Choosing the right healthcare coverage during retirement is one of the most important decisions you’ll make. With multiple Medicare options available, it’s common to feel overwhelmed — especially when comparing Medicare Advantage vs. Medigap plans. While both options can provide valuable coverage, they work very differently and are designed for different retirement needs.
At Senior Insurance Advisors, we help retirees and those approaching Medicare eligibility understand their options clearly, so they can choose a plan that fits their lifestyle, budget, and long-term healthcare goals.
Understanding Medicare Advantage and Medigap
Before comparing the two, it’s important to understand what each option is and how it fits into the Medicare system.
Medicare Advantage plans (Part C) are offered by private insurance companies and replace Original Medicare (Part A and Part B). These plans provide the same core coverage as Original Medicare but often bundle additional benefits such as prescription drug coverage, dental, vision, and hearing services into one plan.
Medigap plans, also known as Medicare Supplement plans, work alongside Original Medicare. Rather than replacing it, Medigap helps pay out-of-pocket costs like deductibles, copayments, and coinsurance that Original Medicare does not cover. You cannot have both a Medicare Advantage plan and a Medigap plan at the same time, you must choose one or the other.
Key Differences Between Medicare Advantage vs. Medigap
Understanding how these plans differ can help you determine which option best aligns with your retirement needs.
How Coverage Is Structured
With Medicare Advantage, the plan becomes your primary coverage. All your care is managed through the private insurance plan, often with bundled benefits and structured cost-sharing.
With Medigap, Original Medicare remains your primary insurance, and the Medigap policy fills in coverage gaps. This structure can lead to fewer surprise medical bills and more predictable healthcare expenses.
Provider Access and Flexibility
One major difference between Medicare Advantage vs. Medigap is provider access.
Medigap plans typically allow you to see any doctor or specialist who accepts Medicare, without needing referrals or staying within a network. This flexibility is especially valuable for retirees who travel frequently or want unrestricted access to providers.
Medicare Advantage plans often use provider networks, meaning you may need to stay in-network to receive the lowest costs. While emergency care is still covered outside the network, routine care may be more limited.
Monthly Premiums and Out-of-Pocket Costs
Medicare Advantage plans often feature lower monthly premiums, and some plans have very minimal upfront costs beyond your Medicare Part B premium. However, out-of-pocket expenses can add up depending on how often you use healthcare services.
Medigap plans generally have higher monthly premiums, but they often result in lower out-of-pocket costs when you receive care. For many retirees, this predictability makes budgeting for healthcare easier.
Additional Benefits
Medicare Advantage plans may include extra benefits such as dental, vision, hearing, fitness programs, and wellness services. These benefits can be appealing for individuals who want comprehensive coverage under one plan.
Medigap plans focus strictly on medical coverage and do not usually include these extras. However, many retirees prefer Medigap for its simplicity and broad provider access.
Prescription Drug Coverage
Many Medicare Advantage plans include prescription drug coverage as part of the plan.
With Medigap, prescription drug coverage is not included, so a separate Part D plan is typically added to ensure complete coverage.
Which Plan Is Right for Your Retirement?
When deciding between Medicare Advantage vs. Medigap, there is no one-size-fits-all answer. The right choice depends on several personal factors, including:
- Your current and expected healthcare needs
- Your monthly budget and tolerance for out-of-pocket costs
- Whether you prefer provider flexibility or structured networks
- How often you travel or receive care outside your local area
For retirees who want lower monthly premiums and bundled benefits, Medicare Advantage may be a good fit. For those who value predictability, provider freedom, and long-term stability, Medigap may be the better option.
It’s also important to consider enrollment timing and future flexibility, as switching plans later may involve underwriting or limited enrollment windows.
How Senior Insurance Advisors Can Help
Navigating Medicare options can be confusing, but you don’t have to do it alone. At Senior Insurance Advisors, we take the time to understand your unique situation and walk you through the differences between Medicare Advantage vs. Medigap in clear, simple terms.
Our goal is to help you choose coverage that supports your health, protects your finances, and gives you peace of mind throughout retirement.
Ready to Find the Right Medicare Plan?
The right Medicare plan can make a meaningful difference in your retirement years. Whether you’re enrolling for the first time or reviewing your current coverage, we’re here to help you make a confident, informed decision.
Contact Senior Insurance Advisors today to get personalized guidance, a free quote and find the Medicare plan that best fits your retirement needs.
