Frequently Asked Questions

Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare. These plans are offered by private insurance companies and include all Medicare Part A and Part B benefits, often with additional coverage like prescription drugs, dental, vision, and hearing. Common types include HMOs, PPOs, and Special Needs Plans (SNPs) for those with chronic conditions.

Medigap (Medicare Supplement Insurance) helps pay for out-of-pocket costs not covered by Original Medicare, such as deductibles, copayments, and coinsurance. Popular plans include Plan G and Plan N. Medigap policies are standardized and sold by private insurers, providing predictable costs and the freedom to see any doctor that accepts Medicare — no network restrictions.

Medicare Advantage replaces Original Medicare with a single bundled plan — usually lower premiums but with provider networks and cost-sharing like copays. Medicare Supplement (Medigap) works alongside Original Medicare and covers most of what Medicare doesn't pay, giving you very predictable costs and the freedom to see any Medicare-accepting doctor nationwide. Which is better depends on your health, budget, and how often you travel or see specialists. A licensed broker can walk you through both side by side at no cost.

Most people should enroll during their Initial Enrollment Period (IEP) — a 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. If you're still working and covered by an employer group plan, you may be able to delay without penalty. Signing up late without a qualifying reason triggers permanent Part B and Part D late enrollment penalties, so timing matters.

There are four main enrollment periods: (1) Initial Enrollment Period (IEP) — 7 months around your 65th birthday. (2) General Enrollment Period (GEP) — January 1 to March 31 each year, for those who missed their IEP; coverage starts July 1 and a late penalty may apply. (3) Annual Enrollment Period (AEP) — October 15 to December 7, when you can switch Medicare Advantage or Part D plans for the next year. (4) Special Enrollment Period (SEP) — triggered by life events like losing employer coverage, moving, or qualifying for Extra Help.

If you don't sign up for Medicare Part B when you're first eligible — and you don't have qualifying employer coverage — you'll pay a 10% penalty added to your Part B premium for every 12-month period you delayed. This penalty is permanent and added to your monthly premium for as long as you have Part B. For example, a 2-year delay means a 20% higher premium for life. This is one of the most important reasons to enroll on time.

The Part D late enrollment penalty is 1% of the national base beneficiary premium for every month you went without creditable drug coverage after your Initial Enrollment Period. Like the Part B penalty, it's added to your monthly Part D premium permanently. If you have creditable drug coverage through an employer, union, or VA, you can delay Part D enrollment without penalty — but you'll want documentation of that coverage.

In 2026, the standard Medicare Part B premium is $185.00 per month for most beneficiaries. Higher earners pay more through the Income-Related Monthly Adjustment Amount (IRMAA) — surcharges that kick in if your income from two years ago exceeded $106,000 (individual) or $212,000 (joint). Part B also has a $257 annual deductible in 2026. Your Part A (hospital) coverage is typically premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years.

IRMAA (Income-Related Monthly Adjustment Amount) is an additional amount higher-income Medicare beneficiaries pay on top of their standard Part B and Part D premiums. In 2026, IRMAA applies if your Modified Adjusted Gross Income (MAGI) from two years ago was above $106,000 (single) or $212,000 (married filing jointly). If your income has recently dropped significantly — due to retirement, for example — you can appeal your IRMAA using Form SSA-44.

HMO (Health Maintenance Organization) plans require you to use a network of doctors and hospitals and usually need referrals to see specialists. They tend to have lower premiums and out-of-pocket costs. PPO (Preferred Provider Organization) plans let you see any Medicare-accepting provider, though you pay less when you stay in-network. PPOs don't require referrals and are a better fit if you travel frequently or have specialists you want to keep. We represent both types and can help you compare them for your area.

It depends on the plan. Each Medicare Advantage plan has its own network of doctors, hospitals, and specialists. Before enrolling, you should verify that your primary care doctor, specialists, and preferred hospital are in-network. Our team checks this for you as part of every consultation — we look up your specific providers against the plans available in your ZIP code.

No — you cannot use a Medigap policy alongside a Medicare Advantage plan. Medigap only works with Original Medicare (Parts A and B). If you want to switch from Medicare Advantage to Original Medicare with a Medigap supplement, you'll need to drop your Advantage plan during an eligible enrollment period, and in Florida you may face medical underwriting if you're outside your open enrollment window.

Original Medicare (Parts A and B) does not cover routine dental care, eyeglasses, contact lenses, or hearing aids. Many Medicare Advantage plans include these benefits as extras, though the coverage level varies by plan. If you have Original Medicare with a Medigap supplement, you'd need a separate standalone dental, vision, and hearing policy to fill that gap. We offer several affordable options for both situations.

Special Needs Plans (SNPs) are a type of Medicare Advantage plan designed for people with specific diseases or characteristics. There are three types: Chronic Condition SNPs (C-SNPs) for conditions like diabetes, heart failure, or COPD; Dual Eligible SNPs (D-SNPs) for people who qualify for both Medicare and Medicaid; and Institutional SNPs (I-SNPs) for people living in a nursing facility. SNPs often include extra benefits and care coordination tailored to your condition.

Yes, but only during specific windows. During the Annual Enrollment Period (October 15 – December 7), you can switch Medicare Advantage plans, drop Advantage for Original Medicare, or change Part D drug plans. During the Medicare Advantage Open Enrollment Period (January 1 – March 31), you can switch Advantage plans or return to Original Medicare once. Switching Medigap plans outside your open enrollment window may require medical underwriting in most states, including Florida.

Medicare does cover short-term skilled nursing facility care — up to 100 days after a qualifying 3-day hospital stay, with full coverage for days 1–20 and a daily copay for days 21–100. However, Medicare does not cover custodial long-term care (help with daily activities like bathing and dressing) in a nursing home or at home. Long-term care insurance or Medicaid are the primary options for ongoing custodial care costs, which can exceed $80,000 per year in Florida.

With Original Medicare, you do not need a referral to see a specialist — you can see any Medicare-accepting doctor directly. With a Medicare Advantage HMO, you typically do need a referral from your primary care doctor. PPO Medicare Advantage plans generally don't require referrals. If seeing specialists without a referral is important to you, this is a key factor to consider when choosing between plan types.

Beyond Medicare plans, we offer dental, vision, and hearing coverage to help with routine care not covered by Medicare. We also provide Hospital Indemnity policies that pay cash benefits for hospital stays, Critical Illness insurance for cancer, heart attack, and stroke events, and Final Expense life insurance designed to cover burial and funeral costs.

No — Core Insurance Solutions does not charge any fees for our services. We offer free, no-obligation consultations to help you understand your options and find the best Medicare and supplemental insurance plans for your unique needs. We're compensated by the insurance carriers when you enroll, so our help costs you nothing.

Getting started is easy. Simply call us at (863) 225-2875, fill out our online contact form, or visit our office in Lakeland, Florida. One of our licensed agents will schedule a free consultation to discuss your healthcare needs, review your current coverage, and help you find the best plan options available in your area.