
Medicare covers a lot, but Medicare Parts A and B alone may not offer all the coverage you want or need. For example, Medicare doesn’t cover most dental, vision, and hearing care, including hearing aids. It also doesn’t cover most non-emergency transportation or care outside of the United States. Even when Medicare does cover your care, there may be out-of-pocket costs left to you, like copays and coinsurances, that can really add up. Today we’ll discuss ways to add on to your Medicare to help you access these types of care. A quick-reference handout is available here for download.
Medigaps: Covering out-of-pocket costs
Medigaps are health insurance policies that work with Original Medicare—not with Medicare Advantage. They are sold by private insurance companies.
- If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may cover outstanding deductibles, coinsurance, and copayments.
- Medigaps may also cover health care costs that Medicare does not cover at all, like emergency care received when travelling abroad.
If you want to purchase a Medigap policy, you need to find out the best time to buy one in your state.
• In most states, insurance companies must only sell you a policy at certain times and if you meet certain requirements.
• If you miss your window of opportunity to buy a Medigap, your costs may go up, your options may be limited, or you may not be able to buy a Medigap at all.
• Even if you do not have the right to buy a Medigap in your state, you may still be able to buy a policy if a company agrees to sell you one. However, know that companies can charge you a higher price because of your health status or other reasons.
Medicare Advantage Plans: Supplemental benefits
Medicare Advantage Plans may cover things that Medicare can’t cover. These are called supplemental benefits. Examples of common supplemental benefits are: dental care, vision care, hearing aids, and gym memberships.
Medicare Advantage Plans can also offer benefits that are not primarily health-related for beneficiaries who have chronic illnesses, like meal delivery, transportation for non-medical needs, and home air cleaners.
Medicaid: For limited income and assets
Medicaid in your state may cover dental, vision, hearing, long-term care, or transportation services. You may qualify for Medicaid if you have a low income and minimal assets. Contact your local Medicaid office to learn if you qualify.
Stand-alone plans: Covering what Medicare doesn’t
You can purchase stand-alone dental, vision, or hearing plans through private insurance companies.
Strategies for low-cost care outside of Medicare
You can find low-cost care for services not covered by Medicare, in places like Federally Qualified Health Centers or Community Health Centers. Schools and facilities that train dentists, optometrists, and audiologists may also offer low-cost care. Students work with patients under the supervision of experienced, licensed providers.
Look out for over-the-counter (OTC) hearing aid scams
Medicare does not cover most hearing care, including hearing aids. Because OTC hearing aids are a new product, older adults may not realize that they can buy one without a prescription from a doctor. Fraudsters may take advantage of this, stealing a person’s Medicare number when selling the devices. Also, some companies selling OTC hearing aids may make false claims, have unclear or misleading labels, and fail to offer the guarantees and customer support they promise.
Below are red flags that may point to hearing aid scams, identified by the National Council on Aging (NCOA):
- Unknown brand names: Instead, look for well-known and reputable brands with reviews on hearing and retail websites. You can learn about a company’s reputation online at the Better Business Bureau or TrustPilot.
- Misleading labels: Make sure your device is clearly labeled as a hearing aid (rather than, for example, a “hearing enhancement”) to avoid buying a different kind of product.
- Fake FDA registration certificates: The FDA does not issue registration certificates, so this could be a scam or misleading marketing.
- Extremely low prices: Companies selling hearing aids far below the price of other companies may be trying to sell you a hearing product other than a hearing aid, or trying to sell you a very poor-quality device. Consider your budget but remember that a deal that seems too good to be true, may be just that.
- No trial period or warranty: Most companies offer at least a 30-day trial period to test new devices, and some offer even more. Be cautious of companies that don’t offer these trial periods or warranties.
- Lack of customer support: Avoid companies that don’t clearly have contact information on their website. Reputable companies should be easy to contact with issues you’re experiencing.