Understanding Your New Social Security Statement: What to Know About Medicare Part B and Potential IRMAA Surcharges for 2026 As we move into a new year, many people begin receiving updated Social Security benefit statements in the mail. These statements not only show your projected monthly benefit but also reveal your Medicare Part B premium for the upcoming year—along with any additional charges, such as IRMAA (Income-Related Monthly Adjustment Amount), that may apply. If you recently opened your 2026 Social Security statement and noticed higher-than-expected deductions, you're not alone. Here's what you need to know. Why Your Social Security Statement Shows New Medicare Premiums Each fall, Medicare announces updated premiums for the coming year. Your Social Security statement includes these amounts so you can see: Your gross Social Security benefit Your Medicare Part B premium deduction Any applicable IRMAA surcharges for Part B and/or Part D Your net monthly benefit (what you’ll actually receive) This transparency helps you plan for the year ahead—especially if your premium has changed. What Is Changing for Medicare Part B in 2026? Every year, Part B premiums may adjust to reflect health care costs and changes in the Medicare program. Your statement will show the new monthly premium for 2026, and this amount will automatically be deducted from your Social Security benefit unless you pay it separately. Why You Might See IRMAA Charges IRMAA stands for Income-Related Monthly Adjustment Amount, and it’s an additional charge added to your Medicare Part B and Part D premiums if your income is above certain limits. How IRMAA Is Determined Social Security looks at your tax return from two years prior—which means your 2024 income determines your 2026 IRMAA tier. You may see IRMAA charges in your statement if: You had unusually high income in 2024 (such as capital gains, Roth conversions, property sales, etc.) Your income increased due to bonuses, overtime, or distributions You filed jointly but now file singly (or vice versa) Your tax return was amended or corrected What If Your Income Has Gone Down Since 2024? Many people receive IRMAA charges even though their current income is much lower—especially after retiring. The good news: You may qualify to have IRMAA reduced or removed. You can file an IRMAA Reconsideration Request if you experienced a life-changing event, such as: Retirement or reduced work hours Marriage or divorce Death of a spouse Loss of income from property Employer settlement payout ending Social Security may then adjust your IRMAA based on your current income, not your income from two years ago. What to Do When You Receive Your Statement If your 2026 statement has unexpected Part B premiums or new IRMAA charges, here are the steps to take: ✔ 1. Review the premiums carefully Confirm the Part B amount and look for any IRMAA line items. ✔ 2. Compare them to your current financial situation If the income used to calculate IRMAA doesn’t reflect your actual current income, you may be eligible for a reduction. ✔ 3. Gather supporting documents This may include recent pay stubs, retirement letters, or other financial documentation. ✔ 4. File an appeal if needed You can request a review using Form SSA-44 if you experienced a qualifying life-changing event. Don’t Panic—Help Is Available Seeing higher-than-expected deductions on your Social Security statement can be frustrating and confusing. But in many cases, higher premiums—especially IRMAA—can be corrected with the right documentation. If you’re unsure whether you qualify or need help understanding your 2026 statement, reaching out to Senior Insurance Advisors can help you make sense of your situation and explore available options.
Medicare costs are going up in 2026 — and it’s important to know exactly how those changes could affect you or your loved ones. The Centers for Medicare & Medicaid Services (CMS) recently released updated premium, deductible, and coinsurance figures for Medicare Parts A and B, as well as revised income-related adjustment amounts for Part D. Below is a breakdown of what these changes mean and how to prepare. 1. Part A (Hospital Insurance) Updates Part A covers inpatient hospital care, some skilled nursing facility stays, hospice, and more. While most people don’t pay a Part A premium (because they’ve paid into Social Security for at least 40 quarters), the deductible and coinsurance are increasing: Inpatient hospital deductible (per benefit period): Goes from $1,676 in 2025 to $1,736 in 2026 . Hospital coinsurance (days 61–90) : Rises to $434/day (from $419). Hospital coinsurance (lifetime reserve days) : Increases to $868/day (from $838). Skilled Nursing Facility (SNF) coinsurance (days 21–100) : Jumps to $217/day (from $209.50). For those who don’t have enough Medicare work credits (fewer than 40 quarters), Part A still has a monthly premium: $311/month for those with 30–39 quarters $565/month for those with fewer than 30 quarters 2. Part B (Medical Insurance) Cost Changes Part B helps cover doctor visits, outpatient care, medical equipment, and more. Here’s how the 2026 numbers shape up: Standard monthly premium : Rising to $202.90 , up by $17.90 from 2025’s $185. Annual deductible : Increasing to $283 (from $257). Why the jump? CMS says the increase is largely driven by projected increases in utilization and prices — though policy changes helped tamp the rise. 3. Income-Related Premium Adjustments (IRMAA) for Part B If you have a higher income, your Part B premium could be significantly higher than the standard rate. These “Income-Related Monthly Adjustment Amounts” (IRMAA) apply to roughly 8% of Medicare beneficiaries. Here are the 2026 monthly premiums by income: 2026 Modified Adjusted Gross Income (AGI) IRMAA Total Part B Premium ≤ $109,000 (individual) / ≤ $218,000 (joint) $0 $202.90 $109,001–$137,000 / $218,001–$274,000 $81.20 $284.10 $137,001–$171,000 / $274,001–$342,000 $202.90 $405.80 $171,001–$205,000 / $342,001–$410,000 $324.60 $527.50 $205,001–$500,000 / $410,001–$750,000 $446.30 $649.20 ≥ $500,000 / ≥ $750,000 $487.00 $689.90 There’s also a separate table for those who only have Part B coverage for immunosuppressive drugs , with its own IRMAA structure. 4. What This Means for You Budget for higher costs. If you’re on Original Medicare, expect higher monthly Part B costs and a bigger deductible. This could affect how much you need to set aside or how you evaluate supplemental (Medigap) plans. High earners take note. If your income is above the thresholds listed above, your Part B premium could be substantially higher. That’s something to factor into both your retirement planning and Medicare enrollment. Review your coverage. These changes may influence whether you choose Original Medicare + Medigap, a Medicare Advantage plan, or certain Part D plans. Make sure to revisit your options during the next enrollment period. Plan ahead . Since these amounts go into effect in January 2026, you still have time to adjust your budget, shift savings, or explore different Medicare plan options. Final Thoughts Rising Medicare costs are a reality again in 2026 — especially for Part B. While these increases can be frustrating, being informed puts you in a stronger position to adapt. Review your income, your coverage choices, and your long-term budget to make sure Medicare continues to work for you. If you’d like help understanding how these changes might affect your situation (or someone you care for), Senior Insurance Advisors be happy to walk through options and planning strategies.
Losing a job is stressful enough on its own, but when your health insurance is tied to your employment, it adds another layer of uncertainty. If you’re approaching Medicare age and find yourself suddenly without employer coverage, the good news is—you have options. Here’s what you need to know about setting up Medicare after an unexpected job loss. 1. Know Your Enrollment Window If you’re 65 or older and lose your job (and your employer health insurance), you qualify for a Special Enrollment Period (SEP) . This gives you 8 months from the time your coverage ends to sign up for Medicare Part A and Part B without facing a late enrollment penalty. 👉 If you already signed up for Part A (hospital coverage) earlier because it’s premium-free, you’ll just need to add Part B (doctor visits, outpatient care, etc.). 2. Don’t Delay Part B Some people postpone enrolling in Part B while working, since employer coverage is often sufficient. But once you lose that coverage, it’s critical to enroll right away. If you delay beyond your 8-month SEP, you could face lifetime penalties and gaps in coverage. 3. Consider COBRA Carefully You may be offered COBRA to continue your employer health plan for up to 18 months. While COBRA can bridge a short gap, it does not count as “creditable coverage” to delay Medicare enrollment. If you rely only on COBRA and skip signing up for Medicare, you’ll face penalties later. In most cases, it’s better to elect Medicare first and consider COBRA only as a supplement if needed. 4. Add Prescription Coverage Once you have Part A and Part B, you’ll want to consider how to cover prescriptions. You have two main paths: Part D prescription drug plan (standalone, paired with Medicare Supplement). Medicare Advantage plan (Part C) that often bundles medical and drug coverage in one plan. If you skip Part D without other creditable drug coverage, penalties may apply later. 5. Think About Extra Coverage Original Medicare doesn’t cover everything. After losing employer coverage, many people choose to add: A Medicare Supplement (Medigap) plan to help with deductibles and coinsurance. Or a Medicare Advantage plan that often includes extras like dental, vision, and hearing. Your best option depends on your health needs, budget, and doctors. 6. Get Help if You Need It Sorting through Medicare choices after an unexpected job loss can feel overwhelming. The good news is you don’t have to navigate it alone. Senior Insurance Advisors can help you compare plans, understand your enrollment deadlines, and avoid costly mistakes. Final Thoughts Losing your job unexpectedly is a tough transition, but getting your Medicare coverage set up doesn’t have to add to the stress. By acting quickly and understanding your options, you can ensure your healthcare needs are covered without gaps or penalties.
