plans. We are going to jump in and provide some information, I hope it is simple, about the Four Parts of Medicare.  THE FOUR PARTS OF MEDICARE AND WHAT MEDICARE PART A COVERS Colorful Block Poster Showing an Overview of Medicare, and The Four Parts That Make Up Medicare   MEDICARE PART A Covers Hospitalization Costs, Skilled Nursing Care, and Hospice Care. Medicare Part A is basically free to 99% of those enrolled in Medicare. This is what we pay for during our working careers in Medicare and Social Security taxes.     Braden Medicare Insurance 2025 Medicare Part A Benefits Chart MEDICARE PART B Cocentervers Outpatient Services, surgical centers, doctor visits, Lab Work, Diagnostics, Durable Medical Equipment (DME), and Treatments received as an Outpatient in a Hospital or Doctor's Office. Some Prescriptions are also included under Part B, but only those that a physician, RN, or NP must administer. Medicare Part B costs EVERYONE $170.10 per month in 2022. This amount applies regardless of the plan selected; everyone is charged this amount, and many must pay a higher Part B premium if they are considered "High Wage Earners."     THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART B COVERS   Braden Medicare Insurance 2025 Medicare Part B Benefits Chart   THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART C COVERS MEDICARE PART C Originally named Medicare Choice (That Is Where Part C Came From). These are known as Medicare Advantage Plans. Instead of your Medicare being a Government Health Plan, Medicare Advantage plans are offered by private insurers. Medicare Advantage Plans were designed to give Medicare Beneficiaries an alternative to Original Medicare. Medicare Part C and Medicare Part D plans are the same. While these plans are required to cover the same benefits as Original Medicare, they do so in different ways, and ultimately, the decisions are made by the Insurance company. Medicare Advantage plans offer a variety of "Extra" or "Additional" benefits not provided by Medicare. These benefits include Dental, Vision, and hearing coverage; transportation to medical appointments; an OTC subsidy; a credit toward your Part B premiums; and assistance with groceries and utilities. How can they do this? The Government pays Medicare Advantage Insurance companies $12,000 annually for each Medicare beneficiary enrolled in one of their plans. This is also where the money comes from for all their advertising and commercials. Medicare Part C plans all have an MOOP . MOOP stands for Maximum-Annual-Out-Of-Pocket amount. If the plan you like has a $5,000 MOOP, it means you would need to pay $5,000 out of pocket in the form of Copayments and Coinsurance before your plan pays 100% of your Healthcare Costs. Because every Medicare Advantage (MA) plan is based on a Calendar Year, the MOOP resets on January 1st each year. THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART D COVERS MEDICARE PART D Covers Prescription Drugs and Prescription Medications. Typically, you choose the best, lowest-priced Prescription Drug Plan (PDP), which includes a premium and the costs of your medications. You may change these plans annually if your medications have changed during the previous year.

Michael T. Braden August 21, 2024 Medicare 101 Coke or Pepsi? Domino's or Pizza Hut? Miller Lite or Bud Light? Burger King or McDonald's, Popeye's, KFC, or Chick-fil-A ? Everyone has their own preference for what tastes best. And, Medicare Insurance is no different. Aside from "Why Is Medicare Not Free," the second most-asked question from our clients is: "Which Is Better, Medicare Advantage or Medigap/Medicare Supplement plans?" Braden Medicare Insurance Poster with the heading "Medicare Advantage vs Medigap. In all fairness, I believe 100% of Independent Medicare Brokers will tell you that Medicare Supplements paired with Original Medicare offer superior coverage, flexibility, and predictability than any Medicare Advantage plan available. This is because it provides better benefits and access to quality healthcare. Over your lifetime, the combination of Original/Traditional Medicare with a Medicare Supplement Plan N, G, or F will have the lowest exposure to financial risk . But everyone with Medicare has a choice, and it is essential to do your best to make the most out of your decision. Many factors come into play; the first is that Healthcare is Personal. As such, everyone has a different view of what is most important to them and their families regarding healthcare. Do you travel? Do you like being in control of your Healthcare? Do you prefer to see a Primary Care Provider, or would you want referrals to a specialist? How large is your rainy Day Fund? What plans are available in your area? Do you wear glasses or contacts? Have you had any Health Scares? Do you take Prescription Medications, etc? Another key but inexact thing to do is not to think about your health and your healthcare needs at 65, because you will only be 65 for a year. You need to try to project what you think your life and, more importantly, your health will look like over the next 5, 10, and 20 years. I know that is difficult, but look back and reflect on your older family members, remember when they were 65 and then at 75 or 80? Eventually , life and Father Time set in, and we realize we are no longer in our 40s or 50s and are not bulletproof . I know it isn't easy to predict, but you will not be able to thoroughly compare your needs unless you complete this exercise to the best of your ability. In this brief article, we will discuss the key differences between Medicare Advantage Plans and Medigap Plans. For more detailed information, you can find much more information on all things Medicare on our website at www.bradenmedicare.com and on the www.medicare.gov website. How To Compare Medicare Advantage vs. Medigap Plans If you are new to Medicare or want to change your plan, finding one with the right health benefits for you is essential. When deciding which plan to enroll in, your first step should be to choose between Medigap and Medicare Advantage plans. Understanding which plan type best fits your needs is the top priority when enrolling in coverage. And, remember, you only have one chance to enroll in any Medicare Supplement Plan that you desire during your one-time, Initial Enrollment Period (IEP). Many people think they can get by on the cheap for a few years. Still, if you run into a big health situation or health scare, you may not qualify for a Medicare Supplement or Medigap plan down the road, because you will have to pass the Medical Underwriting process. We have seen too many adverse outcomes for good people, so please do your homework and put careful thought into your decisions. If you do that, whatever you choose (Medicare Advantage or Medicare Supplement/Medigap) will be the best plan for you . There are many differences between Medicare Advantage vs. Medicare Supplement plans. It is crucial to research and thoroughly understand how each plan type works before making a decision . You are not alone in your research, and we are here to help you every step of the way. Note: Consider your children and your spouse when making your decision, and involve them as much as possible. Why? The answer is simple: eventually, whether you like it or not, or want to think about it or deny it, there is a high likelihood that they will be the ones in charge of your healthcare. And you may not believe this, but spouses, children, and grandchildren always want the best coverage and care for their parents and grandparents more than most people want for themselves. The Major Differences Between Medicare Advantage Plans and Medigap (Medicare Supplement) Plans While Medicare Supplement plans pay secondary to Original Medicare, Medicare Advantage plans become your primary source of coverage when you enroll. Did you know that Medicare (The US Government) Medicare pays about $1,000 per month to the Medicare Advantage Insurance Companies, simply for taking on the risk of your healthcare? The idea is that this covers your healthcare expenses. In reality, this is where most Medicare Advantage plans get the money to advertise heavily and offer additional benefits not allowed under Original Medicare. When Medicare was established, the idea was to give older Americans access to hospitalization and healthcare in retirement. Eventually, Insurance companies lobbied the House of Representatives and the U.S. Senate to offer "alternatives" to Original Medicare. This was when President Clinton signed Medicare Part C (C stood for Choice at the time) into Law. Later, President George W. Bush signed Medicare Part D into law. As with your taste in food and beverages, mentioned at the start of this article, depending on your lifestyle, budget, and medical coverage needs, one type of Medicare plan will suit you better than another . The Pros & Cons of Medicare Advantage and Medigap/Medicare Supplement Plans There are several differences between Medigap vs. Medicare Advantage plans. A Medicare Advantage plan (Medicare Part C) is structured as an all-in-one  option with low monthly premiums. Medicare Supplement plans offer additional coverage to Original Medicare with low to no out-of-pocket costs. The chart below reviews the pros and cons of Medicare Advantage and Medicare Supplement plans. Braden Medicare Insurance Graphic Slide entitled "The Pros & Cons of Medicare Advantage and Medicare Supplement/Medigap plans. When it comes to Medicare Advantage vs. Medicare Supplements, the most common complaint we hear from our clients is that they cannot accurately predict their out-of-pocket costs when enrolled in a Medicare Advantage plan. They are also shocked that there are so many hoops to jump through , and many times they have been stalled by needing to get 2-4 second opinions before receiving treatment for their condition. They find out the hard way that having a Medicare Advantage Plan is like the Man Behind The Curtain in the Wizard of OZ, because your insurance company sadly has the final say on your coverage and your treatment, you don't, and sadly, neither does your doctor. On the other hand, the biggest compliment we hear from clients is regarding Medicare Supplement plans. Most beneficiaries choose Medicare Supplement plans for their ease and reliability. The option to see any doctor who accepts Original Medicare is the cherry on top of Medicare Supplement plans. Brazden Medicare Insurance is showing an Apple next to a Pear with the heading of Medicare Supplement vs Advantage Which Plan Is Better in the End, a Medicare Advantage Plan or a Medigap Plan (Medicare Supplement)? Medicare does not offer a one-size-fits-all plan. The best policy for you is the one that best meets your healthcare needs. Medicare Supplement plans are the best option if you want complete reassurance and predictability with your healthcare, but are comfortable paying higher premiums in exchange for lower out-of-pocket costs. In contrast, Medicare Advantage plans are the best option if you hope to save on monthly premiums and receive additional benefits while accepting responsibility for additional out-of-pocket costs at the doctor’s office. For overall ease and reliability, our recommendation is always Medicare Supplement plans. However, we know that may not work for everyone. Our goal is to provide you with your best options regardless of plan type.   Wrapping Things Up   Do you want predictable costs, the freedom to choose any doctor, avoid referrals, and peace of mind while traveling? If you answered yes, you are looking for a Medicare Supplement plan. Are you comfortable with unpredictable copayments, strict doctor networks, and referrals in exchange for a lower monthly premium and additional benefits? If your answer is yes, Medicare Advantage may be a good fit for you. The best part of working with agents is that, no matter which option you choose, we ensure it is the best fit for you. Perhaps you are already thinking about making the switch from a Medicare Advantage to a Medicare Supplement plan , or the other way around. If you need further assistance or would like more information beyond what we've provided in this article, please contact me directly at mike@bradenmedicare.com .

