Your Medicare questions, answered.
I'm Erick Vallarino, an insurance agent here in the Valley. These are the questions people ask me most, at the kitchen table and on the phone. My help costs you nothing.
When can I sign up for Medicare?
Your window to sign up is usually 7 months: the 3 months before the month you turn 65, that month, and the 3 months after. If your birthday is on the 1st of the month, it all moves one month earlier. If you already get Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65, you're signed up for Part A and Part B automatically. If not, you usually sign up through Social Security (or the Railroad Retirement Board if you worked for a railroad), and I'll walk you through it, step by step.
Do I have to sign up at 65 if I'm still working?
Not always. If you or your spouse are still working and have health insurance from that job, you may be able to wait to sign up for Part B, with no penalty. When the job or the insurance ends, whichever comes first, you have 8 months to sign up. Those 8 months start even if you keep the job's insurance through COBRA, so don't wait for COBRA to end. If the employer has fewer than 20 employees, or you have a Health Savings Account (HSA), there's more to check, so call me before you decide.
What happens if I miss my sign-up window?
You can still sign up from January 1 to March 31 of each year. That's called the General Enrollment Period, and your coverage starts the month after you sign up. But you may pay a late penalty. For Part B, it's an extra 10% for each full year you could have signed up and didn't, for as long as you have Part B. If you or your spouse were still working and had insurance from that job, you may have a Special Enrollment Period instead, so call me first.
Advantage, Supplement and drug plans.
What's the difference between Medicare Advantage and a Medicare Supplement?
Medicare Advantage is one plan from a private company, approved by Medicare, that bundles your Part A and Part B. You still get everything they cover, and most plans add extra benefits, like some dental, vision and hearing care, and more. Most include drug coverage, and each plan has a yearly limit on what you pay for covered Medicare services. In many cases, you use the plan's network of doctors. A Medicare Supplement (Medigap) works next to Original Medicare. You can see any doctor or hospital in the U.S. that takes Medicare, and the supplement helps pay your share of the bills. For your medicines, you can add a separate drug plan. You can't use both at the same time. Neither one is right for everybody, so we start with your doctors and your medicines.
Will my doctors take a Medicare Advantage plan?
It depends on the plan. Most plans have a network of doctors, hospitals and pharmacies, and some plans need a referral to see a specialist. A PPO also lets you see doctors outside the network, usually for more. So I look up your doctors and your medicines in the plans I offer before you choose, not after the bill comes. What I check for you.
What extra benefits do Medicare Advantage plans have?
For 2027, most Medicare Advantage plans in the Valley include dental, vision and hearing benefits. Most also help pay for fillings, glasses and hearing aids.
For 2027, some Medicare Advantage plans in the Valley include dental benefits that can pay thousands of dollars a year toward your dental care. Each plan has its own limits and rules.
Some plans also add things like a fitness program, an allowance for over-the-counter items, or rides to the doctor. What's included, and how much, is different in each plan, and it can change each year. Plans with these benefits are offered in the Valley by companies I'm contracted with: Aetna Medicare, HealthSpring, Humana, Prominence Health Plan, UnitedHealthcare and Wellcare. Not every company offers every one of these benefits.
We go over the benefits together, but your doctors and medicines come first.
If I join a Medicare Advantage plan, do I still have Medicare?
Yes. You still have Medicare, and your Medicare rights and protections. The plan covers most of your Part A and Part B care, so you show the plan's card when you get care. Keep your Medicare card in a safe place. You may need it for hospice care, and if you ever go back to Original Medicare. You generally keep paying your Part B premium, unless Medicaid or a Medicare Savings Program pays it for you.
Does a Medicare Advantage plan cover me when I travel, or in Mexico?
In the U.S., yes, for emergencies and urgent care, even outside the network. Other care away from home depends on the plan: an HMO usually covers only emergencies, urgent care and kidney dialysis while you're temporarily away from its area, and a PPO may cover other care too, often for more. If you travel or cross the border a lot, tell me, and we'll check this before you choose.
For 2027, many Medicare Advantage plans in the Valley cover emergency and urgent care outside the United States, including in Mexico. Some don't, so if you go to Mexico, that is one of the first things I check. This is for emergencies, not routine care, and each plan sets its own limits. You may have to pay first and then ask the plan to pay you back. Plans with these benefits are offered in the Valley by companies I'm contracted with: Aetna Medicare, HealthSpring, Humana, Prominence Health Plan, UnitedHealthcare and Wellcare. Not every company offers every one of these benefits.
Does a Medicare Supplement cover me when I travel, or in Mexico?
In the U.S., with most policies, you can see any doctor or hospital that takes Medicare, anywhere in the country, with no network. Medicare SELECT policies may require certain hospitals or doctors for full benefits. Outside the U.S., several plan letters, like G and N, help pay for emergency care that starts in the first 60 days of a trip, within the plan's limits. We'll check the letter you're looking at.
When should I get a Medicare Supplement?
The easiest time is your Medigap Open Enrollment Period. It lasts 6 months and starts the first month you have Part B and are 65 or older. During those 6 months, a company can't turn you down or charge you more because of health problems you already have. Some policies may delay coverage of a pre-existing condition for as long as 6 months. Qualifying prior health coverage can shorten or eliminate that wait, and some special protections prevent it. We'll check which rules apply to you. After your Medigap Open Enrollment Period ends, a company can ask about your health first, and it may say no or charge you more. This window only comes once, so let's mark the date on your calendar.
Do you help with Medicare Supplements, or only Medicare Advantage?
Both. Supplement plans go by letters, like Plan G and Plan N. The same letter covers the same things with every company, but the price can be very different. So I put the prices from the companies I work with side by side, for the letter you want, and you choose. How I shop supplements.
Can I get a supplement between October 15 and December 7?