The Medicare Annual Enrollment Period (AEP) is a crucial time for seniors to evaluate their healthcare coverage. For caregivers, this period offers an opportunity to ensure that loved ones have the most suitable and cost-effective Medicare plan. Understanding the AEP and how to assist during this time can significantly impact the quality of care and financial well-being of those you support. What Is the Medicare Annual Enrollment Period? Medicare AEP runs annually from October 15 to December 7. During this window, beneficiaries can: Switch from Original Medicare to a Medicare Advantage Plan (Part C) or vice versa. Change Medicare Advantage plans. Enroll in, drop, or switch Medicare Part D (prescription drug) plans. Make changes to Medigap (Medicare Supplement) policies if eligible. Any changes made during this period take effect on January 1 of the following year. How Caregivers Can Assist Loved Ones 1. Understand the Available Medicare Plans Familiarize yourself with the different Medicare options: Original Medicare (Parts A & B): Provides hospital and medical coverage. Medicare Advantage (Part C): An alternative to Original Medicare, often including additional benefits like vision, dental, and prescription drug coverage. Medicare Part D: Offers prescription drug coverage. Medigap: Supplemental insurance to cover costs not paid by Original Medicare. Understanding these options helps in comparing plans and selecting the best fit for your loved one's healthcare needs. 2. Review Current Healthcare Needs Assess your loved one's health status, including: Chronic conditions or ongoing treatments. Preferred healthcare providers and hospitals. Current medications and prescription needs. Budget for healthcare expenses. This review ensures that the chosen plan aligns with their specific requirements. 3. Compare Medicare Plans Utilize online tools and resources to compare different Medicare plans . Pay attention to: Monthly premiums. Deductibles and out-of-pocket costs. Coverage for prescription drugs. Network of healthcare providers. Resources like Medicare.gov and PlanEnroll.com offer plan comparison tools to assist in this process. 4. Seek Professional Guidance Consider consulting with Medicare advisors or insurance agents who specialize in senior healthcare plans. They can provide personalized advice and help navigate the complexities of Medicare. Senior Insurance Advisors offer free consultations to assist in selecting the appropriate coverage. 5. Ensure Proper Documentation To manage your loved one's Medicare plan effectively, ensure you have the necessary documentation: Authorization forms allowing you to discuss their health information. Durable Power of Attorney (DPOA) if you need to make decisions on their behalf. Medicare cards and records of previous coverage. Having these documents facilitates smoother interactions with healthcare providers and insurance companies. 6. Monitor and Adjust Plans Annually Medicare plans can change annually, affecting coverage and costs. Regularly reviewing and adjusting the plan ensures that it continues to meet your loved one's needs. Set reminders to evaluate their plan each year during the AEP. Tips for Caregivers Stay Organized: Keep a file with all Medicare-related documents, including plan details and correspondence. Communicate Clearly: Discuss plan options with your loved one, considering their preferences and comfort. Be Proactive: Start the review process early to avoid last-minute decisions. Utilize Available Resources: Take advantage of community workshops, online webinars, and informational sessions offered by local agencies or insurance providers. How Senior Insurance Advisors Can Help Senior Insurance Advisors specialize in simplifying the Medicare process for seniors and their caregivers. They offer: Free consultations with no obligation to enroll. Assistance in comparing and selecting Medicare plans. One-on-one support to address specific concerns. Educational resources to empower informed decision-making. Their goal is to ensure that seniors receive the coverage they need without confusion or unnecessary costs. Final Thoughts The Medicare Annual Enrollment Period is an essential time for seniors to reassess their healthcare coverage. As a caregiver, your support in navigating this process can lead to better health outcomes and financial savings for your loved one. By staying informed, seeking professional guidance, and maintaining open communication, you can make this process more manageable and beneficial for those you care for. Contact Senior Insurance Advisors for a free consultation.
