Your Medicare Questions, Answered

Most people should sign up during their Initial Enrollment Period — a 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Enrolling in the first 3 months ensures your coverage starts on your birthday. If you miss this window without qualifying coverage elsewhere, you could face lifetime penalties on your Part B premium.

Not necessarily. If you have health insurance through your employer (or your spouse's employer) and that employer has 20 or more employees, you can typically delay Medicare without penalty. When that employer coverage ends, you get a Special Enrollment Period to sign up without penalty. However, the rules differ for smaller employers. Ashley can help you figure out the right timing for your situation.

Most people are automatically enrolled in Medicare Part A and B when they begin collecting Social Security benefits. If you're not collecting Social Security yet, you'll need to actively enroll through Social Security — online at ssa.gov, by calling 1-800-772-1213, or by visiting a local Social Security office.

Original Medicare (Parts A and B) does not cover routine dental, vision, or hearing care. However, many Medicare Advantage (Part C) plans include these benefits. If you're on Original Medicare and want this coverage, you'd need to purchase separate dental, vision, or hearing insurance. Ashley can compare plans that offer these benefits in San Diego County.

Original Medicare does not cover most outpatient prescription drugs. To get drug coverage, you need to either enroll in a standalone Part D plan (if you have Original Medicare) or choose a Medicare Advantage plan that includes drug coverage. Ashley compares drug plans based on your specific medications to find the lowest total cost.

Original Medicare generally does not cover healthcare outside the U.S. However, some Medicare Supplement (Medigap) plans include limited foreign travel emergency coverage. Medicare Advantage plans vary — check the plan's Evidence of Coverage. If you travel internationally, this is an important factor to consider when choosing your coverage.

Original Medicare does not cover: long-term custodial care (nursing home stays for daily living assistance), routine dental care, dentures, routine eye exams or glasses, hearing aids, most prescription drugs, cosmetic surgery, or most care outside the U.S. Understanding these gaps is exactly why many people add a Supplement plan, Medicare Advantage, or both Part D and a Medigap plan.

Most doctors in the U.S. accept Medicare — but not all. When using Original Medicare, you can see any doctor who accepts Medicare nationwide. Medicare Advantage plans typically have a network of providers; seeing someone outside that network may cost more or not be covered at all. Ashley always checks whether a plan covers your specific doctors before recommending it.

Medicare Part A is premium-free for most people (if you or a spouse worked 10+ years paying Medicare taxes). Part B has a standard monthly premium (around $174 in 2024, higher for higher incomes). Add a Medicare Advantage plan (some have $0 premiums), a Supplement plan, and/or a Part D plan — each has its own premium. Ashley helps you model total annual costs so you can budget accurately.

IRMAA (Income-Related Monthly Adjustment Amount) is an extra premium added to Part B and Part D for people with higher incomes. It's based on your income from 2 years prior. If your income has recently dropped significantly (due to retirement or a life event), you can appeal the IRMAA surcharge using Social Security Form SSA-44.

Yes. Several programs help people with limited income pay for Medicare costs: Medicare Savings Programs (help pay Part B premiums, deductibles, and copays), Extra Help (a federal program that helps with Part D costs), and Medicaid (for those who qualify). Ashley can point you toward the right resources if cost is a concern.

Yes. During the Annual Open Enrollment Period (October 15 – December 7 each year), you can switch Medicare Advantage plans, switch from Medicare Advantage back to Original Medicare, or change your Part D drug plan. Changes take effect January 1 of the following year. There are also Special Enrollment Periods triggered by qualifying life events.

Yes, during Open Enrollment (Oct 15–Dec 7), you can return to Original Medicare. However, if you want to add a Medigap plan at that point, you may need to pass health underwriting (because your Medigap Open Enrollment has passed). This is one reason some people stay on Original Medicare with a Supplement from the start — it gives them more long-term flexibility.

A Special Enrollment Period (SEP) is a time outside the annual enrollment window when you're allowed to make Medicare changes. Common triggers include: losing employer coverage, moving out of your plan's service area, qualifying for or losing Medicaid, or your plan leaving the area. The SEP rules vary by the triggering event.

Ashley is paid directly by the insurance carriers — not by you. Her services are always free to Medicare beneficiaries. This is how independent Medicare brokers work nationwide. You pay the same monthly premium whether you enroll through a broker or directly through the insurance company.

Yes. Ashley is an independent broker, meaning she is not employed by or committed to any single insurance company. She can recommend plans from any carrier she's contracted with, and her only obligation is to find the plan that's best for you. She'll tell you honestly if your current plan is a good fit.

Ashley doesn't disappear after enrollment. She's available year-round to help you with billing questions, claims issues, finding in-network providers, and any other Medicare concerns. She also proactively reviews your plan each fall to make sure it still meets your needs.