- Unsupported claims: There is currently no cure for hearing loss, so be wary of companies that claim their products can cure hearing loss or offer immediate relief from symptoms.
Hearing aid scams can range from dishonest companies misleading you to someone calling to tell you Medicare will cover a hearing aid in an attempt to get your Medicare number or promise you other unneeded medical supplies.
For more information call your local SHIP/SMP contact. In Florida the State Health Insurance Assistance Program (SHIP) is known as SHINE. Call 866-413-5337 toll-free, email shineinfo@aaaswfl.org, or visit floridashine.org.

The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,534,081 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
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Last Updated: February 5, 2025 by Leave a Comment
2025 Community Health Survey for Collier and Lee Counties
We’re partnering with NCH, the Florida Department of Health in Collier County, the Healthcare Network, and the Health Planning Council of Southwest Florida to help conduct a community survey on healthcare needs in Collier and Lee Counties. Your participation is crucial in identifying gaps in services, improving access to care, and ensuring a healthier future for all residents. Your input will directly influence the development of programs and resources that better meet our community’s needs. We appreciate your time and valuable insights! (En español)
Download the survey or fill it out online.
Posted: January 29, 2025 by Leave a Comment
Medicare Minute: Premium-related Appeals and Troubleshooting
Late enrollment in Medicare or a higher income can lead to higher premiums. However, everyone has the right to appeal their premium determination. Understanding how these premiums work can help you assess their accuracy and decide if you should appeal. Download a detailed handout from the Medicare Rights Center here.
Income-Related Monthly Adjustment Amount (IRMAA)
The Medicare Income-Related Monthly Adjustment Amount, often shortened to IRMAA, is an amount you may owe in addition to your Part B and Part D premium if your income is above a certain level. Federal law sets income brackets that determine your—or you and your spouse’s—IRMAA each year.
Find the chart of monthly premiums for Part B and Part D based on your annual income here.
You can ask for a new IRMAA determination. If the Social Security Administration determines that you owe an IRMAA, they will mail you a notice called an initial determination. This notice should include information on how to request a new initial determination. A new initial determination is a revised decision that Social Security makes regarding your IRMAA. You can request that Social Security revisit its decision if you have experienced a life-changing event that caused an income decrease, or if you think the income information Social Security used to determine your IRMAA was incorrect.
Part B Late Enrollment Penalty
For each 12-month period you delay enrollment in Medicare Part B, you will owe a 10% Part B late enrollment penalty (LEP)—generally every month for as long as you have Medicare. Everyone has a right to file an appeal with the Social Security Administration (SSA) regarding their LEP. To appeal, follow the directions on the letter informing you about the penalty. Unfortunately, being unaware of the requirement to enroll in Part B is unlikely to be a successful argument for an appeal.
How to calculate the Part B LEP:
Let’s say you delayed enrolling in Medicare Part B for seven years and you owe a premium penalty. Your monthly premium would be 70% higher for as long as you have Medicare (7 years x 10%). Since the base Part B premium in 2025 is $185, your monthly premium with the penalty will be $314.50 ($185 x 1.7).
Part D Late Enrollment Penalty
For each month you delay enrollment in Part D, you will owe a 1% Part D LEP (generally every month for as long as you have Part D). The Part D penalty is always calculated using that year’s national base beneficiary premium. Your penalty will not decrease if you enroll in a Part D plan with a lower premium.
Everyone has the right to file an appeal with C2C Innovative Solutions regarding their LEP determination. C2C Solutions is the company contracted by Medicare to handle these appeals. You can appeal the penalty (if you think you were continuously covered) or its amount (if you think it was calculated incorrectly). You should complete the appeal form you received from your plan, attach any evidence you have, and mail everything to C2C Innovative Solutions.
How to calculate the Part D LEP:
Let’s say you delayed enrollment in Part D for seven months (and you didn’t have other creditable drug coverage, which allows you to delay enrollment). Your monthly premium would be 7% higher for as long as you have Part D (7 months x 1%). The national base beneficiary premium in 2025 is $36.78 a month. Your monthly premium penalty would therefore be $2.57 ($36.78 x 0.07 = $2.57) per month, which you would pay in addition to your plan’s premium.