Michael T. Braden December 31, 2025 MEDICARE 101 In today's article, we will discuss and explain what pre-existing conditions are covered and accepted by Medicare. Yes, Medicare does cover pre-existing medical conditions. From the moment you enroll, Medicare ensures that you receive the treatment and care you need, regardless of your health. However, certain exceptions and specifics apply depending on the type of Medicare plan you choose. Braden Medicare Insurance's Poster of "MEDICARE & PRE-EXISTING CONDITIONS", Featuring a Red Heart and a Green Checkmark PRE-EXISTING HEALTH CONDITIONS AND MEDICARE When it comes to preexisting health issues, Medicare shines as a beacon of accessibility. Unlike many private health insurance plans, Medicare ensures that most chronic and preexisting medical conditions are covered from the moment you become eligible. This means that as soon as you enroll, you have immediate access to a broad range of medical services without the worry of waiting periods or denial based on your medical history. Original Medicare, which includes Medicare Part A (hospital) and Part B (medical), offers extensive coverage for various medical services and treatments. This is particularly reassuring for Medicare beneficiaries with chronic conditions, as there are no restrictions or waiting periods imposed based on their condition. Medicare Part C, also known as Medicare Advantage plans, plays a crucial role in covering pre-existing medical conditions. These plans, provided by private insurance companies, are required by federal law to offer coverage equivalent to Original Medicare, without waiting periods or exclusions for pre-existing conditions. PRE-EXISTING COVERAGE WITH ORIGINAL/TRADITIONAL MEDICARE Original Medicare consists of Medicare Part A and Medicare Part B. Medicare provides beneficiaries with comprehensive health insurance coverage for hospital and medical services, respectively. From the first day of your eligibility, Medicare ensures that your prior medical conditions are covered, allowing you to receive necessary treatments and care without delay. This is significant relief for those who depend on timely medical services to maintain their health. However, there are a few exceptions, such as services related to an open workers’ compensation or an active automobile insurance claim, which may not be covered. Knowing which exceptions apply helps avoid unexpected out-of-pocket expenses. MEDICARE SUPPLEMENTS AND MEDIGAP PLANS Medigap policies, also known as Medicare supplement plans, are designed to fill the gaps left by Original Medicare. These policies can be particularly beneficial for individuals with preexisting health conditions, as they help cover out-of-pocket expenses such as copayments, coinsurance, and deductibles. However, obtaining Medicare supplement coverage can be more complex for those with preexisting conditions, as medical underwriting is conducted outside the Medigap Open Enrollment Period. WHAT ARE GUARANTEE ISSUE RIGHTS? Guaranteed Issue rights protect Medicare beneficiaries with pre-existing conditions. During specific periods, such as the six-month Open Enrollment window after enrolling in Medicare Part B, Medigap insurers cannot decline your coverage based on your health status. This allows beneficiaries to purchase any available Medigap plan without the fear of rejection due to existing health concerns. To qualify for these rights, you must be eligible and enroll within the designated timeframe to ensure complete protection. Missing this window may affect your ability to access specific Medigap plans without medical underwriting or a waiting period. MEDICARE SUPPLEMENT AND MEDIGAP PLANS CAN INCLUDE WAITING PERIODS While traditional Medicare does not impose restrictions based on preexisting medical conditions, Medigap policies can have different rules. Some Medigap insurers may impose a waiting period of up to 6 months for coverage of pre-existing conditions, especially if you lacked continuous prior healthcare coverage. However, this waiting period can be avoided by enrolling during your Medicare Initial Enrollment Period or by having creditable coverage before enrolling in Medigap. Additionally, beneficiaries under 65 with a disability may face additional barriers when seeking a supplement plan, as federal law does not require insurers to sell Medigap policies to them. Many states have their own laws about under-65 supplement policies, requiring insurers to offer at least one plan during a Guaranteed Issue period. However, availability and plan types vary significantly by state.    MEDICARE PART C (MEDICARE ADVANTAGE PLANS) AND PRE-EXISTING CONDITIONS Medicare Advantage plans must cover preexisting medical conditions and provide necessary healthcare services without delay. However, it is crucial to understand the challenge of switching from a Medicare Advantage plan to Original Medicare. Those with prior health conditions who wish to switch may struggle to obtain a Medigap policy due to medical underwriting. This highlights the importance of selecting the right health insurance coverage initially, as it may be the plan you end up staying with long-term. RESTRICTIONS WITH MEDICARE PLAN NETWORKS Network restrictions are a common feature of many Medicare Advantage plans. These restrictions dictate which healthcare professionals and facilities beneficiaries can use, potentially limiting access to preferred doctors and specialists, especially for individuals with complex health needs. It’s essential to review the network specifications of any plan you consider to ensure it meets your healthcare needs. Because private insurance companies offer these plans, they use preferred networks as a cost-management tool. By keeping expenses manageable, they can include additional plan benefits at no extra cost to the policyholder. ADDITIONAL BENEFITS OFFERED BY MEDICARE ADVANTAGE PLANS Medicare Advantage plans often offer additional benefits beyond standard Medicare coverage, which can be particularly useful for managing pre-existing medical conditions. These extra services can include: Wellness programs (like preventive services and gym memberships), Vision care, Dental care, and Prescription drug coverage. These benefits provide comprehensive support for your health needs and can significantly enhance your overall health and well-being. For individuals with chronic conditions, the supplementary services offered by many Medicare Advantage plans, such as preventive care resources, can be invaluable. These added benefits can help manage health issues more effectively and improve your quality of life, providing more details on how to enhance your overall well-being. MEDICARE PART D AND PRE-EXISTING CONDITIONS MEdicare Part D is the part of Medicare that covers Prescription Medications. For many individuals, prescription drug coverage is a vital component of managing their health, including pre-existing conditions. Medicare Part D ensures that beneficiaries have access to necessary medications. Part D prescription Drug plans provide coverage for prescription medications, including those required for chronic conditions, without imposing higher costs based on health status. This ensures equitable access to medicines for all enrollees. WHAT ARE SPECIAL ENROLLMENT PERIODS FOR PEOPLE WITH PRE-EXISTING CONDITIONS? Special Enrollment Periods (SEPs) are vital for individuals with pre-existing medical issues, enabling changes to Medicare plans following significant life events that occur outside an Open Enrollment Period. Utilizing a Special Enrollment Period will help maintain continuous and comprehensive health coverage after a qualifying event. POSSIBLE CHALLENGES AND SOLUTIONS While Medicare covers pre-existing conditions, beneficiaries may still face challenges in accessing optimal care. Restrictions in Medicare Advantage plan networks can limit access to preferred doctors and specialists, and out-of-pocket costs for frequent or extensive care can increase without supplemental health insurance coverage. Braden Medicare Insurance's Poster Describing Medicare Enrollment Periods, IEP, AEP, OEP, and SEP. For those on traditional Medicare, the optimal timeframe to qualify for a Medigap policy is within the first six months of enrolling in Medicare Part B. This Open Enrollment window ensures beneficiaries are eligible to enroll in Medigap regardless of their health condition. This coverage can help manage costs associated with increased healthcare needs that can result from having a chronic health condition. THE BEST WAY TO COMPARE AND CONTRAST YOUR MEDICARE OPTIONS When evaluating your Medicare healthcare options, consider factors such as Medicare Advantage networks, Medigap policy benefits, the availability of prescription drug plans, and how these components may work together to meet your healthcare needs. It is essential to understand what costs you may be responsible for under each option. It is a fact that Medicare Supplement plans have additional premiums when compared to MA & MAPD plans, but they virtually eliminate any other Out-Of-Pocket expenses you may have, after the annual Medicare Part B Deductible is met. The projected Part B Deductible is just $283 for 2026. Even though Medigap/Medicare Supplement policies often have higher premiums than Advantage plans, they help cover out-of-pocket costs such as copayments, coinsurance, and deductibles, making them a valuable option for those seeking more comprehensive financial protection. It also helps to know what your premium is without having to keep a separate Rainy Day Fund for Health emergencies. Qualifying for Medigap during your Initial Enrollment Period can help you avoid medical underwriting and waiting periods, ensuring immediate coverage for any existing health conditions. The Medicare Annual Enrollment Period starts 3 months before your birth month when you turn 65, and it continues for the 3 months after your birth month. WRAPPING THINGS UP Pre-Existing conditions are a regular part of healthcare; very few people are perfect, with no health maladies or past health issues that might affect them in retirement. This is why I wanted to share and educate Medicare beneficiaries about pre-existing conditions under Medicare. Unlike your current or past Healthcare plans, I honestly believe you will come to view Medicare as I do. Medicare, especially Original Medicare with a Medicare Supplement Policy Plan G, is absolutely the best, most affordable, and most comprehensive health plan you will ever have. Braden Medicare Insurance is a licensed, Independent Medicare Broker and a CMIS (Certified Medicare Insurance Planner. We are based in Arizona and licensed in AZ, CA, CO, IA, IN, FL, MI, NM, NV, OH, OR, PA, TX, and WI. If you have any questions about Medicare or Medicare Pre-Existing conditions, please feel free to reach out to me anytime. My email address is mike@bradenmedicare.com . You can also reach me by phone or text at (480) 225-1393 , at www.bradenmedicare.com . Please remember that I started my business 10 years ago to help and support Medicare Beneficiaries. We have never charged a penny for any of our services, advice, or opinions. We are in the business of teaching and explaining all aspects of Insurance for those 60 and over. We honestly care about our clients, we treat our friends like family, and we speak Medicare fluently.

