Your Medicare questions, answered.

A Medicare broker is a licensed insurance professional who represents multiple insurance companies rather than just one. We help you compare the plans we represent against your doctors, prescriptions, and budget, walk you through enrollment, and stay on as your point of contact for questions and plan reviews afterward.

No. Our guidance, plan comparisons, enrollment help, and ongoing support come at no additional cost to you. There are no fees, and there is never an obligation to enroll in anything.

Brokers are paid a commission by the insurance company when you enroll in a plan, at rates that are regulated for Medicare plans. That compensation comes from the carrier, not from you.

No. Your premium is exactly the same whether you enroll through a broker or directly with the insurance company. Using a broker adds guidance, not cost.

Yes. We are independent and currently licensed and appointed with 12+ carriers. That independence is what lets us compare options for you instead of defending a single company’s catalog.

Yes, that is the core of what we do. We compare the plans we represent side by side on costs, benefits, provider networks, and prescription coverage, then explain the trade-offs in plain language so you can decide.

Yes. J&M Benefit Solutions is a husband-and-wife brokerage based in Jacksonville, and you will find us out at community events around Northeast Florida all year.

Our office is on Jacksonville’s Westside at 5310 Lenox Ave, Suite 22, Jacksonville, FL 32205, by appointment only. Call us at 904.869.2959 and we will get you directions, or set a time that works for you.

Absolutely. You are welcome to visit our Westside office, and we regularly sit down with clients face to face. In-person meetings are how many of our client relationships start.

Yes. When it is easier for you, we are happy to come to you. Wherever we meet, the goal is the same: guidance that feels personal and comfortable.

Yes. Phone and video appointments work well for comparisons, reviews, and most enrollments, and the advice is identical to what you would get in person.

Yes, and this is the part we care most about. Enrollment is the beginning of the relationship, not the end. We remain your resource for questions, plan changes, and annual reviews year after year.

Call us first. Whether it is a claim question, a billing surprise, or a coverage denial, we help you understand what happened and work through the plan’s process to get it addressed.

Yes. Before you enroll, we check the plans you are considering against your list of doctors and hospitals, because network fit matters more than any premium difference.

Yes. Bring your exact prescription list, names and dosages, and we check each medication against a plan’s drug list and preferred pharmacies before you commit.

Most people first enroll during their Initial Enrollment Period, the seven months surrounding their 65th birthday: the three months before their birthday month, the birthday month, and the three months after. Special and General Enrollment Periods exist for other situations. Our month-by-month timeline walks through the whole window.

Only if you are already receiving Social Security or Railroad Retirement benefits, in which case you are enrolled in Parts A and B automatically and your card arrives in the mail. Everyone else needs to sign up.

About three to six months before you turn 65. That leaves time to gather your doctors, prescriptions, and budget, understand your two coverage paths, and enroll early enough for day-one coverage.

It depends, mostly on the size of your employer. With creditable coverage from an employer of 20 or more employees, you can usually delay some parts of Medicare without penalty. With fewer than 20 employees, Medicare generally becomes primary and skipping it can leave gaps. Details are in Still Working at 65?

Usually yes, if the coverage comes from active employment at a larger employer and counts as creditable. You then get a Special Enrollment Period to add Part B later without penalty. COBRA and retiree coverage do not count as active employer coverage for this rule.

The same employer rules generally apply to coverage through a working spouse: if the plan is creditable and comes from active employment, you can usually delay Part B and get a Special Enrollment Period later. Confirm the employer’s size and the plan’s creditable status before deciding.

It is your first, seven-month window to enroll: three months before your birthday month, your birthday month, and three months after. Enrolling in the first three months gives you coverage starting the first of your birthday month.

Enroll in the three months before your birthday month and coverage generally starts the first day of the month you turn 65. Enroll during or after your birthday month and coverage generally starts the first of the month after you sign up.

Through Social Security: online at ssa.gov, by phone, or at a local office. If you choose a Medicare Advantage, Supplement, or Part D plan on top of that, the plan enrollment is a separate step, and one we handle with you.

Yes. Social Security handles enrollment in Parts A and B, even though Medicare itself is run by the Centers for Medicare & Medicaid Services.

