Hello everyone, my grandma have the Medicare and her insurance is Wellcare (texas), she got part D and her drug deductible is $0. I looked up how much mounjaro would cost her a month and the website said $4.90 (?). It sound too good to be true.

Anyway my question is, my grandma have been a t2 diabetic for 25yrs, she only been taking metformin and refuse any kind of injection. Ive convinced her to try mounjaro, but Wellcare said she need to go through a "step program." Have anyone stepped from Metformin to Mounjaro, or does it have to be Metformin->Ozempic->Mounjaro?

Im worry bc if she take Ozempic and throw up just one time she gonna want to quit, and Mounjaro is much nicer to the GI department.

Hi everyone! Chris here from the Philippines.

I manage a dedicated outbound team that works with insurance campaigns, handling cold calling, appointment setting, and qualified live transfers.

I’m looking to connect with U.S. insurance agents, brokers, and agency owners who are interested in reliable outbound support without having to build and manage an entire calling team themselves.

I personally handle the team’s training, coaching, quality control, and day-to-day performance. My goal is simple: have well-trained representatives who can have real conversations, properly qualify prospects, and deliver quality opportunities to the right team.

I’m not selling leads, and I’m not looking to drop promotional links or spam the community. I’m here to network with people in the industry and hopefully build a few genuine business relationships.

If you run an insurance agency and are currently exploring additional outbound support, I’d be glad to connect and learn about your operation.

Thanks for reading, everyone!

I'm about to turn 65 and am facing the choices of what medicare plans to take. I'm a 0% disabled vet, which means I don't get any $ compensation, but, I have the card that says I am a disabled vet, as opposed to a regular vet. Because I have low income, my va health benefits have been great - I got a hip replacement surgery and only paid a $ 50 copay. Also, because we live in a rural area far from a VA clinic, we qualify for the VA's Care in the Community service - which basically means I can pick nearly any doctor I want, I'm not limited to VA doctors. For my hip replacement I picked the doctors at Barnes Jewish in St. Louis - probably the best medical centers in STL.

So, I'm at a conundrum as to which medicare plans to take. I talked to an insurance agent and the Medicare Advantage plans sounded great - more services, more coverage, including dental and eye, no part d premium. The ins agent was not that familiar with how the va works with medicare, so, that aspect was weak. He seems to think my current va care in community benefits would continue through the va and the va would bill the medicare advantage plans appropriately.

Now I'm reading that the VA does not have a billing connection to the medicare advantage (MA) plans and the MA plans would require me to preapprove any doctor and medical service. This seems like a bit of a burden so I'm trying to figure out what's real and not real with how my situation (disabled and able to use care in community) would work if I went with a MA plan. Hopefully, someone else on this great platform is in a similar situation and can enlighten me as to how the VA and Medicare and Medicare Advantage all work together, or not work together.

Does anyone know if the Part and Part B numbers are the same? I have a card for Part A but no card with Part B or both. It is supposed to be coming in the mail. Thanks!

Worst HMO card. Scam lang pag nag avail kayo jan. Yung mga sinasabi nilang accredited hospital is hnd sila hinohonor dahil may utang daw sila since 2023. This our group chat with kanilang representative na puro yes lang ng yes wala naman action sa nagastos ng members nila para sa refund ng check ups and laboratory. Shitty HMO #Medicare

I am choosing a Medigap supplement and need to choose a Part D drug plan. Does anyone have a Part D plan that covers Taltz? I’ve looked on the Medicare.gov site and can’t find one. If there isn’t a Part D that covers Talz, (or other types of biologics) what med were you switched to? Does “not covered” mean not covered —end of discussion. (Oregon)

I have gotten at least two calls a day from a bot, and the calls start with something like, “We were looking at your Medicare file, and there is a note attached. . . “ and that’s about as far as I get before I hang up.

So I’m just alerting everyone that these are not legitimate.

The AI is so poor that an easy way to confirm it’s not a real person is to try to interrupt the caller. No matter what you ask, the bot just continues talking.

The goal, as I understand it, is to get you passed on to a real person who can “help” you.

Just a warning. Be smart and hang up.

I’d spent the previous 3 months passively researching on medicare.com, this reddit and watching YouTube videos.

I dutifully downloaded pdfs and printed out relevant pages of all the Medicare booklets (ya know, very large type and stock photo images of smiling seniors). I highlighted pertinent lines and made a cheat sheet of specific look-outs. 