Michael T. Braden August 21, 2025 Medicare 101 THE QUESTION "HOW TO CHOOSE THE RIGHT MEDICARE PLAN FOR YOU AND YOUR NEEDS" MAY SOUND SIMPLE, BUT IT IS SO TRUE. YOU NEVER WANT TO GET A PLAN BASED ON OTHER PEOPLE'S RECOMMENDATIONS, BECAUSE OTHER PEOPLE AREN'T YOU. Choosing the right Medicare plan can feel overwhelming. With multiple options available, it is essential to understand what each plan offers and how it aligns with your personal health needs and budget. This guide will help you navigate the different Medicare coverage options, clarify common questions about costs, and provide practical tips to make an informed decision. Braden Medicare Insurance Poster: Looking At Medicare Terminology With A Microscope. TO CHOOSE THE RIGHT MEDICARE PLAN, YOU FIRST NEED TO UNDERSTAND ALL OF YOUR OPTIONS WITH MEDICARE Medicare is a federal health insurance program primarily for people aged 65 and older, but it also covers some younger individuals with disabilities. When you become eligible, you have several coverage options to consider: Original Medicare (Part A and Part B): This is the traditional government-run plan. Part A covers hospital stays, skilled nursing, and some home health care. Part B covers doctor visits, outpatient care, and preventive services. Medicare Advantage (Part C): These are private insurance plans approved by Medicare that combine coverage for Part A and Part B. Many also include prescription drug coverage and additional benefits, such as vision, dental, and wellness programs. Medicare Prescription Drug Plans (Part D): These plans provide drug coverage in addition to Original Medicare or certain Medicare Advantage plans. Medicare Supplement Insurance (Medigap): These plans help pay some out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Each option has pros and cons depending on your health needs, budget, and preferences. For example, if you want more predictable costs and extra benefits, a Medicare Advantage plan might be suitable. If you prefer flexibility in choosing providers, Original Medicare with a Medigap plan may be a better option. Braden Medicare Insurance's Medicare Part D Poster, Featuring Medicare Part D Displayed On A Chalkboard TIPS ON DETERMINING AND CHOOSING THE RIGHT PLAN FOR YOU Selecting the right plan requires careful consideration of several factors: Assess Your Health Care Needs: How often do you visit doctors or specialists? Do you need regular prescription medications? Are you managing any chronic conditions? Compare Costs: Look at premiums, deductibles, copayments, and coinsurance. Consider your budget and how much you can afford monthly and annually. Check Provider Networks: If you have a preferred doctor or hospital, verify if they accept the plan. Some Medicare Advantage plans have limited networks. Review Extra Benefits: Some plans offer vision, dental, hearing, or wellness programs. Decide if these extras are important to you. Understand Coverage Rules: Some plans require referrals or prior authorizations. Know the rules to avoid surprises. Use Online Tools and Resources: The official Medicare website and trusted advisors can help you compare plans side by side. By taking these steps, you can narrow down your options and select a plan that balances coverage and cost effectively. Braden Medicare Insurance Poster Featuring A Senior Couple Wondering If They Need Medicare Part D If They Do Not Take Any Medications DOES EVERYONE PAY $187 A MONTH FOR MEDICARE? A common question is whether everyone pays the same monthly premium for Medicare. The answer is no. The standard Part B premium amount can vary based on income and other factors. For example: The base premium for Part B in 2025 is approximately $187.00 per month. Higher-income beneficiaries may pay more based on their modified adjusted gross income. Some people qualify for assistance programs that reduce or eliminate premiums. Additionally, Part A is usually premium-free if you or your spouse paid Medicare taxes while working. However, if you do not qualify for premium-free Part A, you may have to pay a monthly premium. Understanding these details helps you budget accurately and avoid unexpected costs. It is also essential to review your plan annually during the Medicare Open Enrollment Period to ensure your coverage and costs still meet your needs. Braden Medicare Insurance 2025 Medicare Monthly Cost Estimate Worksheet, Using This Worksheet Helps Medicare Beneficiaries Budget And Understand Their Monthly Expenditures For Healthcare ADVICE WHEN IT COMES TO CHANGING, SWITCHING, AND ENROLLING IN A MEDICARE PLAN Enrolling in Medicare or switching plans can be confusing, but following these tips can simplify the process: Sign up on time: The Initial Enrollment Period starts three months before you turn 65 and lasts seven months. Missing this window can lead to penalties. Review your plan annually: During the Open Enrollment Period (October 15 - December 7), you can change plans if your needs or plan options change. Seek professional advice: Licensed Medicare counselors or agents can provide personalized guidance. Keep track of deadlines: Late enrollment can result in higher premiums or gaps in coverage. Understand your rights: You can appeal decisions or file complaints if you experience issues with your plan. By staying informed and proactive, you can maintain coverage that aligns with your evolving health and financial needs. HOW YOU CAN GET THE MOST FROM YOUR PREFERRED MEDICARE PLAN Once you have chosen a plan, maximize its benefits by: Using preventive services: Medicare covers many screenings and vaccines at no cost. Managing prescriptions wisely: Use preferred pharmacies and generic drugs when possible. Keeping records: Track your medical expenses and claims to avoid billing errors. Communicating with providers: Ensure they accept your plan and understand the coverage it provides. Staying informed: Medicare rules and plans can change, so keep up to date. Taking these steps helps you get the best value and care from your Medicare coverage. Choosing the right Medicare plan is a critical decision that impacts your health and finances. By understanding the different Medicare coverage options, costs, and enrollment rules, you can confidently select a plan tailored to your needs. For more detailed information and personalized assistance, visit medicare .

Michael T. Braden December 20, 2025 MEDICARE 101 WHAT YOU NEED TO KNOW ABOUT MEDICARE IN 2026 WHAT WILL MEDICARE COST IN 2026 (CMS), The Centers for Medicare & Medicaid Services recently released its cost estimates for Medicare in the 2026 Plan Year. This article provides a brief recap of key information everyone needs to know about Medicare for 2026. Understanding the wonderful, wacky world of Medicare can often feel overwhelming, especially when the costs change each year. Understanding these adjustments is essential for budgeting and ensuring appropriate coverage for your healthcare needs. WHAT WILL MEDICARE COST IN 2026 WHAT COSTS ARE COVERED BY MEDICARE When we talk about “Medicare costs,” we are generally referring to a few different types of payments you might make: Premium: A fixed amount you pay each month for your coverage (like Medicare Part B). Deductible: The amount you must pay for healthcare services before Medicare begins to pay its share. Coinsurance: The percentage of the cost you pay for a service after you have met your deductible. Copayment: A fixed dollar amount you pay for a service (familiar with Medicare Advantage and Part D plans). MEDICARE PART A COSTS IN 2026 Medicare Part A , which covers inpatient hospital stays, skilled nursing facility care, and hospice care, is often referred to as “premium-free.” Most people do not pay a monthly premium for Part A. This is true if you or your spouse paid Medicare taxes for at least 10 years (or 40 quarters) while working. However, Part A does have costs related to its services: Inpatient Hospital Deductible: In 2026, the Part A deductible for each hospital benefit period is $1,736. This is an increase of $60 from $1,676 in 2025. You must pay this amount when admitted to the hospital. Hospital Coinsurance: After your deductible is met, you pay $0 for the first 60 days. Days 61-90: $434 per day Lifetime Reserve Days (Days 91+): $868 per day Skilled Nursing Facility Coinsurance: For days 21-100 of care, your cost will be $217.00 per day. MEDICARE PART B COSTS IN 2026 Medicare Part B covers doctor visits, outpatient services, preventive care, and durable medical equipment. These are the costs that most beneficiaries will see in their monthly budget. Standard Monthly Premium: The 2026 standard Part B premium is $202.90 per month. This is a significant increase from the $185.00 monthly premium in 2025. Annual Deductible: The 2026 annual Part B deductible increased from $257 to $283. This is the amount you must pay for outpatient services before Part B begins to pay. Coinsurance: After you meet the $283 deductible, you are typically responsible for 20% of the Medicare-approved amount for most services. This 20% has no annual limit. MEDICARE SUPPLEMENT COSTS FOR 2026 Those potential Part A and Part B costs—like the $1,736 hospital deductible and the unlimited 20% Part B coinsurance—are why many people choose a Medicare Supplement  (Medigap) plan. Medigap plans are sold by private insurance companies and are designed specifically to “fill in the gaps” left by Original Medicare. You pay a separate monthly premium for your Medigap plan. In return, the plan covers many or all of your out-of-pocket costs. For example, popular plans like Medigap Plan G  will pay for your Part A deductible, your Part A coinsurance, and—most importantly—your 20% Part B coinsurance. By paying a predictable monthly premium for a Medigap plan, you protect yourself from large, unexpected medical bills. This makes budgeting for healthcare much simpler and provides invaluable peace of mind. MEDICARE ADVANTAGE, AKA MEDICARE PART C Everyone should understand all of their options. Medicare Part C (Medicare Advantage): These plans are an alternative to Original Medicare, offered by private companies. You must still pay your Part B premium. These plans bundle Part A, Part B, and often Part D (prescription drug coverage) into one plan. These are also referred to as "All-In-One plans". They have their own cost structures with copayments and networks. For 2026, the average monthly premium for these plans is projected to decrease slightly. The maximum out-of-pocket limit for Part C plans in 2026 will be $9,250. Medicare Part D (Prescription Drug Coverage): This is your standalone coverage for prescription drugs. These plans are also sold by private insurers, and the premiums vary from State to State and County to County. CAN YOUR INCOME AFFECT WHAT YOU PAY FOR MEDICARE? Your monthly Medicare premiums may be higher based on your income. This is referred to as the Income-Related Monthly Adjustment Amount  (IRMAA). This surcharge applies to individuals and couples with higher earnings. For 2026, IRMAA is based on your Modified Adjusted Gross Income (MAGI) from your 2024 tax return. The adjustment starts for individuals with a 2024 MAGI over $109,000 and for couples filing jointly with a 2024 MAGI over $218,000. If your income falls into this range, the Social Security Administration will add a surcharge to both your Part B and Part D premiums. For example, an individual with a 2024 MAGI between $109,001 and $137,000 will pay an extra $81.20 per month for Part B, for a total monthly premium of $284.10. DO MEDICARE PREMIUMS AND DEDUCTIBLES CHANGE EVERY YEAR? If you are new to Medicare, you might be wondering if these costs increase every year. The federal government sets the premiums and deductibles for Medicare Part A and Part B. They are adjusted annually based on several factors, including: Overall Healthcare Costs: The rising prices of medical services, treatments, and technologies. Program Spending: The adjustments must cover the projected costs for all Medicare beneficiaries in the coming year. Drug Costs: CMS has noted that rising spending on physician-administered drugs is a key driver of Part B premium increases. IDEAS TO MINIMIZE YOUR OUT-OF-POCKET COSTS Seeing these 2026 cost increases can be concerning, but you have options to manage them. Review Your Coverage Annually: The Annual Enrollment Period (AEP) each fall is the perfect time to review your Part D or Medicare Advantage plan to ensure it still meets your needs and budget. Enroll in a Medigap Plan: If you have Original Medicare, the most effective way to manage unpredictable costs is to enroll in a Medicare Supplement (Medigap) plan. By covering the Part A deductible and the 20% Part B coinsurance, a Medigap plan provides a powerful buffer against rising healthcare expenses. Check for Assistance Programs: You may be eligible for a Medicare Savings Program  (MSP) or Extra Help, which can assist with paying premiums, deductibles, and prescription drug costs. Understanding these new 2026 costs is the first step. The next step is to ensure your coverage provides the financial security you deserve. If you are worried about the $1,736 hospital deductible or the uncapped 20% coinsurance on Part B, a Medicare Supplement plan can help. WRAPPING THINGS UP Each year in the Fall, just before the Medicare Annual Enrollment Period begins, we begin to hear projections of any cost increases or primary rule or regulatory changes for the upcoming Medicare Calendar Year/Plan Year. These changes are never "Official" until CMS (The Centers for Medicare & Medicaid Services) releases the information. While it is true that every time the COLA ( C ost O f L iving A djustment) increases for Social Security, Medicare Increases eat up most of the increase. While Medicare costs rise more than they decrease from year to year, these increases are very slight and manageable compared with those we are used to seeing in the under-65 Health Market. If you have a Medicare question that you cannot find an answer to, please feel free to email Michael directly at mike@bradenmedicare.com . Michael Braden's Business Card