Medicare’s Annual Enrollment Period (AEP) — October 15 through December 7 — is the one time each year when you can make changes to your Medicare Advantage (Part C) or Part D prescription drug plan for the coming year. And while it’s tempting to wait until late October or November to review your options, getting a jump start on your 2026 Medicare plan changes can make all the difference — especially with rising healthcare costs, evolving plan benefits, and potentially limited appointment availability with agents. Whether you’re happy with your current plan or curious about new options, here’s how to stay ahead of the game and ensure you make smart, timely decisions during AEP. 🗓 Why It Pays to Start Early Waiting until the last minute can result in: Rushed decisions Limited time to compare plans Missed benefits or cost savings Delays in accessing care or prescriptions in January Starting early gives you time to evaluate, compare, ask questions, and feel confident about your choices before the December 7th deadline. ✅ Step 1: Review Your Annual Notice of Change (ANOC) Every September, your Medicare Advantage or Part D plan will mail you an ANOC. This document outlines what’s changing in your current plan for 2026, including: Premiums Deductibles Copays Drug formulary changes Provider network updates Extra benefits (dental, vision, hearing, OTC, etc.) Take 10–15 minutes to read through it carefully and flag any changes that could affect your budget or care. ✅ Step 2: Make a List of What Matters Most As you prepare to compare plans, ask yourself: Are my current doctors and specialists still in-network? Have my prescriptions changed? Did my out-of-pocket costs feel too high this year? Am I using extra benefits like dental, vision, or OTC? Do I anticipate any changes in my health or care needs in 2026? Having a clear list of priorities helps narrow down the best plans for your situation. ✅ Step 3: Gather Your Information If you’re working with a Medicare agent (highly recommended!), gather this information ahead of your appointment to make the process smooth and accurate: Medicare card and plan ID cards List of current prescriptions and dosages Preferred pharmacy Name of primary care physician and specialists Preferred hospital or medical group Any current dental/vision providers you use Having this ready allows your agent to compare accurate costs and networks across all available 2026 plans in your ZIP code. ✅ Step 4: Schedule Your Medicare Review Early Many agents begin plan reviews as early as October 1st, so schedule your appointment as soon as possible. By mid-to-late October, calendars tend to fill up fast. Appointments are typically short (15–30 minutes) and can often be done over the phone or video for convenience. ✅ Step 5: Don't Assume Your Current Plan is Still Best Even if you're happy with your current plan, it's wise to compare it to new 2026 options. Plans can and do change — and the "best" plan this year may no longer offer the best value or coverage next year. There may be new plans in your area with: Lower premiums Better drug coverage Lower maximum out-of-pocket limits Improved dental/vision benefits ✅ Step 6: Enroll Early to Avoid Delays Once you’ve chosen a plan, don’t wait. Submitting your application early in the enrollment window ensures: Timely delivery of ID cards and welcome materials No delays in accessing care on January 1st Less stress around the holidays Final Thoughts: Early Planning = Peace of Mind Medicare Annual Enrollment doesn’t have to be overwhelming or confusing. By reviewing your current plan, identifying your priorities, and working with a trusted agent, you can confidently make a smart, informed decision for 2026 — without the last-minute rush. Need help reviewing your Medicare options for 2026? I’d be happy to walk you through a personalized plan comparison and help you enroll early for peace of mind. Let’s schedule your review today — spots are filling fast!
Top 10 Red Flags to Watch Out for When Choosing a Medicare Insurance Agent Navigating Medicare can be overwhelming, especially with all the plans, rules, and changes that happen year after year. A trustworthy Medicare insurance agent can make the process smoother, clearer, and tailored to your needs. But not all agents have your best interests at heart. Whether you’re new to Medicare or reviewing your current plan, it’s essential to recognize the warning signs that you might not be dealing with the right agent. Here are the top 10 red flags to look out for when choosing a Medicare insurance agent: 1. They Push One Insurance Company Only A reliable Medicare agent should offer multiple carriers and plan options, not just one. If they constantly promote only one company without explaining why it suits you best, you may be dealing with a captive agent or someone more focused on commission than your needs. 2. They Promise Too Much Be cautious if an agent guarantees extra benefits, huge savings, or "secret" perks. Medicare is standardized and regulated—no one can promise you a miracle plan that no one else can access. If it sounds too good to be true, it probably is. 3. They Skip the Needs Assessment A good agent will ask about your doctors, medications, preferred pharmacies, travel habits, and budget before recommending a plan. If an agent jumps straight into selling you something without understanding your situation, that’s a red flag. 4. They Rush You to Enroll If you’re being pressured to sign up on the spot, take a step back. A trustworthy agent will give you time to compare plans, ask questions, and even consult family or advisors. 5. They Don’t Explain the Fine Print Medicare Advantage and Part D plans come with rules, networks, co-pays, and coverage phases. If an agent glosses over these details, it could cost you later. You need to understand what you're signing up for. 6. They Avoid Putting Things in Writing Every conversation and recommendation should be documented. If an agent hesitates to give you a summary in writing, or won't email you details, that’s suspicious. Transparency is non-negotiable. 7. They’re Not Licensed or Certified Agents must be licensed in your state and certified annually to sell Medicare Advantage and Part D plans. Always verify their credentials. You can check with your state’s Department of Insurance. 