Identify billing errors
Health care providers and their billing departments sometimes make billing errors or honest mistakes. If you think your doctor or their billing department made an error or mistake, contact them directly to resolve the issue. They should correct these errors if you tell them.
You can spot these errors by keeping an appointment calendar or using a My Health Care Tracker to keep track of your medical appointments and services. You can call your local Senior Medicare Patrol (SMP) for a My Health Care Tracker if you don’t already use one. The tracker can help you compare your appointments, services, and notes to your Medicare statements.
If something does not seem right on your Medicare statement, remember to first call your provider. Here are just a couple examples of potential errors:
If your provider does not resolve the issue, or if you notice a pattern of errors, contact your local Senior Medicare Patrol (SMP). In Southwest Florida, call 866-413-5337. They can assist to try to resolve the error. Your SMP can also help you identify Medicare potential fraud, or abuse, and can help you report it to CMS and the correct authorities.
SHINE counselors can also provide you with individual Medicare counseling to support you in your specific situation. Call us at 866-413-5337 or email shineinfo@aaaswfl.org.
The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,534,081 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
Posted: January 27, 2025 by Leave a Comment
Medicare’s General Enrollment Period
Typically, individuals enroll in Medicare during the months surrounding their 65th birthday. However, if you missed your seven-month Initial Enrollment Period, there’s still hope. You may be eligible to sign up during the General Enrollment Period (January 1 – March 31). Once you’ve signed up, your coverage will begin the following month.
Have questions? SHINE, your local SHIP program, can help. To request SHINE counseling, call the Helpline at 866-413-5337 or visit www.floridashine.org to submit a contact request.
Posted: January 22, 2025 by Leave a Comment
Area Agency on Aging for SWFL Launches a Long-Term Hurricane Ian Recovery Assistance Program in Lee County
Recovery from a major disaster such as Hurricane Ian is a process that can take years. Seniors and adults with disabilities can be especially vulnerable and often face unique challenges, making their recovery even more difficult. The Area Agency on Aging for Southwest Florida (AAASWFL) is committed to helping seniors and adults with disabilities rebound from their losses and sustain their physical, social, economic, and emotional well-being.
We have been awarded a micro-grant from the Lee County Unmet Needs Long Term Recovery Group (UNLTRG) to help provide ongoing support to older adults and adults with disabilities in Lee County with unmet needs associated with Hurricane Ian.
We are very grateful for the opportunity to continue supporting clients in recovery.
To qualify for this assistance, you must be a Lee County resident age 60+ or age 18+ with a disability. To learn more, call our helpline at 866-413-5337 and ask about our Hurricane Ian Disaster Assistance Program.
We know that the disaster assistance process can be difficult to navigate. Our new Disaster Assistance Coordinator, Patti Teel, is here to help Lee County residents who are still working to recover from Hurricane Ian. She can help assess your eligibility for local assistance, connect you with matching recovery programs and provide application assistance upon request.
Help is just a phone call away!
Last Updated: December 26, 2024 by Leave a Comment
Protect Yourself from Financial Scams This Holiday Season
Financial scams and fraud can happen at any time but usually start to
increase during this time of year. Older adults are especially vulnerable.
Protect yourself and your loved ones from being scammed or becoming a victim of fraud this holidays season.
Area Agency on Aging for SWFL is participating in this year’s Home for the Holidays campaign, a national campaign led by USAging and the Eldercare Locator. The campaign features a brochure, Protect Your Wallet: A Guide to Avoiding Financial Scams, which highlights common scams that target older adults, tips for avoiding scams and resources for reporting scams.
If you need help identifying financial scams, we can help! Call 866-413-5337.