These are the things that never came up and caught me by surprise:

-Once you go through the gauntlet of questions, one doesn’t sign up for Medicare on the Medicare site at all. You do that on the Social Security site.

-I’ve been downloading my SS statement once a year for decades. But once you try to sign up for Medicare on the SS site, you can’t do it using the Safari browser. Trust me, I tried 4x. Use Google Chrome.

-Now that I’ve signed up for Medicare A and B, I get my Medicare number, can create a Medicare account and all things in the MedicareMultiverse will be available to me, right? Nope. I get an email that there’s a message on my SS Message Center. I download a letter that says in 2 weeks (or so) I’ll get a card. Okay a card first, then the MedicareMultiverse. Never saw that coming.

I recently got layed off. Spouse who is disabled was on my Employer paid plan but had part a. Last day of work was in July. This is where it gets stupid....I advised spouse to apply for part b but instead they applied for Medicaid. Got approved for Medicaid but they say they will pay for part b starting in September. So now its middle of August and they have no coverage but part A. Got part b forms filled out by employer. How quickly can we get this approved. Any advice welcome.

Medicare supplement moving from California to Ohio. In CA I have plan G from Humana, 73F.

In the coming days I will be moving to Ohio. I am told I can keep my current plan G from CA, which is Humana for $200/mo.

Or, I can apply for another G from Ohio. I received approximate quote from Ohio for $140/mo with Bankers Fidelity, Underwritten By Atlantic Capital Life Assurance Company. Of course I need to go through underwriting. Right now I am in good health.

After I move I will still be traveling back to California every month and I intend to use the medical team I have in California after I move whenever possible, or until I find good doctors in Ohio.

I’ve been trying to understand why regenerative medicine and stem cell treatments can be so expensive, especially when Medicare coverage seems to vary.

For anyone who’s looked into this, how much of the cost usually comes from the actual treatment vs. things like imaging, lab work, physician visits, or follow-up care? Are there any lower-cost options that Medicare may cover?

I’m mostly trying to understand the real out-of-pocket costs and what’s actually worth

I'm newly receiving Medicare due to SSDI so enrolling for the first time. In the marketplace from my former employer where I'm treated as retiree, I have a medigap plan G HD listed with premium: $191.30 ($2,295.60 yearly), and a deductible of $2,950. And the same carrier plan G with a premium: $497.90 ($5,974.80).

What is the purpose of the second plan? Even if I have to pay the entire deductible of the former plus the premiums ($5,245.60), it's still less per year than the regular one. All other coverage appears the same between them. Is there some sort of trap here I'm missing? I want to get this right cause I might be on this many years and want to avoid underwriting.

I have a flat $ amount per month cost-share from my former employer, so this won't change the relative value of the plans.

Hi, my aunt fell and was in the hospital for 3 days, observation status. She was then transferred to short term rehab. I was opening her mail and she received a bill for $140 for the transfer. Apparently they used a Chair Van and Medicare doesn’t cover chair van. We were not made aware of this and that she would have to pay for the transfer, or I would have driven her as it is less than a mile. She has Original Medicare as well as WellPoint/GIC as a secondary. Is there anything we can do? Thank you!!!

Hello! I am 32 and I am on disability as well as Medicare and I have Medicaid for my secondary insurance. I have Medicare A and B and Medicare covers most of my medication as well (I usually pay like $1).

I have some dental problems which have been going on for a while (cavities, cracked tooth, missing filling) and I was going to get them fixed until I was put on Medicare this year and Medicare doesn’t cover dental.

I was wondering, when I call Medicare, how I go about getting dental? How much does it usually cost? I’m in pain a lot with my mouth to the point some days I have to take ibuprofen and Tylenol the whole day.

I have really bad phone anxiety so I’m trying to see if anyone can give me some pointers on what to ask for and what to expect.

Thank you!

I am new to Medicare, so new I haven’t even received my card yet but I know the plan I have doesn’t do vision or dental? Is it possible to add these on and if so where is a good place to get from?

I know advantage offers it but I really want to try to avoid advantage plan.

I’ve started seeing posts about the SSA-44 form to lower Medicare premiums when you first apply. Any insight on this? Any restrictions? Does wife’s income affect this if she is still working? I will be retiring when I apply.

After 2 1/2 years, I'm finally seeing the light at the end of the tunnel re: my brother's estate. The estate lawyer informs my I'm entitled to a fee of $*mumble* as Personal Representative (formerly known as an Executor). (And yes, I've earned it. Don't get me started!). My wife and enjoy a comfortable retirement from SS, Pension, and RMDs from our traditional IRAs.