8. They Ignore Your Doctors and Medications Your preferred providers and prescriptions should be central to plan selection. If an agent doesn’t check formulary coverage or provider networks, you might end up in a plan that doesn’t meet your needs. 9. They Don’t Disclose Their Compensation Agents are usually paid by insurance companies, not by you. But ethical agents will explain this clearly and won’t steer you toward plans based solely on commissions. If an agent seems evasive about this, be cautious. 10. They Disappear After You Enroll Support shouldn't end after enrollment. A good Medicare agent will offer ongoing help—answering questions, helping with appeals, and checking in during the Annual Enrollment Period. If they vanish after you sign, that's a major red flag. Final Thoughts Choosing a Medicare plan is a big decision. The right agent should act as your advocate—someone who listens, explains, and genuinely wants to help. If you spot any of these red flags, trust your instincts and seek help elsewhere. Your health and financial well-being are too important to leave in the hands of someone who isn’t looking out for you. Senior Insurance Advisors is your trustworthy partner to help you with Medicare We’ll begin with a brief conversation to understand your specific needs—like your medications, preferred doctors, and what you want from your coverage. Then we’ll compare plans from several top companies and explain the differences in clear, simple terms. There’s no pressure at all—you’ll have all the time you need to make a confident, informed decision. Get in touch today to book your no-cost consultation.
Medicare is a vital part of retirement planning, providing essential health coverage for millions of Americans aged 65 and older. But simply enrolling in Medicare isn’t enough. To get the most value from your benefits, it’s important to understand how the system works, what options are available, and how to tailor your plan to your needs. At Senior Insurance Advisors , we specialize in helping retirees navigate the complexities of Medicare. Our team is here to ensure that you not only get the coverage you need but also maximize your benefits and savings for a healthy, secure retirement. Understand the Basics of Medicare To make the most of your benefits, start with a clear understanding of the different parts of Medicare: Medicare Part A covers hospital stays, skilled nursing facility care, and hospice. Medicare Part B includes outpatient care, doctor visits, and preventive services. Medicare Part C, or Medicare Advantage is an all-in-one alternative to Original Medicare, often including extra benefits like dental, vision, and prescription coverage. Medicare Part D provides standalone prescription drug coverage. Knowing what each part covers, and what it doesn’t, is the first step in choosing the right plan for your lifestyle and budget. Enroll at the Right Time Timing is everything when it comes to Medicare. Missing your Initial Enrollment Period (IEP) can lead to late enrollment penalties and gaps in coverage. Your IEP begins three months before your 65th birthday, includes the month you turn 65, and ends three months after. If you’re still working and covered by employer insurance, you may qualify for a Special Enrollment Period (SEP) later. Our licensed advisors at Senior Insurance Advisors can help you navigate Medicare enrollment to avoid unnecessary costs and ensure continuous coverage. Consider a Medicare Advantage Plan Medicare Advantage plans (Part C) often provide greater value by bundling multiple benefits into a single plan. These plans are offered by private insurers approved by Medicare and can include: Dental and vision coverage Hearing aids Gym memberships and wellness programs Prescription drug coverage Some plans even offer transportation services and telehealth options—important perks for retirees. To see if Medicare Advantage is right for you, visit our Medicare Advantage page. Don’t Overlook Prescription Drug Coverage Prescription drugs can be a significant expense in retirement. Whether you choose Original Medicare with a Part D plan or a Medicare Advantage plan that includes drug coverage, it’s important to review your medications each year to ensure your plan still meets your needs. Our team at Senior Insurance Advisors can conduct a free Medicare plan review to help you compare your options. Learn more about how we can help on our Medicare Part D page . Take Advantage of Preventive Services Medicare offers a wide range of preventive services at no cost, including: Annual wellness visits Cancer screenings Flu shots Cardiovascular screenings Diabetes prevention programs Staying proactive with your health can help you catch conditions early—and avoid costly treatments down the road. Review and Adjust Your Plan Annually Your health needs and budget can change from year to year, which is why it’s important to review your Medicare coverage annually during Open Enrollment (October 15 – December 7). During this time, you can: Switch from Original Medicare to Medicare Advantage or vice versa Change your Medicare Advantage plan Enroll in or switch Part D plans At Senior Insurance Advisors, we offer free annual Medicare reviews to help you stay informed and covered. Work with a Licensed Medicare Advisor Choosing the right Medicare plan can be overwhelming—but you don’t have to do it alone. A licensed advisor can help you: Understand plan benefits and costs Avoid coverage gaps and penalties Tailor your plan to your specific health needs and lifestyle Save money on premiums and prescriptions Our advisors provide personalized Medicare guidance. We’re here to simplify the process and help you make confident, informed decisions. Get the Most Out of Your Medicare in Retirement Maximizing your Medicare benefits isn’t just about saving money, it’s about ensuring peace of mind as you enjoy retirement. With the right plan and expert guidance, you can get better coverage, avoid surprises, and stay healthy for the years ahead. Ready to get started? Schedule your free Medicare review today with one of our licensed advisors at Senior Insurance Advisors, your trusted partner in Medicare and retirement planning.