Michael T. Braden December 11, 2025 MEDICARE ENROLLMENT Enrolling in Medicare is a pivotal step, heralding a secure and healthy retirement. However, navigating the path to the right coverage can be challenging, with intricate rules, complex choices, and costly pitfalls. Braden Medicare Insurance's Top Ten Medicare Mistakes Poster UNDERSTANDING AND AVOIDING THE TOP 10 MEDICARE MISTAKES FOR NEW ENROLLEES Selecting your Medicare coverage is a crucial financial and health decision. By recognizing common errors, you can confidently navigate the process and choose a plan that safeguards both your health and finances. WHY MANY NEW MEDICARE BENEFICIARIES MAKE INCORRECT INITIAL DECISIONS If Medicare feels overwhelming, you're not alone. The system combines government-run programs (Parts A and B) with private insurance options (Part D, Medicare Advantage, and Medigap). With various enrollment windows, cost structures, and rules, it's easy to make a costly mistake that could limit your access to care when you need it most. #1 MISSING CRUCIAL ENROLLMENT DEADLINES This is perhaps the most critical error. Your Initial Enrollment Period (IEP) is your prime opportunity to enroll. Missing it without qualifying for a Special Enrollment Period (such as having employer coverage) may result in lifelong late enrollment penalties. The Part B penalty, for example, permanently increases your monthly premium. In 2023, nearly 800,000 Medicare beneficiaries paid this penalty, with an average premium increase of 28 percent. Missing your Part D enrollment can also lead to a permanent penalty. Understanding these dates is crucial. Learn more in our guide, Your Guide to Medicare Enrollment Periods: When to Sign Up. #2 FOCUSING ONLY ON THE MONTHLY PREMIUM Choosing a plan with a $0 or very low monthly premium is tempting. Many Medicare Advantage plans offer this feature. However, a low premium often results in higher out-of-pocket costs when utilizing your benefits. A plan with a higher premium, such as a Medicare Supplement plan, may save you thousands in the long run by covering deductibles and coinsurance. The actual cost of a plan is not its premium but what you'll pay annually, including all medical care. #3 NOT UNDERSTANDING ORIGINAL MEDICARE COVERAGE LIMITATIONS Original Medicare (Parts A and B) provides a solid foundation but was never intended to cover 100 percent of medical expenses. It leaves significant “gaps” for which you're responsible. The most notable gap is the 20 percent coinsurance on Part B services, which has no annual cap. A serious illness or surgery could leave you with thousands of dollars in bills. As detailed in our article What Medicare Doesn’t Cover: Common Surprises, these gaps are precisely why Medicare Supplement (Medigap) plans exist: to fill those gaps and provide predictable costs. #4 IGNORING ENROLLMENT IN A MEDICARE PART D PRESCRIPTION DRUG PLAN Even if you currently take a few prescriptions, don't skip enrolling in a Part D drug plan when first eligible. As mentioned, failing to enroll may result in a permanent late-enrollment penalty if you enroll later. Additionally, a sudden health issue could leave you facing the full, high cost of necessary medications without coverage. #5 NOT COMPARING MEDICARE SUPPLEMENT PLANS TO MEDICARE ADVANTAGE PLANS FAIRLY These two options function differently. A Medicare Advantage (Part C) plan is an alternative to Original Medicare, while a Medigap (Medicare Supplement) plan complements it. Each has unique cost structures, rules, and benefits. For a detailed comparison, call us or visit our Blog Archives on comparing Medicare Advantage Plans With A Medicare Supplement plan. Choosing one without understanding the differences often leads to Buyer's Remorse and can cause a chain reaction that too many people never recover from. #6 NOT VERIFYING IF YOUR PREFERRED DOCTORS & HOSPITALS ARE IN YOUR PLAN'S NETWORK This mistake mainly applies to Medicare Advantage plans, which typically have restrictive HMO or PPO networks. Your preferred doctor or hospital may not be in the network, or you may need a referral to see a specialist. This is where Medicare Supplement plans offer superior value. With a Medigap plan, you can see any doctor or visit any hospital in the United States that accepts Medicare. #7 NEGLECTING TO RE-EVALUATE YOUR COVERAGE ANNUALLY This is crucial for anyone in a Medicare Advantage or Part D plan. These plans can change their benefits, provider networks, and drug formularies (the list of covered drugs) every year. A strategy that fits perfectly this year might be unsuitable next year. Medicare Supplement plans, in contrast, are standardized. Their benefits remain consistent year after year, providing a stable, predictable coverage experience. #8 MISUNDERSTANDING MEDICARE UNDERWRITING RULES FROM THE START While Medigap plans offer significant flexibility, there is a critical enrollment rule. When first eligible (during your 6-month Medigap Open Enrollment Period), you have “guaranteed-issue rights.” This means an insurance company cannot use your health history to deny you a policy or charge you more. If you wait to buy a Medigap plan later, you will likely face medical underwriting and may be denied coverage for pre-existing conditions. #9 COVERAGE WHEN TRAVELING OUTSIDE YOUR COUNTY If you love to travel or reside in two different states during the year (a “snowbird”), your plan’s network is crucial. Most Medicare Advantage plans have regional networks, limiting coverage to emergency care when out of state. Medicare Supplement plans travel with you. Since they work with any provider that accepts Medicare nationwide, your coverage is just as adequate in California as in Minnesota. #10 ATTEMPTING TO NAVIGATE EVERYTHING ALONE Medicare is complex, but you don't have to master it overnight. Trying to research all options independently can lead to frustration and poor coverage decisions. The best approach is to seek help from a knowledgeable, independent resource. A licensed, independent Medicare Broker is the way to go; they can explain the pros and cons of each option tailored to your specific situation, budget, and health needs. They can help you avoid common mistakes and develop a plan that provides real peace of mind. WRAPPING THINGS UP In reflecting on what I have learned as an Independent Medicare Broker and Certified Medicare Planner, I have found Medicare confusing. No one warns us or trains us on what Medicare is, what Medicare provides, and what things are not covered by Medicare. And, regardless of how smart or successful you are, it is virtually impossible to know everything about Medicare that you need to know on your own. So what do you do? You can foolishly attend a bunch of seminars, listen to your hairdresser and what her Sister in Illinois told her, or you can reach out to a local, Independent, Licensed Medicare Broker in your area. They will never charge you a dime for their services or expertise. If you are not confident in knowing how to interview a broker, please feel free to call or email me anytime. I would be honored to help you. Michael Braden's Business Card

Michael T. Braden December 28, 2025 SOCIAL SECURITY NEWS Understanding what your Full Retirement Age is for Social Security is a key part of your financial goals in retirement. The Social Security full retirement age varies for everyone. And, your Social Security benefits can be affected. In this article, we hope to share information that we think could affect every Medicare beneficiary, and specifically their Social Security benefits in retirement. Photo of Braden Medicare Insurance' WHAT IS THE FULL RETIREMENT AGE FOR SOCIAL SECURITY Poster. If you will rely heavily on your Social Security income in retirement, it is important to know your full retirement age and how to make the most of your Social Security benefits. We know there are many questions about your Social Security retirement age, retirement income, and Medicare benefits. Your Social Security full retirement age will vary based on the year you were born, even though your Medicare information remains the same. FULL RETIREMENT AGE (FRA) FOR SSI BENEFITS Full retirement age is the age at which you become eligible to receive your full Social Security benefit amount each month. Your full retirement age is dependent on the year you were born, so not everyone will be able to retire at the same age. Because Americans are living longer and collecting more during retirement, the full retirement age has risen over the years. Previously set at 65, the full Social Security retirement age is scheduled to increase incrementally over 22 years. We understand this can be confusing, so we’ve created our full retirement age chart. Here, you can better understand where you fall with your birth year in relation to your full retirement age. If you retire at your full retirement age, you will receive all of the Social Security benefits you are entitled to. You can decide to retire early and take your benefits before your full retirement age. However, you can face an up to 30% reduction in monetary benefits by doing so. You also have the right to delay your retirement in order to increase the amount you will receive. Each year you delay retirement until you are 70 years old will increase the amount you are entitled to. YOUR FULL RETIREMENT AGE IF YOU WERE BORN IN 1955 If you were born in 1955, your full retirement age for Social Security is 66 years and two months. At this time, you can begin receiving Social Security benefits at your full amount. Remember, you can claim your benefits as early as age 62, but by doing so, you’ll forfeit a portion of your income in the process. If you decide to enroll in benefits at 62, you’ll only receive 74.2% of your entitled income. You can receive 92.2% of your monthly benefits by retiring at 65. YOUR FULL RETIREMENT AGE IF YOU WERE BORN IN 1956 66 years and four months is the full retirement age for someone born in 1956. Although this is the full retirement age to receive 100% of your benefits, retiring at 62 will entitle you to 73.3% of your monthly benefit amount. Retiring at 65 gets you a 91.1% monthly benefit. YOUR FULL RETIREMENT AGE IF YOU WERE BORN IN 1957 Individuals born in 1957 will meet their full retirement age requirement at 66 years and six months. If you were born in 1957, you’d receive 100% of your Social Security benefits at this time, should you retire. For those retiring at 62, you’ll receive 72.5% of your monthly benefit, and at age 65, you’re entitled to 90% of the monthly benefit amount. YOUR FULL RETIREMENT AGE IF YOU WERE BORN IN 1958 If you were born in 1958, your full Social Security retirement age is 66 years and eight months. If you wish to retire early, you can permanently retire at age 62, but you’ll only receive 71.7% of your monthly entitlement. If you decide to retire at 65, you’ll receive 88.9% of your monthly benefit amount. YOUR FULL RETIREMENT AGE IF YOU WERE BORN IN 1959 If your birth year is 1959, you reach full retirement at 66 years and ten months. Early retirement at age 62 will allow you to receive 70.8% of your monthly benefit, and at age 65, you’ll receive 87.8% of your Social Security benefits. FULL RETIREMENT AGE FOR THOSE BORN IN 1960 AND LATER Anyone born in 1960 or later will have a full retirement age of 67. If you were born in 1960 specifically, you can retire at age 62 and receive 70% of your Social Security benefits. If you wish to retire at 65 years of age, you will be subject to receive 86.7% of your monthly benefits. WHAT IS THE AVERAGE FULL RETIREMENT AGE FOR SOCIAL SECURITY? Did you know that, as of 2022, the average retirement age in the United States is 61? However, this is an interesting