If you did not have other creditable coverage, late enrollment can mean permanent premium penalties and a wait for the next General Enrollment Period. The full picture is in our penalties guide

Generally, your Part B premium rises 10 percent for each full 12-month period you could have had Part B but did not enroll and had no creditable coverage. The increase lasts for as long as you have Part B.

Generally, 1 percent of the national base premium for every month you went without Part D or other creditable drug coverage after your window closed, added to your premium for as long as you have Medicare drug coverage. A gap of 63 days or more starts the clock.

Part A is hospital insurance: inpatient stays, skilled nursing after a qualifying stay, hospice, and some home health. Part B is medical insurance: doctor visits, outpatient care, labs, equipment, and preventive services. Together they are called Original Medicare. All four parts are explained here

Hospital care under Part A and medical care under Part B: doctors, outpatient services, labs, durable medical equipment, and a long list of preventive services. It does not include prescription drug coverage; that is Part D.

By itself, Original Medicare generally does not cover routine dental, vision, or hearing care, hearing aids, long-term custodial care, or outpatient prescription drugs. It also has no annual cap on your out-of-pocket costs, which is the gap Supplements and Advantage plans address in different ways.

Medicare Advantage (Part C) is an alternative way to receive your Part A and B benefits through a private, Medicare-approved plan. These plans typically use provider networks, usually include drug coverage, often add extra benefits, and cap your annual out-of-pocket costs.

A Medigap plan works alongside Original Medicare: Medicare pays first, and the supplement helps pay your share, deductibles and coinsurance. You can generally see any provider in the country that accepts Medicare, and you add a separate Part D plan for prescriptions.

Part D is prescription drug coverage, offered either as a standalone plan added to Original Medicare or built into most Medicare Advantage plans. Every Part D plan has its own drug list, which is why checking your exact medications matters.

Advantage replaces how you receive your benefits through a network-based private plan with pay-as-you-go costs and an out-of-pocket cap. A Supplement works with Original Medicare for broad provider access and more predictable costs, usually at a higher monthly premium. Here is the full comparison

No. Medigap does not work with Medicare Advantage, and it is illegal for anyone to knowingly sell you a Medigap policy while you are on an Advantage plan. You choose one path or the other.

Original Medicare generally does not cover routine dental care like cleanings, fillings, or dentures, though it can cover certain dental services tied to covered medical procedures. Many Medicare Advantage plans include dental benefits; what is included varies by plan.

Original Medicare generally does not cover routine eye exams or glasses, though it covers certain medical eye care, such as cataract surgery and disease-related exams. Many Advantage plans add routine vision benefits.

Original Medicare does not cover hearing aids or routine hearing exams. Some Medicare Advantage plans include hearing benefits; coverage details vary by plan.

Outpatient prescriptions are covered through Part D, either a standalone drug plan or drug coverage inside a Medicare Advantage plan. Original Medicare alone covers only limited drugs, such as those administered in a clinical setting.

Yes. Part A covers inpatient hospital care after its deductible, with cost sharing that depends on the length of the stay. How much of that lands on you is a big part of the Advantage-versus-Supplement decision.

Yes. Part B covers outpatient mental health services such as therapy and psychiatric visits, Part A covers inpatient psychiatric care, and Part D covers prescribed medications. Cost sharing depends on your plan setup.

Yes, extensively. Medicare covers a yearly wellness visit and a long list of screenings and vaccines, many at no cost to you when your provider accepts assignment.

No, if nothing important changed, keeping your plan is often right. But you should review it every year, because plans change their costs, networks, and drug lists each January even when your needs do not.

Yes. Plans can change premiums, copays, extra benefits, and provider networks from one calendar year to the next. Your plan mails an Annual Notice of Change each fall; read it, or bring it to us and we will read it with you.

Yes. Copays, coinsurance, deductibles, and the out-of-pocket maximum can all reset or change each January, even on the same plan.

Yes. A plan can change its drug list, pricing tiers, and preferred pharmacies each year, which means a medication that was inexpensive this year deserves a fresh check for next year.

Yes. Provider networks change, and a doctor or hospital can leave a plan’s network. This is one of the most common reasons clients call us mid-year, and a key thing we re-check at every annual review.

Four things: your plan’s Annual Notice of Change, your doctors and hospitals against next year’s network, your prescriptions against next year’s drug list, and your total expected costs. That review takes minutes with your documents in hand, and we do it with clients at no cost every fall.