Medicare provides essential health coverage for millions of Americans, but many people are surprised to learn that it doesn’t cover everything. Gaps in Medicare coverage can leave beneficiaries responsible for significant out-of-pocket costs. Understanding what Medicare doesn’t cover—and how to protect yourself financially—can help you make informed decisions about your healthcare. What Medicare Doesn't Cover While Medicare Parts A and B (Original Medicare) cover hospital stays, doctor visits, and certain medical services, they do not include several important healthcare expenses: 1. Dental, Vision, and Hearing Care Medicare does not cover routine dental exams, cleanings, fillings, dentures, eyeglasses, or hearing aids. These services are essential for maintaining overall health, yet they can be costly without supplemental insurance. 2. Long-Term Care If you need help with daily activities such as bathing, dressing, or eating, Medicare won’t cover extended stays in a nursing home or assisted living facility. Medicaid may help those who qualify financially, but most individuals will need other planning strategies. 3. Prescription Drugs Original Medicare does not cover most prescription medications. Beneficiaries must enroll in a Medicare Part D plan or choose a Medicare Advantage plan that includes drug coverage to help with these costs. 4. Overseas Medical Care If you travel outside the U.S., Medicare typically won’t cover your healthcare expenses. Without supplemental insurance, you could face high medical bills if you need care while abroad. 5. Alternative and Cosmetic Treatments Medicare does not cover acupuncture (except for certain cases of chronic pain), chiropractic care beyond spinal adjustments, or elective cosmetic procedures. How to Fill the Gaps in Medicare Coverage Fortunately, there are several ways to protect yourself from the costs Medicare doesn’t cover: 1. Medicare Supplement Plans (Medigap) Medigap policies help pay for expenses such as copayments, deductibles, and coinsurance. These plans, offered by private insurers, can reduce your out-of-pocket costs and provide peace of mind. L earn more about Medicare Supplement Plans → 2. Medicare Advantage Plans Many Medicare Advantage (Part C) plans include additional benefits such as dental, vision, hearing, and even wellness programs. These plans are a great alternative to Original Medicare, offering broader coverage under a single policy. Medicare Part D provides prescription drug coverage and is sold by private insurance companies. Most Medicare enrollees purchase prescription drug coverage as an addition to their Medicare coverage. Learn more about Medicare Advantage (Part C) → 3. Standalone Dental, Vision, and Hearing Insurance Since Medicare doesn’t cover routine dental, vision, or hearing care, separate insurance policies can help cover these essential services. 4. Long-Term Care Insurance Long-term care insurance can help cover the costs of assisted living, nursing homes, and in-home care, reducing the financial burden on families. 5. Travel Insurance with Medical Coverage If you travel frequently, investing in a travel insurance plan that includes emergency medical coverage can provide peace of mind. Get Expert Guidance on Medicare Coverage Navigating Medicare’s complexities can be overwhelming, but you don’t have to do it alone. At Senior Insurance Advisors, we help individuals understand their Medicare options and find the best supplemental coverage to meet their needs. Contact us today to ensure you have the protection and benefits you need for a secure and healthy future!
