Welcome to Fast Friday Q&A on Real Easy Medicare with Al Kushner! In this episode, Al tackles a wide range of Medicare questions from enrollment timing to coverage details, providing clear, concise answers you can act on immediately.

1. Coverage Start Dates
   • Part A/B begin the first day of your 65th birthday month (or prior month if born on the 1st) when enrolled during IEP
   • MA and Part D plans start January 1 during open enrollment; SEP start dates vary
2. Keeping Your Doctor
   • Original Medicare + Supplement: see any provider accepting Medicare
   • MA: must use network doctors except emergencies; verify participation by phone
3. Missed Enrollment Windows
   • Locked into MA until next OEP (Oct. 15–Dec. 7) unless qualifying SEP; MA OEP (Jan. 1–Mar. 31) allows one change
4. Cost Breakdown
   • Part B: $185/month base premium (2025), $257 annual deductible
   • Part A: free with 40 work quarters
   • Part D: $15–$100/month
   • Medigap: $50–$300/month depending on plan and location
5. MA vs. Medigap
   • MA: lower premiums, network restrictions, built-in gap coverage
   • Medigap: higher premiums, provider freedom, separate Part D required
6. Drug Coverage Solutions
   • Request formulary exceptions with medical justification
   • Pay cash price toward OOP cap if necessary before switching plans
7. Plan Change Rules
   • MA and Part D: open enrollment only or SEP
   • Medigap: change anytime but underwritten after IEP unless guaranteed issue
8. Dental & Vision
   • Original covers minimal emergency services
   • MA plans often include dental and vision extras; evaluate plan specifics
9. Appeals & Denials
   • Start level-1 redetermination within 60 days of denial; escalate through five levels with stronger documentation
10. Working Past 65
    • Employer with 20+ employees: delay Part B penalty-free; enroll in Part A at 65; eight-month SEP after coverage ends
11. Travel & Relocation
    • Original Medicare portable nationwide; MA covers emergencies out-of-network only
    • Moving triggers SEP for MA/Part D; Medigap guaranteed issue may apply
12. Doctor & Plan Matching
    • Use Physician Compare and office referrals; always verify network status and new-patient openings
13. Part D Coverage Gap Update
    • As of 2025, Part D donut hole will be eliminated; $2,000 true OOP cap then $0 cost share
14. Cost Assistance Programs
    • Medicare Savings Programs and Extra Help for low-income beneficiaries
    • SHIP offers free state counseling

Next Week Preview: A weeklong series on solving Medicare problems—from enrollment hurdles and billing errors to network disputes and prescription challenges.

Welcome to Tips & Tricks Thursday on Real Easy Medicare with Al Kushner! In this episode, Al delivers 19 actionable strategies to streamline your Medicare journey, reduce costs, and safeguard your benefits.

1. Medicare Card Protection Trick
   • Carry copies or phone photos of your card; keep the original safe at home; annotate emergency contacts on copies
2. Provider Network Research Trick
   • Call doctor offices to ask about prior authorization delays, denial rates, and new-patient policies—not just network inclusion
3. Part D Pharmacy Shopping Trick
   • Identify preferred pharmacies for lower copays; compare local versus mail-order pricing for each medication
4. Medigap Shopping Trick
   • Solicit quotes from at least five insurers for identical Plan F coverage; evaluate rate increase histories and household discounts
5. Claims Tracking Trick
   • Maintain a spreadsheet of services and compare against Medicare Summary Notices; set up a Medicare.gov account for real-time monitoring
6. Emergency Preparation Trick
   • Assemble and update tri-location emergency folders containing card copies, medication lists, and provider contacts
7. Annual Review Trick
   • Begin plan comparisons in September; list providers and prescriptions first, then calculate total annual costs
8. Provider Communication Trick
   • Confirm Medicare assignment, request cost estimates before procedures, and obtain copies of all test results
9. Prescription Money-Saving Trick
   • Ask pharmacists about generics, manufacturer discounts, pill splitting, and 90-day supply savings
10. MA Extra Benefits Trick
    • Maximize gym, dental, vision, OTC, and transportation benefits by scheduling early and reviewing benefit catalogs
11. Appeal Process Trick
    • Document all interactions, request written denial explanations, use certified mail, and escalate to supervisors as needed
12. Customer Service Strategy
    • Call during off-peak hours, note representative names and reference numbers, and persist politely
13. Open Enrollment Preparation
    • Research plan changes before October, focusing on network shifts and formulary updates
14. Medicare Advantage Escape Hatch
    • Use MA’s Jan 1–Mar 31 Open Enrollment to switch plans or revert to Original Medicare if dissatisfied
15. SEP Trigger Awareness
    • Recognize moving ZIP codes, losing coverage, or provider exits as SEPs to change MA or Part D plans off-cycle
16. Technology Optimization
    • Utilize Medicare.gov and plan mobile apps for claims tracking, provider searches, and instant benefit checks
17. Fraud Protection
    • Never share your Medicare number with unsolicited callers; report scams immediately to 1-800-MEDICARE
18. Medigap Underwriting Tip
    • If denied coverage, apply to different insurers—underwriting criteria vary significantly between companies

Welcome to Wisdom Wednesday on Real Easy Medicare with Al Kushner! Drawing on four decades of experience, Al reveals elite-level strategies to optimize your Medicare coverage and reduce costs.

1. Hidden 90-Day Benefit Period
   • A single benefit period spans multiple hospital or SNF stays within 60 days, avoiding repeated $1,632 Part A deductibles; track your 60 lifetime reserve days carefully
2. Medicare Secondary Payer Techniques
   • Strategically choose when employer or indemnity insurance pays first to minimize out-of-pocket; stack accident, critical illness, or hospital indemnity policies
3. Medigap Birthday Rule Exploits
   • In states like California and Oregon, switch Medigap plans annually during your birth month without underwriting; intra-company switches may apply elsewhere
4. Network Quality over Quantity
   • Evaluate local specialist depth rather than total network size; identify responsive providers by calling offices about appointment availability
5. True Out-of-Pocket Cap Insight
   • The $2,000 Part D true out-of-pocket cap replaces the donut hole; timing high-cost drug purchases no longer accelerates a gap
6. Appeal Success Path
   • Appeals win rates climb from 20% at level 1 to 60% at ALJ level; persistence and thorough documentation are critical
7. Social Security–Medicare Synergy
   • Coordinate premium deductions, assistance programs (QMB, SLMB, QI), and optimal enrollment timing for tax and cost advantages
8. HSA Continuation Strategy
   • Delay Part A enrollment under HSA-qualified employer coverage to maintain tax-free HSA contributions post-65; requires pre-65 planning
9. Geographic Cost Planning
   • Compare Medicare Advantage and Medigap rates across ZIP codes before relocating; retirement location can double or halve premiums
10. Critical Enrollment Timing
    • Medigap’s six-month guaranteed issue window versus MA’s annual OEP and SEPs; missing these windows locks in coverage

Next Episode Preview: Tips & Tricks Thursday—actionable hacks and shortcuts you can implement immediately to streamline your Medicare journey.