trend, as the earliest you can receive Social Security benefits is at age 62. While you may not be eligible for Social Security at 61, many employees have pension plans or retirement accounts through their employers that offer a solid financial backing for an early retirement. Everyone has a different financial outlook, and making decisions about your financial future should be done with a professional. But if you do retire before you are eligible for Social Security benefits, it’s important to plan accordingly. Photo of Braden Medicare Insurance's "Understanding Your Social Security Full Retirement Age and Making Informed Decisions" WILL YOUR SOCIAL SECURITY BENEFITS INCREASE IF YOU WORK UNTIL YOUR FULL RETIREMENT AGE? It is possible to increase the amount you receive through Social Security. Your Social Security benefits may increase if you continue working after full retirement age, but it is not guaranteed. Social Security amounts are calculated using your 35 highest earned working years. In order for your benefits to grow, you’ll have to earn enough money that is higher than the highest 35 working years you have on record. This could increase your average income, thus increasing your benefits. We want to inform you that by continuing to work after full retirement age, you can also increase your Social Security income by extending the receipt of benefits until you turn 70. Once you turn 70, you will max out the amount you can receive for Social Security. WHAT MAKES THE RETIREMENT AGE RISE? Back in 1983, the Social Security program was having financial issues. Because of this, the idea of raising the retirement age came about to help sustain the program. H.R.1900 – Social Security Amendments of 1983 legislation would pass, and the Social Security Administration would maintain the program accordingly, where it still provides retirement benefits to eligible Americans today. By raising the retirement age, the result was that more individuals contributed to the program for a longer period, allowing the Social Security Administration to increase its pool and pay out more benefits in the future. CAN YOU STILL ENROLL IN MEDICARE IF YOU TAKE EALY SOCIAL SECURITY BENEFITS? Medicare eligibility does not correlate with your retirement age. This means you can receive Medicare at age 65 regardless of your retirement status. There are instances in which you may be able to qualify for Medicare before turning the age of 65 if you are disabled, but if you are simply retiring before this time, it will not make you eligible for Medicare benefits. Although you can’t enroll early, you also don’t want to sign up for your Medicare benefits late. Doing so can cause you to pay more upfront for Original Medicare benefits due to late penalties. Late enrollment could also trigger you to not enroll in a qualified Medicare Part D Prescription Drug plan in a timely manner. Coverage will also incur a lifetime penalty that will never end. Additionally, any Medigap coverage you wish to enroll in may require medical underwriting to obtain if you wait to enroll. So, while retiring early doesn’t affect your ability to obtain Medicare benefits, it’s still important to plan and to avoid signing up later than your 65th birthday whenever possible. FULL RETIREMENT AGE FOR MEDICARE IS AGE 65 You can receive full Original Medicare (Medicare Part A and Part B) benefits when you turn 65 years old. While you can receive early retirement Social Security benefits at 62, you’ll still need to wait for Medicare benefits, provided you are not disabled. The same applies to enrolling in other Medicare benefits, including Medicare Supplement (Medigap) plans, Medicare Advantage (Medicare Part C), and Medicare Part D coverage. To receive any of these benefits, you must be at least 65 years old under normal circumstances. Remember, your full retirement age depends on your birth year, and you become eligible for Medicare when you turn 65. The two are not connected. Note: In most states, if you qualify for Medicare early, you are only permitted to enroll in a Medicare Advantage plan until you turn 65. Then, once you turn 65, you can enroll in the Medicare plan of your choice. MEDICARE'S IEP (INITIAL ENROLLMENT PERIOD) FOR FRA (FULL RETIREMENT AGE) Picture of Braden Medicare Insurance's Medicare Initial Enrollment Period (IEP) Poster. For most, your eligibility for Medicare benefits begins three months before your 65th birthday and lasts for three months after you turn 65. This is known as your Initial Enrollment Period. This includes eligibility for Original Medicare, Medicare Supplement, Medicare Advantage, and Medicare Part D benefits. Some may refer to this as the full Medicare retirement age, but that’s inaccurate and misleading. This is because, while both are essential benefits later in life, the retirement age affects Social Security benefits, not Medicare benefits. Therefore, regardless of your retirement status, you can receive Medicare benefits as long as you qualify and are 65 years or older. WRAPPING THINGS UP Preparing for your retirement means looking at multiple areas of your life. It’s an important and deserving milestone, but every decision you make matters. However, you can create a game plan that works for your lifestyle by planning ahead. To help get you started, here are some essential points to remember when planning: Start saving money and set financial goals Pay off as much debt as possible Contribute to your employer’s retirement savings program, Understand your employer’s pension plan Explore your Social Security benefits and the age at which you wish to retire Calculate your retirement expenses In addition to your finances, you’ll also want to prepare for your healthcare after retirement. Many Medicare benefits are available for those turning 65, and by taking the proper steps, you can enroll in the coverage you deserve while keeping costs low. Even if you already have Medicare benefits, reviewing your coverage from time to time is a great idea, and ensuring that you’re enrolled with the right benefits for your lifestyle. If you have any questions or just want a friendly Medicare expert to talk with, please feel free to contact us at anytime. 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Michael T. Braden, August 27, 2024 MEDICARE ADVANTAGE Introduction To Medicare Advantage Plans, aka Medicare Part C Medicare Advantage plans are not Medicare.  They are Medicare-inspired, Healthcare plans offered by private insurance companies.  These companies determine which procedures they will cover. There are limited networks, with annual Out-of-Pocket Expenses (MOOP) between $5,700 and $12,000 .  A Medicare Advantage Plan is a private health insurance plan approved by Medicare.  You have the option to receive your Part A, Part B, and Part D benefits from a Medicare Advantage Plan instead of Original Medicare.  Initially , these private insurance company offerings were referred to simply as Medicare Part C.Medicare Advantage plans typically have an HMO or PPO network of physicians and hospitals. All Medicare Advantage Plans are 80/20 plans, in which the insurance company pays 80% of covered charges, and you are responsible for paying your 20% share as you go. Each year, during the fall Annual Enrollment Period, you will need to choose a new plan for the coming year.  MA and MA/PD (Medicare Advantage Plans) were created as alternatives to Original Medicare and Medicare Supplement /Medigap insurance.  By joining one of these plans, you direct Medicare to pay the Advantage Plan a set monthly amount for your care.  In return, the plan will deliver all of your Part A & Part B benefits and services.  Essentially, your care and services are managed by a private insurance company instead of the government.  The Insurance carrier assumes all risk. Unfortunately, each insurance company sets its own rules, and it has the final say on which procedures are covered and which are not. You must continue to pay your Medicare Part B premium each month ; you must be enrolled in Medicare Part A and Part B; and you must live in the Medicare Advantage Plan's service area. Medicare Advantage plans are  NOT Medigap plans.  They work differently because your insurance company pays all of your bills instead of Medicare, which means they also decide what they will and will not cover. There are several significant advantages to choosing a Medicare Advantage plan.  First , most of their plans offer $0 monthly premiums. The majority of Medicare Advantage plans also include Prescription Drug coverage.  There are many other benefits, including Dental, Vision, and Hearing benefits, Over-The-Counter (OTC) Benefits, Transportation, and more.   At Braden Medicare, we are contracted with leading Medicare companies that offer Medicare Advantage plans in Arizona. It is essential to mention that we do not offer every plan available in every county in the United States. Any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

Michael T. Braden, August 27, 2024 FOUR PARTS OF MEDICARE The ABC Of Medicare Is A Brief Re-Cap OF The Basics Of Medicare THE ABC's OF MEDICARE   MEDICARE PART A   Pays for hospital stays, skilled nursing care, blood products, and hospice care. About 99% of people enrolled in Medicare Part A will never have to pay a premium for Medicare Part A coverage because of the Medicare Taxes they paid through payroll deductions throughout their working careers. The Medicare Deductible for Medicare Part A is $1,632.   MEDICARE PART B   Covers outpatient services such as preventive care, physician visits, laboratory tests, diagnostic imaging, outpatient surgery, durable medical equipment, chemotherapy, radiation therapy, Drug Injections for various conditions , and more. Everyone who enrolls in Medicare Part B must pay their monthly Medicare Part B Premium and their Annual Part B Deductible, regardless of whether they participate in Original Medicare, a Medicare Advantage Plan, or even if they choose Original Medicare with a Medicare Supplement policy. Your Medicare Part B premium can be paid by Credit Card, Direct Bill, EFT Transfers, or can be paid from your monthly Social Security Benefits. For 2024 , the monthly Medicare Part B premium is $174.70, and the Annual Part B deductible is $240. This means you must meet the annual Deductible before Medicare begins to pay. Both Medicare Part A and Medicare Part B are 80% government-paid, with the remaining 20% borne by the beneficiary or patient . With Original Medicare, you are free to choose a Doctor or Hospital that accepts Medicare Terms for payment. (Approximately 94% of all Doctors accept Medicare.   MEDICARE PART C  Medicare Part C is commonly referred to as Medicare Advantage (MA) . Medicare Advantage plans are offered and managed by private, for-profit insurance companies instead of the Government. Instead of being responsible for paying 20% of all services, your insurance company will have specific Copayments and Coinsurance that you must pay for services throughout the year. M/A plans are either HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) networks . With these plans , you must use the Doctors and Hospitals listed in their network to receive full coverage for any procedure.   The company decides which services they will pay for , and, in fact, they are well known for denying claims and coverage; they do not disclose this in their TV commercials or in marketing flyers, postcards, or brochures . Medicare Advantage plans each have their own MOOP.  MOOP stands for Maximum-Out-Of-Pocket Expense. This is the amount you must reach before your insurance company pays for all of your healthcare services.     MEDICARE PART D   Covers Prescription Drugs. Because there is no prescription drug coverage with Original Medicare (except for those drugs and medications that are provided during a hospital stay).   On October 8, 2003, President George W. Bush signed Medicare Prescription Drug coverage into law. Medicare Part D  covers retail prescription drugs for Medicare beneficiaries through unique, stand-alone drug insurance plans.  You pay a monthly premium to join any Medicare Part D Prescription Drug plan available in your area that fits your needs the best. Choose the Plan that saves you the most money on your prescription medications. These plans range from $0.00 - $169 per month. We strongly believe that it is best to work with an experienced Medicare Broker, such as Braden Medicare Insurance, to find the best plan at the lowest cost for your individual needs. Each Insurance Company offering Medicare Part D Prescription Drug Plans must have at least 1 Plan that provides the Senior Savings Model, which caps the monthly maximum you can spend on Insulin at $35.00.  You should review your plan annually , and you may change your plan during the Medicare Annual Enrollment Period (AEP) in the fall. The new plan will begin on January 1st every year.