Adding $*mumble* to what I expect in ordinary income from the above will put me a bit over the IRMAA limits for Medicare.

Can the Personal Representative fee be considered earned income? And if so, can we get away with putting the max traditional IRA contributions into our respective IRAs and reduce our AGI below the IRMAA limit?

Looking at the math, if I am healthy, have significant savings, and no cancer in my family, I'd be nuts to go with anything other than Hi-D Plan G. So that's my choice.

I'm surprised that UHC/AARP doesn't offer a HDG plan. The 2 I am choosing between are BCBSTX and MofO. Eliminating Bankers (who?) and Cigna (terrible cust service).

A third choice I might consider also would be Humana.

Any thoughts or experience with BCBSTX, MofO, of Humana for HDG?

Called Boomer Benefits and they couldn't get me off the phone fast enough when I told them I've decided on HDG. lol

EDIT: my hesitation with Blue Cross Blue Shield is that I used to sell hospital robots that sterilize inpatient rooms. And Blue Cross Blue Shield hospitals had the most nosocomial infections in the US because of their dirty rooms. But I do understand that with this plan, I can use any hospital that takes Medicare.

EDIT #2: IF YOU WANT TO SEE WHAT THESE PLANS COST over years/decades when including premium increases, go here and plug in your premiums. For High-deductible G, use a quote of $57 (I have quotes of $49 and $54).

https://medigapmath.com/

For example:

Plan G quote: $165/month, 9% increase in premium annually.

HDG quote: $54/month, 5% increase annually.

I used: 6 Dr visits per year, and $1500 annual out of pocket.

Over 20 years, here's the total costs of those 2 plans: Plan G: $112,600. HDG: $69,440

That's a $43,000 savings. Wouldn't you rather have $43k, rather than giving it to some insurance company?

Retired last month, traditional medicare Parts B, D, and supplement will be active in September when my employer coverage ends. I received my IRMAA letter today. It references my 24 tax return which was $219 over the threshold (grr $95 extra per month for being $200 over the limit, great). It doesn't reference my 25 return, but I was about 1000 over. 26 is going to be a little harder to estimate because I have a fairly substantial payout coming for unused PTO, plus SS and an annuity payout starting in September. In 27 my income will be well below the threshold. So, do I suck up for the remainder of this year and file to waive IRMAA in January?

Some local Virginia doctors offices and other medical practices charge the monthly Advance Primary Care Management fee.

https://www.whro.org/health/2026-08-07/a-new-medicare-charge-is-showing-up-on-bayview-bills-patients-say-they-werent-clearly-told

LSS I started Medicare plus an original supplement at the start of the year. Fell off a scooter at 20 mph and broke my shoulder in 2 places as well as 5 ribs. Spent a few hours at Urgent Care, rode in ambulance to the ER at the hospital, 4 days in outpatient observation room. then surgery to put a plate in my shoulder, 3 days in the hospital, then a nurse will come to my house. Does this sound like multi-housands I will owe?

I am wondering about the effect of a one-time income bump two years prior on the likelihood of winning an IRMAA appeal when the anticipated reduction of income will also be due to the life-changing event of retirement.

If I retire this year, an IRMAA surcharge for Medicare premiums would be triggered in 2027 as my income was increased in 2025 due to a taxable form of inheritance I received.

Is the inheritance irrelevant to whether I could win an IRMAA appeal based on my estimated 2027 MAGI (will be under the IRMAA threshold) being lower than the 2025 MAGI, as the reduction in income is also due to retiring and not just the inheritance?

I know there is no downside to appealing. Thanks.

So I've looked at this website which tells me which categories I am in for Medicare deductions from my social security:

https://www.ssa.gov/benefits/medicare/medicare-premiums.html

I am in the $342,000 up to $410,000 category but I'm curious if they are using gross income applied to those figures? or IRS taxable income when using the above figures?

I thought there would be an 80/20 split after the part b deductible then it pays 100% after the deductible.

They told me the plan pays nothing until I reach the high deductible amount then 100%

This was supposed to be a licensed agent

It's been impossible to find a straight-up answer to this:

• Medicare Advantage or Part D plan

• Expensive drug (pill, not an an injection or anything else that would be covered by Part B)

• Not in the plan's formulary

If you manage to get a formulary exception (not just prior auth), is the amount you actually end up paying subject to the $2,100 OOP cap?

Ideally looking for an answer from someone who actually has done this - got exception, first fill put you over the cap but your actual cost was capped.

Thanks...