YOU ASKED, WE ANSWERED
Medicare FAQ
The questions we hear most often, about coverage, costs, enrollment, and how we work. If you don't see your question here, call us and we'll answer it directly.
YOU ASKED, WE ANSWERED
Frequently Asked
Questions
These are the questions we hear most often from people navigating Medicare for the first time, and from people who've had Medicare for years but still aren't sure they're in the right plan. If you don't see your question here, call us or fill out the form and we'll answer it directly.
About Our Services
⟶ Is there any cost for your services? No, our services are completely free to you. We are compensated by insurance carriers when we help you enroll at no additional cost. The premium is identical whether you enroll through us or directly with the carrier.
⟶ Are you tied to one insurance company? No, we are completely independent. We are appointed with every major Medicare carrier in Ohio and have no financial incentive to recommend one over another. Our only goal is the right plan for you
⟶ Do you offer in-home appointments? Yes, we offer both in-person meetings and phone/virtual consultations. We come to you if that's easier, or we can handle everything by phone
⟶ What happens after I enroll, are you still available? Absolutely, we maintain an ongoing relationship with every client, conduct annual reviews each fall, and are available any time you have questions about your coverage, a claim, or a billing issue.
About Medicare Coverage
⟶ Does Medicare cover dental? Original Medicare does not cover routine dental. Some Medicare Advantage plans include dental benefits. Standalone dental plans are also available, ask us about your options.
⟶ Does Medicare cover vision? Original Medicare covers medically necessary eye care but not routine eye exams or glasses. Many Medicare Advantage plans include routine vision benefits.
⟶ Does Medicare cover hearing aids? Original Medicare does not cover hearing aids. Some Medicare Advantage plans include hearing benefits including hearing aid allowances.
⟶ Does Medicare cover prescriptions? Original Medicare does not cover outpatient prescription drugs. Part D plans provide drug coverage. Most Medicare Advantage plans include Part D drug coverage built in.
⟶ Does Medicare cover care outside the U.S.? Original Medicare generally does not cover care outside the U.S. Some Medigap plans cover foreign travel emergencies. Medicare Advantage plans vary on international coverage.
About Costs
⟶ What is the Medicare Part B premium? The standard Part B premium is $202.90/month in 2026. Higher-income beneficiaries pay more through IRMAA surcharges based on income from two years prior.
⟶ What is IRMAA? Income-Related Monthly Adjustment Amount — an additional surcharge on Part B and Part D premiums for higher-income Medicare beneficiaries. It's based on your tax return from two years ago
⟶ Can I appeal my IRMAA if my income has changed? Yes, if you experienced a significant income reduction due to retirement, marriage, divorce, or other qualifying life events, you can appeal your IRMAA surcharge. Ask us about the process
⟶ What is the Medicare out-of-pocket maximum? Original Medicare has no out-of-pocket maximum, your costs are unlimited without Medigap. Medicare Advantage plans have annual out-of-pocket maximums set by CMS. In 2026 the maximum allowed is $9,250 for in-network services.
Still Have Questions?
Call us at (937) 971-4987, email info@premierMedicarePlanning.com, or fill out the form and we'll get back to you the same business day. There's no question too simple — we're here to help you understand your options clearly and completely.
COMMON QUESTIONS
Part D Prescription Plans FAQ
How do I know which Medicare plan is right for me?
The right plan depends on your specific doctors, prescriptions, budget, and preferences. There is no one-size-fits-all answer. That's exactly what our free consultation is designed to determine. We analyze your situation and give you a clear, personalized recommendation.
Can I switch Medicare plans at any time?
Generally no. The primary window to switch plans is the Annual Enrollment Period (Oct 15–Dec 7). There is also a Medicare Advantage Open Enrollment Period (Jan 1–Mar 31). Outside of these windows, changes are limited to Special Enrollment Period qualifying events.
What is a formulary and why does it matter?
A formulary is an insurance plan's list of covered prescription drugs, organized into cost tiers. The same medication can be on different tiers on different plans; meaning your monthly cost for that drug varies significantly by plan. This is why we analyze your specific drugs before recommending any Part D or Medicare Advantage plan.
What is a Scope of Appointment form?
A Scope of Appointment (SOA) is a required CMS form that identifies the Medicare products you've agreed to discuss with an agent before a sales appointment. It must be completed before any Medicare Advantage or Part D sales meeting. We handle this as a standard part of every consultation.
Can I have both Medicare and Medicaid?
Yes, people who qualify for both are called 'dual eligible.' If you qualify for Medicaid, you may be eligible for special Medicare Advantage plans called Dual Eligible Special Needs Plans (D-SNPs) that offer additional benefits. Let us know if you think you might qualify.
How do I file a complaint about my Medicare plan?
You can file complaints with CMS through Medicare.gov or by calling 1-800-MEDICARE. You can also contact your State Health Insurance Assistance Program (SHIP). As your agent we can also help you escalate issues with your carrier, call us first and we'll help you navigate the process.