Medicare 101

In this article, we explain what the Medicare out-of-pocket maximum really means, how it works across different types of Medicare coverage, and how you can better insulate yourself from unexpected medical bills.

Navigating the world of Medicare can sometimes feel overwhelming, especially when the costs change each year. Understanding these adjustments is essential for budgeting and The official 2026 numbers have been released by the Centers for Medicare & Medicaid Services (CMS). We are here to walk you through these new costs, explain what they mean for you, and show you how to manage them effectively.

A little over 50% of Medicare Beneficiaries have Medicare Supplement/Medigap Insurance, often called Medigap Insurance. These policies are designed to work alongside your Original Medicare benefits, covering the financial gaps that Original Medicare leaves behind. Historically, beneficiaries had a wide array of lettered plans to choose from, each offering a different level of standardized coverage. This standardization ensures that a Plan G from one carrier offers the same be

While you may know these plans help cover copayments, coinsurance, and deductibles, several lesser-known features make this coverage even more valuable. Understanding these nuances can help you make a more informed decision about your healthcare future. Here are five surprising facts about Medigap that might change how you view your coverage options.

The Medicare enrollment period is a designated time each year when beneficiaries can make changes to their Medicare coverage. This period typically runs from October 15 to December 7 annually. During this time, you can: Switch from Original Medicare to a Medicare Advantage plan. Change from one Medicare Advantage plan to another. Enroll in a Medicare Part D prescription drug plan. Drop your Medicare prescription drug coverage.

MEDICARE SUPPLEMENT vs MEDICARE ADVANTAGE, which option is better? This has been an ongoing battle for decades and will continue for the foreseeable future. It is one of the most common and confusing decisions people face when enrolling in Medicare.

Medicare can be confusing, but as soon as you understand the different parts of Medicare and how they work together, it all makes sense in short order

UNDERSTANDING AND AVOIDING THE TOP 10 MEDICARE MISTAKES FOR NEW MEDICARE BENEFICIARIES

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: Such as: Premiums, Deductibles, Co-Pays & Co-I

HELPING YOU TO UNDERSTAND MEDICARE PDP PLANS Prescription drug plans help cover the costs of medications not included in original Medicare. They are offered by private insurance companies that contract with the Medicare program. These plans may come with various premiums, deductibles, and copayments. It's essential to understand how these different components work to select the most beneficial plan.

Selecting the best Medicare plan depends on your health needs, budget, and preferences. Here are some practical tips: Assess Your Health Needs: Consider your current health status, medications, and preferred doctors. Compare Costs: Review premiums, deductibles, copayments, and out-of-pocket maximums. Check Provider Networks: Ensure your doctors and hospitals are in the plan's network. Review Extra Benefits: Some plans offer vision, dental, hearing, or wellness programs.

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.

S MEDICARE FREE WHEN YOU TURN 65? Many people wonder about the costs associated with Medicare after reaching 65. The short answer is: no, Medicare is not entirely free of charge. Here’s a breakdown of expected expenses: Part A Costs: Most people do not pay a premium for Part A because they have paid Medicare taxes throughout their working years. However, some may be required to pay a premium if they do not qualify based on their work history. Part B Costs: Part B requires a

UNDERSTANDING MEDICARE ENROLLMENT DEADLINES Medicare enrollment deadlines are specific periods when you can sign up for or make changes to your Medicare coverage. These deadlines are crucial because they determine when you can enroll in Medicare Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). Here are the main enrollment periods to keep in mind: Initial Enrollment Period (IEP): This is a

Understanding health coverage options can be overwhelming, especially when it comes to Medicare. This federal program provides essential health insurance to millions of Americans, primarily those aged 65 and older, as well as certain individuals with disabilities younger than 65. Knowing what Medicare covers, the benefits it offers, and the choices available can help you make informed decisions about your healthcare.

How Medicare Works with Your FEHB (Federal Employee Health Benefits) Many individuals working for Governmental Agencies or Departments have Federal Employee Health Benefits (FEHB). This article explains how Medicare interacts with FEHB plans and what federal employees should know about aligning their benefits with Medicare.

We wrote this to help you better understand Medicare concisely and transparently. Medicare consists of four parts. Medicare Part A,  Part B, Part C, and Part D  MEDICARE PART A - Pays for Inpatient Hospitalization, Hospice, and Skilled Nursing Care. MEDICARE PART B - Pays for outpatient doctor visits, Lab Tests, Screenings, and DME. MEDICARE PART C - Is Medicare Advantage MEDICARE PART D - Covers Prescription Medications.

