Question 1

How do you get paid?

Accepted Answer

Fred gets paid directly by the insurance carriers when you enroll in a plan through Lakes Health Insurance. Calling the carrier directly to enroll will not save you any money on your monthly premium — and you'll be stuck calling an 800# when you need help.

Question 2

Can you help me review my plans each year?

Accepted Answer

Yes! Fred will email you Medicare information throughout the year. As the Annual Election Period each fall approaches, he'll reach out to see if you're interested in reviewing your plan.

Question 3

Part D – What does the 2026 $2,100 cap really mean?

Accepted Answer

In 2026, there will be a cap of $2,100 on co-pays you could spend out of pocket for Part D medications. That $2,100 does not include your premium or deductible. It applies to Part D (pharmacy) medications — not Part B medications like chemotherapy or IV drugs administered in a healthcare setting.

Question 4

Does the $2,100 cap apply to chemotherapy or Part B medications?

Accepted Answer

No. Part D medications are prescriptions your doctor calls into a pharmacy — these fall under the $2,100 cap if they're in the formulary. Part B medications — chemotherapies, IV drugs, or injectables administered in a healthcare setting — do NOT fall under the cap.

Question 5

What is IRMAA?

Accepted Answer

IRMAA stands for Income Related Monthly Adjustment Amount. If your Modified Adjusted Gross Income (MAGI) is above certain thresholds, you pay a surcharge on top of your standard Part B and Part D premiums. It's based on your federal tax returns using a two-year look-back period.

Question 6

Can I appeal my IRMAA?

Accepted Answer

Yes. If you had a life-changing event (retirement, divorce, death of spouse, loss of income) that reduced your income, you can appeal your IRMAA using Form SSA-44.

Frequently Asked Questions