Frequently Asked Questions

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I get paid directly by the insurance carriers when you enroll in a plan through Lakes Health Insurance. Note that 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..

Yes! I will email you the Medicare information you need throughout the year. I will make sure that as the Annual Election Period each fall approaches, I reach out to see if you are interested in reviewing your plan.

Regarding Medicare Part D prescription drug coverage costs in 2026, there will be a cap of $2,100 on co-pays that you could spend out of pocket. That $2,100 does not include your premium or deductible. 

Unfortunately, it is not. Think of your medications in two main categories.

1. Part D medications. Those are the prescriptions your doctor calls into Walgreens or CVS.  These are the medications that fall under this $2,100 cap if they are in the formulary. 

2. Part B medications. When it comes to chemotherapies or medications you get by an IV or injectables, anything in a healthcare setting, those are typically Part B medications. They do not fall under this cap.  Typically, in a Medicare Advantage plan, a person will pay 20% of their Part B medications up to the Max out-of-pocket defined by the Medicare Advantage plan. That 20% has nothing to do with this $2,100 cap.

IRMAA is Income Related Monthly Adjustment Amount. This can affect how much you pay for Medicare Part B & Part D. If you have a higher Modified Adjusted Gross Income (MAGI), you may incur an IRMAA surcharge. This is based on your federal tax returns using a two-year look-back period. Consult with a tax professional or financial advisor to help calculate your estimated MAGI. 

2025

The table below shows what you might pay for Medicare Part B based on the federal income tax numbers. Consult with a tax professional or financial advisor to help calculate your estimated MAGI.

Individual tax return   Joint tax return          Married & separate tax return         Monthly Part B Premium

$106,000 or less         $212,000 or less              $103,000 or less                        $185 / Month

$106,001-$133,000      $212,000 - $266,000             N/A                                    $259 / Month

$133,001-$167,000       $266,001 - $334,000             N/A                                    $370/Month

$167,001-$200,000      $334,001 - $400,000            N/A                                    $480.90/Month

$200,001-$499,999      $400,001 - $749,999          $106,001-$396,999                    $591.00/Month

$500,000 or above    $750,000 or above            $397,000 or above                   $628.90/Month

2026

The table below shows what you might pay for Medicare Part B based on the federal income tax numbers. Consult with a tax professional or financial advisor to help calculate your estimated MAGI.

Individual tax return   Joint tax return          Married & separate tax return         Monthly Part B Premium

$109,000 or less         $218,000 or less              $109,000 or less                        $202.90 / Month

$109,001 - $137,000    $218,001 - $274,000               N/A                                   $284.10 / Month

$137,001 - $171,000     $274,001 - $342,000              N/A                                   $405.80 / Month

$171,001 - $205,000    $342,001 - $410,000              N/A                                   $527.50 / Month

$205,001 - $500,000  $410,001 - $750,000        $109,001 - $391,000                   $649.20 / Month

$500,001 or above    $750,001 or above           $397,000 or above                     $689.90 / Month

2025

The table below shows what you might pay for Medicare Part D based on the federal income tax numbers. Consult with a tax professional or financial advisor to help calculate your estimated MAGI.

Individual tax return   Joint tax return          Married & separate tax return       Monthly Part D Premium

$106,000 or less         $212,000 or less              $103,000 or less                        Your Plan Premium

$106,001-$133,000      $212,000 - $266,000             N/A                                    $13.70 + YPP

$133,001-$167,000       $266,001 - $334,000             N/A                                    $35.30 + YPP

$167,001-$200,000      $334,001 - $400,000            N/A                                    $57.00 + YPP

$200,001-$499,999      $400,001 - $749,999          $106,001-$396,999                    $78.60 + YPP

$500,000 or above    $750,000 or above            $397,000 or above                   $85.00 + YPP

*YPP = Your Plan Premium

2026

The table below shows what you might pay for Medicare Part D based on the federal income tax numbers. Consult with a tax professional or financial advisor to help calculate your estimated MAGI.

Individual tax return   Joint tax return          Married & separate tax return       Monthly Part D Premium

$109,000 or less          $218,000 or less             $103,000 or less                      Your plan premium (YPP)

$109,001 - $137,000     $218,000 - $274,000            N/A                                       $14.50 + YPP

$137,001 - $171,000      $274,001 - $342,000            N/A                                       $37.50 + YPP

$171,001 - $205,000     $342,001 - $410,000            N/A                                       $60.40 + YPP

$205,001 - $500,000   $410,001 - $750,000      $103,001-$369,999                         $83.30 + YPP

$500,001 or above      $750,001 or above         $397,000 or above                        $91.00 + YPP

*YPP = Your Plan Premium

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