The Medicare AEP (Annual Enrollment Period) runs from October 15th through December 7th every year. During AEP, about 48 million Medicare Beneficiaries will make at least one change to their Healthcare portfolio for the 2026 Plan Year. The Medicare Annual Enrollment Period (AEP) occurs each fall. During the AEP, Medicare beneficiaries can change their current Medicare Advantage Plan or their Stand-Alone Medicare Part D Prescription Drug Plan.

WHY ARE MEDICARE ADVANTAGE PLANS BAD? Misinformation and a lack of understanding can lead to Medicare Advantage nightmares. So, we are here to help clear the air. Medicare Advantage plans are not always problematic. However, they are certainly not a good fit for everyone. You should only enroll in Medicare Advantage coverage if it is the best fit for your unique situation. Below, we clarify why these seemingly too-good-to-be-true plans have a less-than-stellar reputation an

The easiest way to avoid excess charges is to use physicians who accept Medicare assignment. You will never be billed more than Medicare allows for your healthcare services. It’s always a good idea to ask your doctor if they accept assignment before you make an appointment. Don’t forget to ask the same question of any Medicare provider, such as lab facilities and home health care companies. You can also find providers in your area that participate with Medicare using the Med

Once you start receiving Social Security benefits or Railroad Retirement benefits, Medicare premiums will be automatically deducted from those payments. But until then, you may be better off paying Medicare online by using Medicare’s automatically deducted monthly payment system called Easy Pay If you did not work enough quarters to qualify for Premium Free Medicare Part A, or if you are a High Wage Earner who has been assessed with an IRMAA surcharge, you will be billed for

Looking for the Best Medicare Supplement Plan? The best plan for you is not always the cheapest plan. However, working with a Certified Medicare Planner like Michael Braden at Braden Medicare Insurance is a great start,

Thankfully, there are not nearly as many new concerns as last fall, but I think it's still good to share the information.  The most significant nationwide trend is that healthcare costs continue to rise rather than level off. We have seen that MOOP amounts continue to increase, along with Medicare Advantage, Part B Premiums, Part B Deductibles, Medicare Supplement Premiums, and Medicare Part D Deductibles.

Once you’re enrolled in Parts A and B, the next step is determining how you want to receive your benefits. You have two primary options: stick with Original Medicare, which allows you to visit any provider and any hospital in the US, or choose Medicare Part C, also known as Medicare Advantage, which bundles hospital, medical, and often drug coverage into one plan.

Medicare is the most widely used health insurance program for individuals aged 65 and older. If you are nearing eligibility, it is essential to understand what Medicare is and how its four parts work. However, Medicare does not cover everything. You may need to enroll in additional plans to obtain full coverage.

Everything you need to know about Medicare Supplement Insurance plans, including how to change plans and keep your premiums as low as possible which is very important as we age.

What are Medicare Advantage Plans? Medicare Advantage Plans cover all Medicare services.  Some Medicare Advantage Plans also offer extra coverage, such as vision, hearing, and dental coverage.   

Perhaps the most significant benefit is choice and portability. A Medicare Supplement or Medigap plan allows you to choose ANY Doctor, go to ANY Hospital ANYWHERE in the United States, and you are covered, as long as the Doctor and Hospital both accept Medicare's Assignment/Fee Structure.

MEDICARE PRESCRIPTION DRUG PLANS You must be enrolled in Medicare Part A and/or Part B to be eligible to enroll in Part D. Medicare drug coverage is only available through private plans. If you have Medicare Part A and/or Part B and you do not have other drug coverage (creditable coverage), you should enroll in a Part D plan.

Getting older can be challenging.  The healthcare options available to you may seem confusing or unnecessary.  Your inexperience in this new chapter, coupled with ongoing health concerns, creates a recipe for disaster.   With age comes wisdom, and knowing how to navigate the system will demonstrate it.  Getting the coverage and protection that you need is much easier than it seems.  Here are three essential parts of enrolling in Medicare that will help guide you through the p

A Medicare Supplement plan is an excellent option for people who prefer the government-run Medicare program but want a few more of their costs covered. This article explains what a Medicare Supplement plan is, how it works, the benefits each plan offers, and mo

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.

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.

However, there is a stark difference. Medicare is the National Health Insurance Program for Americans age 65 and over, as well as those with ALS or Renal Failure, or those who have been issued a Disability designation by the Social Security Administration. Medicaid operates at the state level and helps provide Health Care and other vital services to low-income individuals, seniors, single mothers, and children.