Michael T. Braden, August 27, 2024 ENROLLING IN MEDICARE HOW TO ENROLL IN MEDICARE Did you know that the first question anyone asks us at Braden Medicare Insurance is, "When do I sign up for Medicare?" For individuals approaching age 65 and those who have delayed Medicare Part B enrollment, this article is for you.  Enrollment is automatic if you get Social Security. Otherwise, you need to apply for Medicare. One of the interesting aspects of enrolling in Medicare is the fact that you apply for Medicare benefits through the Social Security Administration.  The SSA processes each Medicare enrollment application because it has access to all of your personal information, and it is more efficient for them to vet each prospective Medicare beneficiary first.   Once your application is approved, you will receive a letter confirming your enrollment and that your Medicare Card will arrive by mail within the next two weeks.  Once your Medicare card has been issued, the majority of your contact concerning Medicare will be handled by Medicare.  You will want to set up your own free Medicare Account on the Medicare website at  www.medicare.gov .   Here, you can list your medications and choose to receive information from Medicare. It is also important to remind everyone that, contrary to some long-held beliefs, Medicare is not entirely free.  For 99% of applicants, there is no cost for Medicare Part A, but everyone must pay for Medicare Part B coverage each month.   Whether you choose a Medicare Advantage plan or Original Medicare, everyone is responsible for paying the 2024 Medicare Part B monthly premium. You can apply for Medicare directly through the SSA website at www.ssa.gov —Medicare by $174.70.  A QUICK REVIEW OF THE FOUR PARTS THAT MAKE UP MEDICARE FROM BRADEN MEDICARE INSURANCE Medicare Basics Poster: The Four Parts of Medicare. Highlights Everything That Is Covered Under Medicare Medicare is the only National Insurance Program for Americans age 65 and older.  Medicare consists of Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.  Below is a brief synopsis of what each part of Medicare does and does not do for you. MEDICARE PART A The first part of Medicare is Medicare Part A. Put simply, Medicare Part A is what we receive for all the years we have had Medicare and Social Security taxes deducted from our payroll checks during our working careers. Some people who have not worked or have not accumulated 40 Quarters of work eligibility (10 Years of Medicare contributions) can easily qualify for their Part A benefits through their spouse's earnings . Medicare Part A covers inpatient hospitalization.  Part A covers all costs when you are admitted to the Hospital as an inpatient. Occasionally, doctors may admit someone to the hospital for "Observation", which is not the same as being officially accepted as an In-Patient.  Medicare Part A covers hospital room and Board, Meals, Medications, Surgery, and Anesthesia. Most typically, this includes a semi-private room.  If you have Original Medicare , you can choose to go to any Hospital for care, and if you are on a Medicare Advantage plan, you will need to go to a hospital facility in your plan's network.  If you go to a Hospital outside of your Medicare Advantage plan's network, you will pay full price for all charges during your stay. There is a $1,604 Deductible for Part A, and most people will have that amount covered if they choose Original Medicare with a Medicare Supplement (Medigap) plan.  Those selecting a Medicare Advantage plan will pay a daily Hospital Coinsurance amount that varies by plan.  On average, this rate is between $295 - $395 per day for days 1-7 of any hospital stay. MEDICARE PART B Medicare Part B covers almost everything outside a Hospital.  These items are Doctor Office Visits, Imaging (X-rays, MRIs, CT Scans, etc., Blood Work, Lab Work, Preventative tests and procedures, all surgery and procedures in a Doctor's office or at an Out-Patient Surgical Center, and Durable Medical Equipment, Crutches, Walkers, Wheelchairs, Oxygen, CPAP Machines, etc. Some Injections are also covered under Medicare Part B, but most vaccines are covered under Medicare Part D. MEDICARE PART C Medicare Part C refers to Medicare Advantage.  If you choose to receive Medicare Benefits through a Medicare Advantage Plan, you have chosen Medicare Part C (Originally called Medicare Choice, hence Medicare Part C).  If you choose Medicare Part C, all of your Healthcare is managed by your Insurance plan, typically through your Primary Care Provider (PCP). With Medicare Part C, you will choose either a Medicare Advantage HMO plan or a PPO plan.  The most significant difference is that HMO plans typically include Prescription Drug coverage (Medicare Part D), while most PPO plans do not.  PPO plans are generally considered more flexible, allowing you to see any in-network doctor without the need for or hassle of obtaining a referral from your Primary Care Provider.  Most HMO plans have a $0 monthly premium, while PPO plans typically have low monthly premiums but are rarely premium-free. With Medicare Advantage plans (Medicare Part C), you will have Co-Insurance and Co-Pays for pretty much everything until you reach your plan's MOOP Threshold.  What in the heck is a MOOP?  Good question. MOOP stands for Maximum Out-of-Pocket Expense. Meaning that you will pay your Co-Insurance and Co-Pays until you reach your annual MOOP, which varies by plan.  It is also important to note that everyone will have two MOOP amounts : one for In-Network and one for Out-Of-Network. As a guideline, the lowest-cost In-Network MOOP is approximately $2,800 per year; the national average is closer to $5,000, with a maximum of $9,600.   Once you meet your MOOP, your plan will cover the remainder of the calendar year's costs, excluding your 20% Co-Insurance for Cancer Treatments (Chemotherapy and Radiation).   MEDICARE SUPPLEMENT/MEDIGAP PLANS Original Medicare (Medicare Part A and Medicare Part B) is offered and managed by the government.  With Original Medicare, the government pays 80% of your Healthcare Costs under Medicare Part A and Part B , and you are responsible for the remaining 20%, which is where Medigap or Medicare Supplements, as they are referred to, come in.  These plans (depending on which one you choose, 90% of people choose either Plan G or Plan N). This combination is the most comprehensive Healthcare Plan available. You can go to any Hospital and see any Doctor in the United States, and the Supplement will pay the Medicare Part A deductible for you. Adding a Medicare Plan G will cost most 65-year-olds about $130 to $165 per month.  But, outside of the annual Part B deductible of $280, all of your Hospital and Outpatient costs will be $0.  Plan N has a few restrictions and costs $30 less per month. Medigap and Medicare Supplement plans are the same; it just depends on how you refer to them.   These plans are standardized, meaning that every Plan N is the same nationwide, and every Plan G is identical across all 50 states.  The only difference is the cost of each plan where you live. Many people are drawn to the glitter and glamor of the Free, Extra, and/or Additional benefits that Medicare Advantage plans offer.  But I have to share with all of you that having Original Medicare, a Medicare Supplement Plan G, and a $5,000 Dental/Vision/Hearing Insurance policy will cost you approximately $2,160 per year.  Compare that with your MOOP amounts for any Medicare Advantage plan. I think you will quickly see that the most comprehensive and the most flexible healthcare plan, which keeps you in control of who you see and where you go, and is without question the best overall value with the lowest overall costs, is having Original Medicare paired with Medicare Supplement Plan G. The two best parts of choosing a Medicare Supplement policy (Aside from it being the most comprehensive Major Medical option for those over 65) are that: 1. You never have to go through the headache of re-enrolling in Original Medicare or in a Medicare Supplement year after year.  It is your plan, and as long as A) you are satisfied with it and B) you are paying your premium, it remains your plan.   2. All of your Medicare Plan Premiums, Medicare Supplement Plan Premiums, and all OTC Costs for Band-aids, Cough Medicine, Vitamins, and Aspirin are all 100% Tax Deductible, as long as you itemize your deductions. All of your Dental, Vision, and Hearing costs are also tax-deductible. We always recommend shopping for your Supplement every 3 years or so to compare prices to ensure you are not overpaying.    NOTE: Both Medicare Advantage Plans and Medicare Supplement Plans are offered by Private Insurance Companies, not the government.   MEDICARE PART D  The last part of Medicare is Medicare Part D. The easiest way to remember Part D is that D stands for drugs .  Part D of Medicare covers your Prescription Drug medications, much like you had with your employer's Group Health plan. If you choose Original Medicare, you will need to enroll in a Medicare Part D Prescription Drug Plan within 63 Days of your Medicare Part B effective date or face a penalty for late enrollment, which you will have for the rest of your life.  This penalty is approximately $ 0.38 per month for each month you were without a Part D Drug plan.  That amount is then added to the monthly premium for your Medicare Part D Drug Plan premium once you choose one. Plan options vary by your location in the US.  There are a few  $0 to $10 monthly premium plans that are ideal for those with little or generic medications.  For those with more expensive, brand-name prescriptions, Medicare Part D Drug Plans can range from $22.90 to $169.00 per month.  Note : this premium is only for joining the plan. The cost of Medications will vary. Most generic medications will be $0-$5.00, but many medications can cost hundreds or thousands of dollars, depending on your plan and whether you have met your plan's deductible for the year. Every year , from October 15th to December 7th, you should review your Prescription Drugs with your Medicare Broker/Agent and choose a new plan for the following calendar year, beginning on January 1st .   YOUR MEDICARE CARD Your Red, White, and Blue Medicare Card will contain your individual, unique Medicare Number.  This is similar to your SSN, except it includes both Letters and Numbers. Your Medicare Card will also show your Medicare Part A Effective Date (Typically the first day of your Birth Month when you turn 65) and your Medicare Part B Effective Date. IF YOU ARE ALREADY RECEIVING SOCIAL SECURITY BENEFITS If you’ve received Social Security for at least four months before age 65, you’ll automatically get Medicare Part A and Part B when you turn 65. You’ll have the option to delay Part B if you have other qualifying health coverage. And, if you’ve applied for Social Security, but you haven’t gotten benefits for that long, you’ll automatically be enrolled in Medicare Part A when you become eligible for Medicare. You’ll have to apply for Part B.   IF YOU ARE NOT RECEIVING SOCIAL SECURITY BENEFITS YET If you aren't receiving Social Security yet, you can apply for Medicare once you're eligible in one of three ways:    Apply for Medicare online at the Social Security website. (This is the fastest method.)   You will need to complete CMS Form 40B and, if applicable, CMS Form L564, and submit them to your local Social Security Office.  If you are working with a licensed Medicare Broker, they can assist you with this process.  Enlisting your Broker to help you is only a day or two slower than navigating the Social Security Administration website yourself .  And, you will still need to upload either your completed CMS Form 40B or CMS Form L564 if you are either voluntarily or involuntarily leaving your employer's health plan. Call Social Security at 800-772-1213. (TTY 800-325-0778.)  Contact your local Social Security office. You can request a time to schedule a meeting with an SSA representative at your nearest SSA office, but this is not required and may delay the process by 4-6 weeks.   