Posted: December 26, 2024 by Leave a Comment
Prevent, Detect, Report
Senior Medicare Patrol (SMP) team members help educate and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse. To learn more, visit https://smpresource.org/.
Ask for help. If you have questions about how to protect yourself, need to report fraud, or want help determining whether you’ve been a victim, Senior Medicare Patrol can help. Contact your local SHIP-SMP program by calling the Helpline at 866-413-5337.
SMP News:
Be on the lookout, COLA Scam for individuals receiving Social Security benefits.
On October 11, 2024, SSA issued a Scam Alert related to the annual Cost of Living Adjustment (COLA). While the COLA is automatic and will take effect January 2025, scammers are disseminating false information claiming that steps need to be taken to obtain the COLA. This is false, to read the full Scam Alert, click here (PDF FILE).
Florida Father and Son Charged with $28 Million Health Care Fraud and Kickback Scheme
https://smpresource.org/father-and-son-charged-with-28-million-scheme/
Posted: December 26, 2024 by Leave a Comment
Medicare Minute: What’s New for Medicare in 2025?
Your Medicare coverage and costs can change annually, so it’s important to review your benefits.
Here’s an overview of what’s new in 2025. (Download a detailed breakdown – PDF Handout)
Part A: Hospital Insurance
$285 per month if you’ve worked 7.5 to 10 years
$518 per month if you’ve worked fewer than 7.5 years
$419 per day for days 61-90 each benefit period
$838 per lifetime reserve day after day 90 in a benefit period (You
have 60 lifetime reserve days that can only be used once.
They’re not renewable.)
$209.50 per day for days 21-100 each benefit period
Part B: Medical insurance
(For individuals with incomes below $106,000 or
couples with incomes below $212,000)
Part D: Prescription drug coverage
Catastrophic coverage
You will owe $0 on covered drugs after reaching this cap.
Changes to Part D in 2025
The $2,000 cap on out-of-pocket drug costs
this out-of-pocket limit, you owe nothing for covered drugs for the rest of the year.
covered drugs and your progression through coverage periods—and this information should
appear in your monthly statements.
coverage phases. If you spend money on non-covered drugs, those costs will not help you
reach the annual cap.
The Medicare Prescription Payment Plan (MPPP)
costs.
you manage your monthly expenses.
medications, you can spread those costs throughout the year—rather than paying a lot in the
first months of the year and nothing in later months of the year.
You should pay $0 at the pharmacy for your covered Part D drugs. Your plan will pay the costsharing at the time of your purchase and send monthly bills to you for the cost-sharing
amounts. You pay no fees or interest, even if your payment is late.
“New” Medicare card schemes
Do you know what isn’t new this year? Your Medicare card.
Medicare beneficiaries are not receiving new cards this year, but scammers
may try to convince you otherwise. For example, scammers may falsely tell
you that Medicare is issuing new cards—perhaps a card that is plastic, or a
card that has a chip in it. The scammers may tell you that for them to send
your new card, you need to verify your identity, which could include your
Medicare number. This is an attempt to get your personal or financial
information.
Here are some red flags to look for:
card
charged a fine
Who to contact
• Contact your State Health Insurance Assistance Program (SHIP) if you have
questions about 2025 coverage, enrollment periods, or cost assistance programs. In Southwest Florida, call 866-413-5337 or email shineinfo@aaaswfl.org.
• Contact your Senior Medicare Patrol (SMP) if you may have experienced
Medicare fraud, errors, or abuse. In Southwest Florida, call 866-413-5337 or email shineinfo@aaaswfl.org.
• Contact your Medicare Advantage or Part D plan to ask about 2025 changes
to your costs or coverage. In Southwest Florida, call 866-413-5337 or email shineinfo@aaaswfl.org.
• Call 1-800-MEDICARE (1-800-633-4227) to request another copy of your 2025
Medicare & You handbook.