Mainly during the Annual Enrollment Period, October 15 to December 7, for a January 1 start. Advantage members also get the Medicare Advantage Open Enrollment Period, January 1 to March 31, for one switch. Certain life events open Special Enrollment Periods at other times.

October 15 through December 7 each year. During AEP you can join, drop, or switch Medicare Advantage and Part D plans, with changes taking effect January 1.

January 1 through March 31. If you are already in a Medicare Advantage plan, you can make one change: switch to another Advantage plan, or return to Original Medicare and add a Part D plan.

A window to change plans outside the normal seasons, triggered by qualifying events such as moving out of your plan’s service area, losing other coverage, or your plan leaving Medicare. Each has its own rules and timing.

Moving out of your plan’s service area typically triggers a Special Enrollment Period to pick a new plan where you live. Plan availability differs county to county, so a move is always worth a coverage review, even within Florida.

You get a Special Enrollment Period to choose new coverage, and in some situations specific rights to buy a Medicare Supplement. If you get a non-renewal letter, do not panic and do not wait; bring it to us and we will map your options.

Yes. People who qualify for both are called dual eligible. Medicare pays first and Medicaid can help with premiums, cost sharing, and some services Medicare does not cover.

A D-SNP is a type of Medicare Advantage plan designed specifically for people who have both Medicare and Medicaid, coordinating the two and often including extra benefits tailored to that situation.

Qualified Medicare Beneficiary is a Medicare Savings Program through Medicaid. For those who qualify, it helps pay Part A and Part B premiums and Medicare deductibles, coinsurance, and copays, and providers are not allowed to bill you for Medicare cost sharing.

Specified Low-Income Medicare Beneficiary is a Medicare Savings Program that helps pay your Part B premium for those whose income falls within its limits.

Qualifying Individual is another Medicare Savings Program that helps pay the Part B premium. It requires an application each year, is granted first come first served, and is not available if you also receive full Medicaid.

Extra Help, also called the Low-Income Subsidy, is a federal program that lowers Part D prescription costs, premiums, deductibles, and copays, for people whose income and resources qualify.

Yes. Through Medicare Savings Programs such as QMB, SLMB, and QI, state Medicaid programs pay the Part B premium for people who qualify. Florida has its own application process, and we can point you in the right direction.

A few programs can do that. If a Medicare Savings Program starts paying your Part B premium, that amount stops being deducted. Some Medicare Advantage plans also offer a Part B giveback that reduces your premium deduction.

Some Medicare Advantage plans pay part, or occasionally all, of your Part B premium for you, which shows up as a smaller deduction from your Social Security check. The amount varies by plan and county, and a giveback alone should never be the reason you pick a plan.

Yes, and they work as two separate systems: VA benefits cover care at VA facilities, and Medicare covers care outside the VA. Many veterans enroll in Medicare so they have coverage in both worlds. VA drug coverage counts as creditable, so skipping Part D while you have it does not trigger a penalty.

TRICARE For Life acts as wraparound coverage that pays after Medicare. To keep TFL you must be enrolled in Parts A and B. TFL includes creditable drug coverage, so most TFL members do not need a separate Part D plan, and they generally do not need a Medicare Supplement either.

Look for someone local, licensed in Florida, independent, and appointed with multiple carriers, then confirm the guidance is free and pressure-free. That is exactly how we built J&M Benefit Solutions; here is our story

Yes, we serve clients throughout Duval County and the surrounding Northeast Florida counties, and we are licensed in Florida, Georgia, Oklahoma, Texas, and Michigan for clients who split time between states.

Yes. We check the plans we represent against your specific doctors and medical groups before you enroll, because keeping your doctors is usually the deciding factor.

Yes. Whether you prefer Baptist Health, Mayo Clinic, UF Health, Ascension St. Vincent’s, or another area system, we verify hospital network participation for the plans you are considering before anything is signed.

Yes. Plan availability is county-specific, and we compare the Duval County options we represent against your doctors, prescriptions, and budget. Our Jacksonville guide shows how we approach it.

If you had a Medicare Advantage or Part D plan somewhere else, moving into this area typically triggers a Special Enrollment Period, and your old plan may not operate here. A move is the right moment for a full coverage review, and we make that easy.

Yes. Meet us at our Westside office, at your kitchen table, or at one of the community events we set up at around town all year. And if a call or video meeting is easier, the advice is exactly the same.