Cohen Insurance Agency

06/15/2026

Do you need a referral to see a specialist with Medicare Advantage?
Most people assume yes — because that's how regular insurance works. But with Medicare Advantage, it depends on the plan type.
Here's a quick breakdown:
HMO plans — Yes, you typically need a referral from your primary care doctor before seeing a specialist. Your care is coordinated through your P*P.
PPO plans — No referral needed. You can go directly to any in-network specialist, and you even have the option to see out-of-network providers (usually at a higher cost).
PFFS and SNP plans — It varies. Some require referrals, some don't, depending on how the plan is structured.
This is one of the most important things to understand when choosing a plan — especially if you have specialists you already see or conditions that need ongoing care.

06/11/2026

Most people don't know this — but you can change your Medicare plan outside of Open Enrollment.
It's called a Special Enrollment Period, or SEP.
A SEP gives you a limited window to make changes to your Medicare coverage when a qualifying life event happens. You don't have to wait until fall.
Here's what can trigger one:
— You move to a new address that's outside your plan's service area
— You lose other health coverage, like employer insurance or Medicaid
— You move into or out of a nursing home or assisted living facility
— Your plan loses its Medicare contract or leaves your area
— You qualify for Extra Help (Low Income Subsidy)
— You become eligible for both Medicare and Medicaid
Each SEP has its own timeframe. Most give you 60 days from the qualifying event to act. Miss that window and you may have to wait until Open Enrollment in the fall.
The key is knowing what counts — and moving quickly when it does.
If something in your situation has changed, it's worth finding out whether you qualify for a SEP.

06/08/2026

Still working at 65? Here's what you need to know about Medicare.
Many people assume Medicare is automatic at 65. It's not — and if you have employer coverage, you may be able to delay it without any penalty.
Here's how it works:
If you work for a company with 20 or more employees and you're covered under their group health plan, you can delay both Part A and Part B with no late enrollment penalty. Your employer coverage acts as "primary" insurance, and Medicare steps aside until you're ready.
When you eventually retire or lose that coverage, you get an 8-month Special Enrollment Period to sign up for Medicare without penalties.
A few important points:
— COBRA and retiree coverage do NOT count as employer coverage for this purpose. Once you're on either of those, your SEP clock starts.
— If your employer has fewer than 20 employees, Medicare becomes primary — meaning you should enroll at 65 even if you stay on the employer plan.
— Part A is usually free, so many people enroll in Part A at 65 regardless, even if they delay Part B.
Working past 65 is more common than ever. Knowing your options helps you avoid costly mistakes down the road.

06/03/2026

Most people are surprised to learn that Original Medicare — Part A and Part B — does not cover three very common health needs.
Dental. Medicare does not cover routine dental care. That means no cleanings, no fillings, no extractions, and no dentures. Some limited coverage may apply if a dental procedure is directly tied to a covered medical treatment, but that's the exception, not the rule.
Vision. Routine eye exams are not covered. Neither are eyeglasses or contact lenses. The only vision-related coverage under Original Medicare is for certain medical conditions affecting the eye, like cataracts or glaucoma treatment.
Hearing. Routine hearing exams are not covered. Hearing aids — which can cost thousands of dollars — are also excluded entirely from Original Medicare.
These three gaps affect millions of Medicare beneficiaries every year. Knowing what's not covered is just as important as knowing what is.

06/01/2026

Every year I talk to people who picked a plan because it said $0 premium — and then got surprised by the bills.
Here's the reality:
$0 premium means you don't pay the insurance company monthly. It does NOT mean the plan is free.
You still pay Medicare Part B ($202.90/mo for most people). And when you use the plan, you're paying copays, coinsurance, and potentially thousands toward a deductible.
A $0 premium plan with a $9,000 max out-of-pocket and high specialist copays can cost you far more in a bad year than a plan with a $40/month premium and lower cost-sharing.
The premium is just one number. The full picture matters.

05/28/2026

Medicare Advantage vs. Supplement — The Simple Breakdown
Turning 65 and feeling overwhelmed by Medicare options? Let me break it down.
Medicare Advantage (MA): One all-in-one plan. Lower premiums, copays for doctor visits, usually $0 dental/vision/hearing. But networks matter — you'll see doctors in their plan. Good if you like simplicity and don't travel much.
Medigap Supplement: Fills the gaps Medicare leaves behind. You keep Original Medicare (freedom to see any doctor), and a supplement covers copays, coinsurance, and deductibles. Costs more monthly, but zero restrictions on doctors.
The real question: Do you value low premiums and bundled benefits, or do you want unlimited doctor choice?
There's no "right" answer — it depends on your health, budget, and doctors.

05/25/2026

🚨 Medicare Tip: Do you know if your current coverage is "creditable"?
This one word can cost you — or save you — money for life.
Creditable coverage means your current employer or union plan is at least as good as Medicare's standards. It applies to TWO parts of Medicare:
💊 Part D (Drug Coverage) — If your drug plan is creditable, you can delay Part D without a penalty. If it's not, and you go 63+ days without qualifying coverage, you get a lifetime monthly penalty.
🏥 Part B (Medical Coverage) — If you're actively working (or covered through a working spouse), you may delay Part B penalty-free. But once that coverage ends, you have a limited window to enroll. Miss it — permanent 10% penalty per year you delayed.
📋 Your employer is required to send you a Notice of Creditable Coverage each year — usually before October 15th. Keep that letter.

05/20/2026

Most people don't think twice about Part D when they turn 65.
"I don't take any medications — I'll skip it for now."
That's one of the most expensive Medicare mistakes I see.
If you go without creditable drug coverage and don't enroll in Part D when you're first eligible, the government adds a late enrollment penalty to your premium.
It's 1% of the national base premium for every month you went without coverage.
And it never goes away. You pay it every month for the rest of your life.
The good news — enrolling the right way from the start costs you nothing extra. That's exactly what I help people do.
Have questions about Part D or when you need to enroll? Drop them in the comments or send me a DM. Always free to chat.

Call now to connect with business.

05/18/2026

Turning 65? Don't make this Medicare mistake. 👇

Most people don't know they only have a 7-month window to sign up for Medicare when they turn 65. Miss it, and you could face penalties that never go away — they get added to your premium every single month for life.

The good news? A Medicare broker helps you navigate all of it completely free. We get paid by the insurance companies, not by you.

If you or someone you love is turning 65 in the next 6 months, send me a message or drop a comment below — I'll make sure you don't miss a thing. 🙌

05/14/2026

Here's the one mistake I see most often:
Waiting too long to sign up for Medicare Part B.
If you're retiring and losing employer coverage, you have an 8-month Special Enrollment Period to sign up — but miss it and you'll pay a late penalty every month for life.
The penalty adds 10% to your Part B premium for every 12-month period you were eligible but didn't enroll. That adds up fast.
The key is knowing your window and acting before your employer coverage ends — not after.