The Medicare Rights Center is the author of portions of the content in these materials but is not
responsible for any content not authored by the Medicare Rights Center. This document is
supported by the Administration for Community Living (ACL), U.S. Department of Health and
Human Services (HHS) as part of a financial assistance award totaling $2,534,081 with 100
percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily
represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
Posted: November 27, 2024 by Leave a Comment
Medicare Minute: Adding on to Medicare
Medicare covers a lot, but Medicare Parts A and B alone may not offer all the coverage you want or need. For example, Medicare doesn’t cover most dental, vision, and hearing care, including hearing aids. It also doesn’t cover most non-emergency transportation or care outside of the United States. Even when Medicare does cover your care, there may be out-of-pocket costs left to you, like copays and coinsurances, that can really add up. Today we’ll discuss ways to add on to your Medicare to help you access these types of care. A quick-reference handout is available here for download.
Medigaps: Covering out-of-pocket costs
Medigaps are health insurance policies that work with Original Medicare—not with Medicare Advantage. They are sold by private insurance companies.
If you want to purchase a Medigap policy, you need to find out the best time to buy one in your state.
• In most states, insurance companies must only sell you a policy at certain times and if you meet certain requirements.
• If you miss your window of opportunity to buy a Medigap, your costs may go up, your options may be limited, or you may not be able to buy a Medigap at all.
• Even if you do not have the right to buy a Medigap in your state, you may still be able to buy a policy if a company agrees to sell you one. However, know that companies can charge you a higher price because of your health status or other reasons.
Medicare Advantage Plans: Supplemental benefits
Medicare Advantage Plans may cover things that Medicare can’t cover. These are called supplemental benefits. Examples of common supplemental benefits are: dental care, vision care, hearing aids, and gym memberships.
Medicare Advantage Plans can also offer benefits that are not primarily health-related for beneficiaries who have chronic illnesses, like meal delivery, transportation for non-medical needs, and home air cleaners.
Medicaid: For limited income and assets
Medicaid in your state may cover dental, vision, hearing, long-term care, or transportation services. You may qualify for Medicaid if you have a low income and minimal assets. Contact your local Medicaid office to learn if you qualify.
Stand-alone plans: Covering what Medicare doesn’t
You can purchase stand-alone dental, vision, or hearing plans through private insurance companies.
Strategies for low-cost care outside of Medicare
You can find low-cost care for services not covered by Medicare, in places like Federally Qualified Health Centers or Community Health Centers. Schools and facilities that train dentists, optometrists, and audiologists may also offer low-cost care. Students work with patients under the supervision of experienced, licensed providers.
Look out for over-the-counter (OTC) hearing aid scams
Medicare does not cover most hearing care, including hearing aids. Because OTC hearing aids are a new product, older adults may not realize that they can buy one without a prescription from a doctor. Fraudsters may take advantage of this, stealing a person’s Medicare number when selling the devices. Also, some companies selling OTC hearing aids may make false claims, have unclear or misleading labels, and fail to offer the guarantees and customer support they promise.
Below are red flags that may point to hearing aid scams, identified by the National Council on Aging (NCOA):
Hearing aid scams can range from dishonest companies misleading you to someone calling to tell you Medicare will cover a hearing aid in an attempt to get your Medicare number or promise you other unneeded medical supplies.
For more information call your local SHIP/SMP contact. In Florida the State Health Insurance Assistance Program (SHIP) is known as SHINE. Call 866-413-5337 toll-free, email shineinfo@aaaswfl.org, or visit floridashine.org.
The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,534,081 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
Last Updated: November 25, 2024 by Leave a Comment
Volunteer to Be a Medicare Counselor
Make a difference by helping others navigate Medicare, join our team! In Florida, your local SHIP program is SHINE (Serving Health Insurance Needs of Elders). Learn more about volunteering with SHINE here. We currently need volunteers in DeSoto, Glades, Hendry and Sarasota counties.
SHINE counselors provide unbiased support to Medicare beneficiaries and their families so they can make informed decisions about their care and benefits.
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