The online application typically takes less than 10 minutes, provided you have already completed and uploaded the forms to your files.  Additionally, if you set up an account on the www.ssa.gov website many years ago and do not remember the password you used, it could end up being problematic.  If this is the case, contact your licensed, independent Medicare broker and enlist their help to enroll as expeditiously as possible.  Visiting a local Social Security office could mean waiting in a long line, and the Social Security Administration encourages people not to show up without an appointment.   WHAT IF YOU HAVE BEEN RECEIVING DISABILITY AND ALREADY HAVE MEDICARE BEFORE REACHING AGE 65? Medicare is also available to younger people who get Social Security disability benefits, or SSDI. They’re automatically enrolled in Medicare after 24 months of disability benefit eligibility. However, depending on your state, you may receive Medicare benefits directly from Medicare with a Medicare Supplemental (Medigap) policy .  Or, if you have been receiving Medicare benefits through  Medicare Part C/ C/Medicare Advantage.   When you do turn 65, you can choose for yourself whether you want to get your Healthcare from Original Medicare with a Medicare Supplement/Medigap plan, or if you prefer to receive Medicare via a Medicare Advantage Plan.   SIGN UP & ENROLL IN MEDICARE DURING YOUR INITIAL ENROLLMENT PERIOD (IEP)   If you’re not enrolled automatically, you should sign up three months before your 65th birthday. That way, coverage will start on the first day of your birthday month (unless you were born on the first day of the month, in which case coverage begins on the first day of the prior month). You technically have seven months around your 65th birthday to enroll: the three months before your birthday month, your birthday month, and the three months after. This is called your initial enrollment period. If your birthday is the first of the month, your initial enrollment period includes the four months before your birthday month and two months after. If you wait until your birthday month or the three months afterward to apply for Medicare, your coverage will start the following month. If you miss your initial window, you will need to sign up during Medicare's general enrollment period. However, you may be subject to a permanent penalty unless you have continuous coverage from a large employer group health insurance plan.   IF YOU ARE APPLYING DURING THE GENERAL ENROLLMENT PERIOD If you don't apply during your initial enrollment period for Parts A and B and you're not eligible for a SEP (Special Enrollment Period), you'll have to wait for Medicare's general enrollment period to sign up. This is different from the annual open enrollment period, which runs from Oct. 15 to Dec. 7 each year. The general enrollment period runs from Jan. 1 to March 31 every year. Coverage doesn't start until the month after you sign up, and late penalties may apply. You will also pay for any health costs you incur during the time you were uninsured before your coverage begins.   MEDICARE DOES HAVE PENALTIES THAT CAN BE HANDED OUT IF YOU ARE UNINFORMED If you’re not automatically enrolled in Medicare and you don’t apply on time, you may face late enrollment fees:    Medicare Part A: If you must buy Part A and you don’t purchase it during your initial enrollment period, you may owe 10% more than the monthly premium for twice the time period you didn’t sign up.  Medicare Part B: If you don’t sign up for Part B during your initial enrollment period, your monthly premium increases 10% for each 12-month period that you go without Part B coverage. This is a permanent penalty as long as you have Part B.  Medicare Part D: If you go without Medicare drug coverage or other creditable prescription drug coverage for 63 or more days once your initial enrollment period ends, you'll be assessed a permanent penalty for as long as you have Medicare drug coverage. The penalty is calculated as 1% of the “national base beneficiary premium” multiplied by the number of whole months you weren’t covered. (There is no cap. If you don’t think you need Part D for 72 months, that’s a 72% penalty.) Your exact penalty amount is recalculated each year.   YOU DID IT, YOU GOT ENROLLED IN MEDICARE, NOW WHAT?   Hopefully, you already found an Agent you like, or you are working with a licensed, independent Medicare Broker like us at Braden Medicare.  If not, our sincere and honest suggestion is that you search on Google and find a few local Independent Medicare Brokers in your area. Review their website, review the information, and determine whether you would be comfortable speaking with them.  Any reputable broker will have been in business for at least 3-5 years.  If they do not offer an appealing, well-organized website, you run Forest, Run!  If the website appears to be nothing more than a landing page, keep moving. Read their About Us section to see if they have a Blog or any articles. Spend about 10-15 minutes looking through their site, and make an informed decision based on what you see. You are in control. Then either email them or call them to discuss. Ask them how a Broker can help you with the next steps.  What is the difference between an Agent and a Broker?  An agent typically works for only one or two Insurance companies.  So, that means they can only legally market and sell those companies' products.  On the other hand, a broker typically has multiple companies with which they are contracted.  Using us at Braden Medicare as one example, we are contracted with over 34 Insurance Carriers.   We represent what we believe are the best companies to partner with, including Aetna, Allstate, Aflac, AARP, ACE, Anthem, Amerigroup, Banner, BCBS, Bankers Fidelity, Cigna, Globe Life, Gold Kidney, Humana, Lumico, Manhattan Life, Medico, Mutual of Omaha, Nassau, Royal Arcanum, United American, United Healthcare and National General to name a few. We are also licensed to sell all available Medicare Part D Plans in every state where we are licensed. It takes much more time and commitment to do this, but we believe it is the best way to serve our clients justly . Having multiple options is a significant advantage, helping you avoid overpaying and giving you the best variety of plans and options to choose from.   Working with a Broker is 100% free! It's true! Medicare Insurance works with a built-in commission rate set by each Insurance Company and approved by Medicare and the state insurance department .  So, whoever writes the application receives the commission.  Whether you are working with a local licensed Agent or Broker, or if you thought it was better to call a company's 1-800 Number and get transferred to an agent, you never get a cheaper rate. This is why it just makes good common sense to work with a professional who actually cares about their clients, respects the Medicare process, and is dedicated to serving others!   BRADEN MEDICARE INSURANCE'S FREQUENTLY ASKED QUESTIONS & ANSWERS ABOUT ENROLLING IN MEDICARE DOES MEDICARE COVER VISION CARE?   Medicare does not cover Routine Vision.  We define Routine Vision as what you do at an optometrist's office or at an Eye Care Center. However, Medicare does cover anything you would have done at an Ophthalmologist's Office, including Cataract Surgery, Glasses for post-cataract surgery, Glaucoma, and Macular Degeneration.    DOES MEDICARE COVER DENTAL CARE?     No, Medicare does not cover Routine Dental Services or preventive dental services.  They will cover dental work resulting from an accident or TMJ issues.  Medicare Advantage Plans offer a variety of Dental, Vision, and hearing coverage, depending on the plan.  These are advertised to entice people over to Medicare Advantage plans, but they are slick.  While not illegal, many of their advertising campaigns are misleading and insufficiently informative, which is unfair to consumers .   For example, a $2,000 Annual Dental Benefit usually equals $500 in Dental Benefits each Quarter, and if you do not use it up, the benefits do not roll over to the next quarter.     WILL MEDICARE PAY FOR MY C-PAP MACHINE? Yes, however, each Insurance company has its own list of equipment providers that you must use.  And, these companies are often not the same as those you have used in the past or that you may currently be using.   WILL MEDICARE COVER PHYSICAL THERAPY?   Original Medicare covers an unlimited number of Physical Therapy appointments as long as your Doctor attests to the fact that the treatments are necessary and that you are improving. Medicare Advantage plans will typically cap Physical Therapy at 10 Appointments.   H OW CAN MEDICARE ADVANTAGE PLANS OFFER OTHER BENEFITS THAT Original Medicare cannot OR DO NOT OFFER?   The honest-to-goodness truth is that Medicare Advantage Companies get paid $1,000 each month for every Medicare Advantage member they have enrolled in one of their Medicare Advantage plans.  These payments are authorized by the government in exchange for insurance companies assuming the financial risk of managing a member's healthcare.   These private insurance companies use this money to fund their advertising campaigns and remain profitable.  This is also why they have so many co-pays and co-insurance and require 2nd, 3rd, and even 4th opinions for some procedures.  Historically, the majority of Medicare Advantage Insurers receive high marks from healthy members, but much lower marks when a member has had, or is currently experiencing, health issues.   WILL MEDICARE MAIL ME MY PRESCRIPTION MEDICATIONS?   Yes, both Medicare and Medicare Advantage can mail your Quarterly supply of Prescription Medications through their respective approved mail-order pharmacies . If you are familiar with using Pill Pack from Amazon, you can call Pill Pack directly and request that they send your Quarterly Medications. Signing up for Medicare online takes as little as 10 minutes, and you typically need no documentation. You’ll need your Social Security number, birth city, and start and end dates for any current group health insurance plans or any group health plans after age 65.   WHICH IS BETTER, ORIGINAL MEDICARE OR MEDICARE ADVANTAGE?   You realize this is the sort of question that elicits the most politically correct answer from most Medicare Brokers. My answer is based on my 8+ years as an Independent Medicare Broker and on regular interactions with Insurance Companies, Clients, Hospitals, and Doctors, not to mention my firsthand experience.   There is no comparison in my mind.  Original Medicare is far and away superior to any Medicare Advantage Plan.  However, some SNPs (Special Needs Plans) are the best option for members with unique care needs. Healthcare professionals, Police, Firefighters, and Healthcare professionals often refer to Medicare Advantage as  MEDICARE DISADVANTAGE  for a reason! Many elite and specialty hospitals do not accept Medicare Advantage plans. Overall, Medicare Advantage Plans are challenging to work with. They are known for denying claims and care, requiring multiple referrals, and doing anything they can to turn a profit rather than putting the patient's best interests front and center. Lastly, two other things drive me crazy as a broker. People who believe they are healthy may enroll in an MA/MAPD plan to save money and later switch to a Medicare Supplement plan .   But then something happens that makes them ineligible to enroll in a Medicare Supplement (Medigap) plan down the road. This happens more often than you might think, and it makes me sick that they were not happy with a bird in the hand; instead, they opted to try to get the two birds in the bush. The last item concerns cancer treatments.  There is a 20% Co-Insurance for all cancer treatments under any Medicare Advantage Plan.  And, in the fine print in the Explanation of Benefits section of each Medicare Advantage Policy, you will find that this 20% Co-Insurance for Cancer Treatments, meaning Radiation and Chemo, is required even if/after the member meets their MOOP for the year!   WE ARE ALWAYS HERE FOR YOU How To Connect With Us At Braden Medicare Insurance: Michael Braden's Business Card