Medicare HMOs are common because of the lower premiums they often offer. In some plans, that premium may be as low as $0. However, you must remain enrolled in and pay for Medicare Part B. You usually must also use in-network providers, except in an emergency.  MEDICARE ADVANTAGE HMO PLANS = MEDICARE HEALTH MAINTENANCE ORGANIZATION PLANS In HMO Plans, you generally must get your care and services from providers in the plan's network, except:

Each plan that offers prescription drug coverage under Medicare Part D must provide at least the standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different "tiers" on their formularies. (A formulary is a listing of all of the drugs/medications that a particular plan has available to its members.  All Medicare Part D Plans must have two drugs available in each category. 

Everything you need to know about Medicare starts here: there are three ways to receive Medicare coverage: Original Medicare, Medicare Advantage, and Medicare Part D. Each option has its own benefits and costs. 

Plans F and G are the most popular Medigap plans because they take away ugly healthcare billing surprises. High-deductible F and G Medigap plans do the same thing, but choosing these plans means you have to have enough savings to pay the annual deductible upfront.

Original Medicare includes Medicare Part A  (Hospital Insurance) and Medicare Part B (Medical Insurance).  The Government pays for 80% of all Medicare-covered and Medically Necessary procedures, while you, the Medicare Beneficiary, pa for the other 20% of health services not paid for by Medicare. You typically pay for services as you receive them. When you get services, you’ll pay a deductible at  the start of each year, and you usually pay 20% of the cost of the  Medicare-ap

What makes matters confusing to the public is that it is different from any Healthcare we have ever had, and it uses words, concepts, and acronyms we have never seen or heard of before. However, once you have a chance to work with someone who not only understands Medicare but also has the requisite skills and attributes to teach and explain it to others, it becomes much less daunting. In this article, I have tried to encapsulate Medicare in a basic but friendly format that

If you’re 65 or older, you are eligible for Medicare. You may elect employer coverage instead of Medicare if you or your spouse is actively employed and your employer offers creditable coverage. Generally, if your employer has more than 20 employees, Medicare considers its Group Health Plan creditable. If your employer has fewer than 20 employees, Medicare does not consider your Group Health Plan creditable coverage. In this case, you should consider dropping your plan and en

Currently, and since 2020, Medicare Supplement Plan G has been the most popular and the most purchased Medicare Supplement plan, and it is not even close. As of January 1, 2020, Medicare Supplement Plan F was the most popular plan; however, it is no longer available to anyone who was not 65 before 1/1/2020. Since then, Plan G has taken over.

The reason Special Needs Plans exist is to better serve individuals with a Team approach to their care. Having multiple "Specialists" in their networks is vital to these individuals receiving the best possible care possible. It is also an efficient way to coordinate resources for the Insurance companies. Medicare SNPs typically have specialists in the diseases or conditions that affect their members.

From this article, you’ll learn about what Medicare costs you can deduct from your taxes. We will talk in-depth about Medicare expenses that are and are not deductible, about whether and when the self-employed can deduct their health insurance premiums, and whether or not you can pay for your Medicare premiums with your HSA funds.

A Medicare PFFS Plan is a type of Medicare Advantage Plan (Medicare Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medigap. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.  

CAN YOU CANCEL YOUR MEDICARE ADVANTAGE PLAN? Yes, you can cancel your Medicare Advantage plan. You need to qualify for one of the four Medicare Enrollment Periods during the Medicare Plan Year. The short answer is yes; however, you can only do this during certain times of the year, and there are a few trap doors you need to navigate. But if you are truly unhappy or dissatisfied with your Medicare Advantage Plan, this Article is definitely what you need to read.

What do we mean by Do All Doctors Accept Medicare? The Term "Accepts Medicare" refers to Doctors who have signed an agreement with the Government to see and treat patients, using the national Medicare Fee Schedule for the rates they charge for a given appointment, treatment, or service. No, not all doctors in America accept Medicare. A few do not take it, but the overwhelming majority of physicians and other Healthcare professionals accept Medicare.

Medicare uses Prior Authorization to ensure that certain medical services or prescription drugs meet specific coverage criteria before they are approved and paid for. Prior Authorization rules are implemented as cost-saving measures. Medicare wants to ensure that every Medical Procedure is medically necessary for the beneficiary's health.

A Medicare Insurance Broker, also known as a Medicare Broker or Medicare Agent, undergoes extensive training on Medicare law and Medicaid services and is officially certified by insurance companies by CMS guidelines. They are required to adhere to stringent regulations, particularly about marketing and enrollment, ensuring full compliance with Medicare, state insurance regulations, and private insurance companies.

You may never need to file a Medicare Claim, but if you do, we want to provide you with step-by-step instructions on how to file a Medicare Claim in the event you ever need it.