Fast Friday Q&A: Clear Answers to Your Top 20 Medicare Questions

Welcome to Real Easy Medicare’s Fast Friday Q&A with Al Kushner! In this episode, Al delivers rapid-fire solutions to common Medicare dilemmas—no fluff, just straightforward guidance based on 40 years of expertise.

Enrollment

• Missed Part B IEP? Enroll during General Enrollment (Jan 1–Mar 31), coverage begins July 1; 10% penalty per year delayed
• Switch MA to Original Medicare during Jan 1–Mar 31 MA OEP or Oct 15–Dec 7 OEP
• Delay Part B with active employer coverage (20+ employees); retiree plans don’t count

Cost & Coverage

• Zero-premium MA plans may hike deductibles/copays—always review total plan changes
• Part D removal: 60-day SEP to change plans
• Medigap pricing varies by state, age, and plan—shop multiple insurers

Benefits & Services

• Dental: minimal under Original Medicare; some MA plans include limited dental
• Ambulance: covered under Part B with 20% coinsurance after deductible
• Out-of-network doctors: Original Medicare pays approved rates; MA requires network

Plan Changes & Appeals

• Unhappy with MA? Switch during OEP windows; first-year beneficiaries have guaranteed rights
• Medigap changes subject to underwriting post-IEP; birthday-month rule in select states
• Claim denials: request redetermination within 120 days (Original Medicare) or follow MA appeal process

Special Situations

• Moving states: Original Medicare nationwide; MA/Part D requires new plans via SEP
• Dual VA coverage: VA not creditable for Part B delay; take Part A and consider Part B

Final Advice

• Keep personalized Medicare questions coming for future Fast Friday episodes
• Always verify details with 1-800-MEDICARE or consult qualified advisors for complex scenarios