Types Of Medicare Advantage Plans MEDICARE ADVANTAGE PLANS How much you pay for each visit or service (co-payment or coinsurance). For example, the plan may charge a copayment, such as $10 or $20, each time you see a doctor. These amounts may differ from those under Original Medicare.    MEDICARE ADVANTAGE PLANS AND OPTIONS MEDICARE HMO PLANS   Medicare Advantage HMO Plans are the most popular type of Medicare Advantage Plans. These plans are a form of coordinated care in which you choose a primary care doctor from the network. You typically need a referral from that doctor before you can see a network specialist. Medicare HMO plans often have the lowest monthly premiums of the three types of Medicare Advantage programs. This is because they are generally the most restrictive, requiring a primary care physician. Members visit their PCP first to obtain a referral before seeing a specialist. MEDICARE PPO PPO PLANS PPO Plans are also referred to as coordinated care plans. But PPO Plans are usually more flexible than Medicare HMO plans. Members can generally see any doctor in the network without a referral.  You can also use out-of-network providers, but you will pay more . Always check the rules of your specific plan, which are available in the plan’s Summary of Benefits. MEDICARE PFFS (PRIVATE FEE-FOR-SERVICE PLANS) Private-Fee-For-Service Medicare Advantage Plans typically have no network or a very limited one . You can see any doctor who will bill the plan as long as they agree to the plan’s terms and conditions up front. This puts the burden on you to ask your providers whether they will accept the plan before you seek medical services. These plans have been phased out in many counties where at least two other plan types exist.   OTHER MEDICARE ADVANTAGE PLAN TYPES Medicare Advantage (MA) and Medicare Advantage with Part D (MA/PD) plans vary by county . In fact, there are only a limited number of plans offered by each Insurance Company in each area where they participate . Across the country, there are many areas with few or no Medicare Advantage Plans available. Special Needs Plans (SNPs) are available only to Medicare beneficiaries with certain health conditions. The plans are designed to address those health needs through specialized providers and drug formularies most suitable for people with those conditions. Most SNP plans are HMOs. Medical Savings Account (MSA) plans provide a health savings account alongside insurance benefits. Medicare itself will put a set amount of funds into your account each year. You may spend those dollars whenever you access qualifying health services. MSA plans are not available in all counties. NOTE: All Medicare Advantage plans offer their own summary of benefits . These benefits, as well as the plan’s formulary, pharmacy network, provider network, premium, and/or copayments/coinsurance, may change on January 1 of each year.   WHEN YOU CAN ENROLL IN A MEDICARE ADVANTAGE PLAN You can join a Medicare Advantage plan during your 7-month Initial Election Period for Medicare. You can also join or disenroll from Medicare Advantage during the Annual Election Period. This occurs from October 15th to December 7th. A variety of Special Election Periods exist, too. If you qualify, you might be able to join mid-year. A common one is when you move out of state and lose your existing Medicare Advantage plan. Medicare allows you a 63-day window to choose another plan in your new state. Another SEP occurs if you become eligible for Medicaid or the Part D Extra Help program. People with low incomes have continuous special election periods. This means you can change plans at any time of year.   YOU CAN CHOOSE ANY MEDICARE ADVANTAGE PLAN THAT IS AVAILABLE IN YOUR SERVICE AREA Medicare Advantage programs have service areas. Service Areas are generally plans that are specific to the County you reside in. Remember that you must be enrolled in both Medicare Parts A and B and live in the plan’s service area. You cannot join a plan that does not operate in the county where you live. A licensed health insurance agent can help you determine which plan options exist in your county. They will help you work through a checklist of items to determine which plan best suits you.   HOW MUCH DO MEDICARE ADVANTAGE PLANS COST? Your annual out-of-pocket costs in a Medicare Advantage or Medicare Part C Plan depend on: Some plans charge a monthly premium; others have no premium. Whether the plan pays any of your monthly Medicare Part B premium of $164.90 for the 2023 premium, some plans pay all or part of your Part B premium. Whether the plan has a yearly deductible or any additional deductibles. How much you pay for each visit or service (co-payment or coinsurance). For example, the plan may charge a copayment, such as $10 or $20, each time you see a doctor. These amounts may differ from those under Original Medicare.  The type of health care services you need and how often you get them. Whether you go to a doctor or a supplier who accepts assignment, if: You're in a PPO, PFFS, or MSA plan. You go out of your plan's network.  Whether you follow the plan's rules, such as using network providers. Whether you need extra benefits, and if the plan charges for them. The plan's yearly limit on your out-of-pocket costs for all medical services. Whether you have Medicaid or get help from your state. Note: Each year, plans set the amounts they charge for premiums, deductibles, and services. The plan (rather than Medicare) decides how much you pay for the covered services you get. What you pay for the plan may change only once a year, on January 1st.   MEDICARE ADVANTAGE PLANS SEND INFORMATION TO THEIR MEMBERS EACH YEAR IN THE FALL One of the most significant differences between Original Medicare and Medicare Advantage is that there are no guarantees that any Medicare Advantage plan will be available the following year. If it is, and you are comfortable with your plan and want to keep it (Again, as long as it is available) for the next year, you do not need to do anything; you will automatically be enrolled in the same Plan effective January 1st. If you are not satisfied with your plan, you can choose a new one during the Fall Annual Enrollment Period (AEP). Once you enroll in a new MA or MA/PD plan, your current plan ends at midnight on December 31st, and your new plan begins at 12:01 AM on January 1st. EVIDENCE OF COVERAGE   (EOC) The EOC provides details on what the plan covers, how much you pay, and more. ANNUAL NOTICE OF CHANGE LETTER (ANOC) The ANOC includes any changes to coverage, costs, or service area that will take effect in January. SUMMARY OF BENEFITS (SOB) Every Medicare Advantage plan includes a Summary of Benefits Section.  You need to read through this section and through the Explanation of Benefits section with a fine-toothed comb.  This is where you can see exactly how your benefits will be paid, and this is the fine print that the plan hopes that you will not read. NOTE: If you don't receive these important documents, contact your plan.

Michael T. Braden, August 27, 2024 MEDICARE PART D How Do You Find The Best Medicare Part D Drug Plan? WHAT IS THE BEST, FASTEST, AND EASIEST WAY TO FIND THE BEST MEDICARE PART D DRUG PLAN FOR YOU AND YOUR MEDICATIONS? The best way to compare Drug plans for your specific medications is to speak with your Medicare Broker. They typically can offer plans from multiple Insurance companies. Here at Braden Medicare, we are contracted with every Medicare Part D Plan in Arizona. They will compare your medications, whether you have Original Medicare with a Stand-Alone Medicare Part D Drug Plan or a Medicare Advantage Plan that includes Prescription Drugs. Your Broker will ask for a list of your medications and then compare your medications using a Prescription Finder Tool, similar to the one available on the Medicare website at www.medicare.gov . They will compare your drugs and then offer the 2-3 best plans with the lowest overall cost, using your preferred pharmacy. And if they are good, they will include, as we do, the cost of your medications using GoodRx so that you can see the difference. There are many times when certain medications are much less expensive when purchased through GoodRx. No two plans are the same; some have higher deductibles. Some people who take brand-name or expensive medications may save money by enrolling in a plan without a deductible. These are all things your Broker already knows. NOTE: The lowest overall price will include the plan's monthly premium and the cost of your prescription medications. 6 TIPS FOR CHOOSING A MEDICARE PART D PRESCRIPTION DRUG PLAN If you’re wondering how to choose a Medicare drug plan that works for you, the best way is to start by looking at your priorities. See if any of these apply to you: I TAKE SPECIFIC MEDICATIONS Look at drug plans that include your prescription drugs on their formulary (a list of prescription drugs covered by a drug plan). Then, compare costs. I WANT EXTRA PROTECTION FROM HIGH PRESCRIPTION DRUG COSTS Review drug plans that offer coverage in the coverage gap, and confirm they cover your drugs in that gap. I WANT TO KEEP MY DRUG EXPENSES BALANCED AS MUCH AS POSSIBLE THROUGHOUT THE YEAR Look at drug plans with no or a low deductible, or with additional coverage in the coverage gap. I TAKE A LOT OF GENERIC MEDICATIONS Look at Medicare drug plans with “Tiers” that charge you nothing or low copayments for generic prescriptions. I DO NOT HAVE MANY MEDICATIONS NOW, BUT I WANT COVERAGE FOR PEACE OF MIND AND TO AVOID FUTURE PENALTIES Consider Medicare drug plans with a low monthly premium . If you need prescription drugs in the future, all plans still must cover most drugs used by people with Medicare. Medicare Part D Prescription Drug Plans are designed to be reviewed every year in the fall. If you have had Medications added or had some medicines removed from your lists, it is always a good idea to update your information with your Independent Medicare Broker every year. Hence, you always have the best possible plan. There is never a charge or cost to switch plans, unless the premium on the new plan is higher . I LIKE THE CONVENIENCE OF HAVING ONE PLAN FOR EVERYTHING, INCLUDING MY PRESCRIPTIONS. AND, I LIKE THE EXTRA BENEFITS THAT ARE INCLUDED IN MEDICARE ADVANTAGE PLANS. Look for a Medicare Advantage Plan (Part C) with prescription drug coverage. EVERY MEDICARE PART D DRUG PLAN AND EVERY MEDICARE ADVANTAGE PLAN WITH PRESCRIPTION DRUG COVERAGE OFFER THE FOLLOWING: Monthly Insulin Costs are capped at $35 per month. One important thing to remember is that not every plan carries your specific insulin. So it pays to do your homework ahead of time. Or you can ask your doctor whether they have any other Insulin recommendations, or whether it works better with your plan. The idea is to keep as much money as possible in your billfold or wallet. Every Medicare Part D Drug Plan covers Glucose Monitors and Test Strips. You need your Doctor to write a prescription, then take it to the pharmacy. Be smart and understand which Monitors are available under your plan before you sign up . Many people are loyal to and comfortable with certain Glucose Monitoring Devices and Testing Supplies. If you request a brand not covered by your plan, you will need to pay out of pocket . Beginning on January 1st, 2025 , you can receive the following vaccinations at no cost at any of your Network Pharmacies. Previously, you had to go to your Preferred Pharmacy for this. INFLUENZA PNEUMONIA SHINGLES 9 (Shingrix 2-Part Vaccine) RSV COVID COVID BOOSTERS HEPATITIS A TETANUS BEGINNING ON JANUARY 1ST, 2025 , THERE WILL NO LONGER BE ANY catastrophic phase for MEDICARE PART D DRUG PLANS. THIS WAS PREVIOUSLY KNOWN AS THE "DONUT HOLE". AND, NOT ONLY THAT, BUT THE MAXIMUM ANYONE CAN SPEND ON PRESCRIPTION MEDICATIONS FOR THE CALENDAR YEAR WILL BE CAPPED AT $2,000. Please make sure all of your doctors know which Medicare Part D Drug Plan you have. If they have this information, they can always assist you by ensuring that anything they prescribe is on your plan's formulary, which will save you a lot of money . And, make sure to tell them that you always prefer Generic medications whenever possible.