How does Tricare and VA work with Medicare? Service members who leave active duty may qualify for health care coverage through either the Department of Veterans Affairs (VA) or TRICARE, depending on how they separated from the military. But what happens to your VA or TRICARE benefits when you turn 65, which is the age most people become eligible for Medicare ? Do veterans and military retirees have to take Medicare Part A and Medicare Part B , or do the VA and TRICARE provide enough coverage? It’s all about what works for you. Medicare can add another layer of coverage, protection, cost savings, and convenience if you already have VA benefits or TRICARE. Here’s how. VA benefits and Medicare enrollment You can be enrolled in benefits through Veterans Affairs (VA) and Medicare at the same time. Having both gives you more options for care, as well as the flexibility and freedom to choose providers within the VA or with a non-VA provider in your Medicare network. Plus, Medicare Advantage plans can come with extra benefits that most veterans don’t receive through the VA, such as dental, vision, gym memberships, over-the-counter allowances and transportation benefits. How Medicare and VA benefits work together Although you can have benefits through Veterans Affairs (VA) and Medicare, you’ll need to choose which benefits you want to use when receiving care: To use your VA benefits, you must visit a VA doctor or VA medical facility. The VA may also cover care at a non-VA facility if it’s preauthorized. To use your Medicare benefits, you must receive care at a Medicare-authorized facility. In some cases, Medicare may also be able to pay for services the VA has not authorized. What Medicare does and doesn’t cover will depend on your plan, where you’re receiving care, and which benefits you plan to use — if you can use both. TRICARE and Medicare enrollment As a veteran, your coverage under TRICARE ends once you become eligible for Medicare. That means you’ll need to enroll in Medicare Parts A and B during your Initial Enrollment Period to avoid any lapse in TRICARE coverage. When you enroll in Medicare Parts A and B, TRICARE will automatically switch to TRICARE For Life (TFL). TFL acts as supplemental coverage for your Medicare plan. That means Medicare is your primary payer, while TFL reduces or eliminates out-of-pocket costs for deductibles, coinsurance, and copayments. How Medicare and TRICARE work together When you have Medicare and TRICARE For Life, you can visit any authorized provider. Here’s how the two work together to pay your health care costs: The provider will file the claim(s) with Medicare. Medicare will then pay the portion it’s responsible for and send the claim to the TRICARE For Life. TRICARE For Life will pay its portion directly to the provider for the services TRICARE covers. There are so many factors to consider when choosing the Medicare coverage that is right for you, and it can be an overwhelming process. We would love for you to schedule a free consultation to go over your unique needs. We want to empower you to choose the coverage that is the best for you. Ready to enroll now? Click here to enroll and enter your zip code to get started!
What is the importance of Hospital Indemnity policy? A hospital stay can be upsetting to your health, your wallet and your family. Even if you have other medical insurance, some costs may not be covered. That’s when a Hospital Indemnity insurance can provide a peace of mind in your time of need. Hospital Indemnity insurance complements your existing health insurance by giving you cash to help with the cost your plan doesn’t cover. Unlike standard health insurance, Hospital Indemnity insurance pays you directly. You are paid a set benefit amount, depending on your plan and the length of your stay. And you can use the payment in any way you want. There’s no deductible, and you receive payment even if you have other insurance. How do Hospital Indemnity insurance plans work? The age at which you can apply for Hospital Indemnity insurance varies by provider, but is typically between 18 and 85 years old. A cash benefit is paid for each day your billed for a hospital stay. You simply choose the days of coverage and daily cash benefit. · The number of days you can choose from (3, 6, 7, 8, 9, 10, 21, or 31) · The cash benefit amount per day (from $100 to $600 in increments of $25) · Premiums are age and gender related and they do not increase as you age. If you remain at the hospital for 60 continuous days, your policy benefit period resets, along with most of the additional riders listed below. The other additional riders that can be added are: emergency room services, observation unit monitoring, inpatient mental health services, travel to the hospital or medical facility, ambulance or urgent care center services, cancer diagnosis, outpatient surgery, outpatient therapy and chiropractic, and skilled nursing. How do you get paid? When you need to use your Hospital Indemnity coverage, you can access your benefits by following a few steps. 1) Complete a claim form. 2) Submit the claim form along with any other required information for any covered items. 3) Receive a check in the mail. Hospital Indemnity insurance is a separate insurance product with a distinct purpose and benefits that are paid for specifically covered events. However, the benefit may help lessen the financial impact of your hospital stay, and perhaps it will help you maintain your retirement savings or avoid hardship withdrawals, as you encounter out-of-pocket costs . Choosing A Hospital Indemnity Plan Whether you’re just learning about supplemental health plans, like Hospital Indemnity insurance or actively planning to enroll in them, make sure they have the appropriate coverage to compliment your Medicare coverage. Senior Insurance Advisors will work with you so you’re able to make informed insurance decisions for today and tomorrow. We encourage you to reach out so we can show you how Hospital Indemnity insurance and health insurance together can help you plan for the unplanned.