That fall period is for Medicare Advantage and drug plans. By itself, it doesn't give you a new chance to buy a supplement without health questions. Your best window is your 6-month Medigap Open Enrollment Period, and some people have other special rights to buy one. Call me and we'll check yours.
I don't take any medicines. Do I need a drug plan?
It's your choice, but think it over before you skip it. If you go 63 days or more in a row without drug coverage after your first chance to join, you may pay a late penalty when you join later. The penalty is added to your monthly premium, usually for as long as you have Medicare drug coverage. Drug coverage from a job can count, if it's "creditable," and I'll help you check.
When you can make a change.
Can I change my plan later?
Yes, at certain times of the year. From October 15 to December 7, you can join, switch or drop a Medicare Advantage plan or a drug plan, and the change starts January 1. If you have a Medicare Advantage plan, you can also make one change from January 1 to March 31. Outside those dates, you usually need a Special Enrollment Period. If you joined a Medicare Advantage plan during your Initial Enrollment Period, you can make one change within your first 3 months with both Part A and Part B; the Key dates page explains the choices.
What if I move, or something else changes in my life?
Some life events give you a Special Enrollment Period, a chance to change plans outside the usual dates. Examples are moving, losing other coverage like insurance from a job, moving into or out of a nursing home, and having Medicaid or Extra Help. What you can change, and by when, depends on the event. Call or text me when something changes, and we'll see what you can do.
My plan sent me a letter about next year. What do I do?
It's probably your Annual Notice of Change. Plans send it in September, and it lists the changes to your coverage and costs that start in January. Please don't put it in a drawer. Send me a picture of it, or show it to me when we meet, and we'll go over it before December 7. If your plan still fits, I'll tell you to keep it.
I already have Medicare. Can you still help me?
Yes. I help with the plan you have now: bills, doctors, letters and medicines. Every fall we look at what changes for you. If a change makes sense, we weigh it together, during the times Medicare allows.
What Medicare costs, and who pays me.
How much does Medicare cost?
Most people don't pay a monthly premium for Part A, because they or their spouse paid Medicare taxes long enough while working, generally at least 10 years. Part B has a monthly premium, and it can be higher if your income is higher. The amounts can change each year, and Medicare.gov lists the current ones. For people who qualify, Medicaid or a Medicare Savings Program can pay the Part B premium. What else you pay depends on the coverage you choose. With Medicare Advantage, some plans have a monthly premium, you may pay copays or a share of the cost when you get care, depending on your plan and any help you qualify for, and each plan has a yearly limit on what you pay for covered Medicare services. With Original Medicare and a Medicare Supplement, you pay a monthly premium for the Supplement, and usually one for a separate drug plan, and the Supplement helps pay your share of the bills. I'll go over it with you in plain words.
Does it cost me anything to work with you?
No. My help costs you nothing. The insurance company pays me, not you. For Medicare Advantage and drug plans, Medicare sets a limit on what a plan can pay an agent. On a Medicare Supplement, I won't push you toward a pricier policy to earn more. I'd rather keep you for years and earn your referrals.
Do you work for an insurance company?
Not for just one. I'm an independent agent, and I work with several companies, so I can lay your choices side by side. For Medicare Advantage and drug plans, I'm contracted with Aetna Medicare, HealthSpring, Humana, Prominence Health Plan, UnitedHealthcare and Wellcare. I don't offer every plan in your area. Medicare.gov and 1-800-MEDICARE can show you all of them. If you're better off staying where you are, I'll tell you. Then the choice is yours.
What about Medicaid and Extra Help?
Extra Help is a Medicare program that helps people with limited income and savings pay drug plan costs. Social Security handles it, and I can help you apply, at no charge. Medicaid and the Medicare Savings Programs, which can help pay your Part B premium, are run by Texas Health and Human Services. I don't work for the state, and the state decides who qualifies. You can apply at YourTexasBenefits.com or by calling 2-1-1. If you have Medicaid, call me, and we'll look at which Medicare plans work with it. Some are made just for people with both.
What to expect from me.
Can you come to my house?
Yes, anywhere here in the Valley. We can sit down at your kitchen table or at an office near you. Offices in McAllen, Pharr, Harlingen and Brownsville, by appointment. I only come when you invite me, and we talk about what you asked to talk about. Have your cards and your medicines handy, and we'll go through it all, with no rush.
Do you only help people in the Valley?
No. The Valley is home, but I'm serving all of Texas, so I can help you anywhere in the state, by phone or Zoom if you live farther away. Plans are different in each county, and I'll look up what's available where you live. If your permanent address is in another state, call me anyway, and I'll tell you honestly what I can and can't do.
Can you help with insurance besides Medicare?
Yes. I also help with hospital, cancer and dental policies, and other coverage that isn't Medicare, for people with or without Medicare. See other coverage. If we meet about your Medicare, we talk about what you asked about, and we set another time for anything else.
Do you speak Spanish?
Sí. I help people in Spanish or English, whichever you prefer. This page is in Spanish too, so everyone in the family can read it.
I'm helping my mom or dad. Can I call you for them?
Of course. Call with them or for them, and bring anyone you want to the table. I'll explain things to all of you, in plain words. Before I look at their own plan and records, I need the OK from the person with Medicare, or from someone they have legally named. After that, they can call me directly too.
I got a letter or a call about my Medicare. Is it real?
Be careful. Medicare will never call you uninvited and ask for personal information. If someone calls asking for your Medicare Number, hang up and call 1-800-MEDICARE. Most of that mail is someone trying to make a sale. Send me a picture, and I'll tell you if it's real.
What happens after I sign up? Will you keep calling me?
I'm still your agent, all year. Bills, doctors, letters, questions: you call me, not a 1-800 number. I won't keep calling you. You call or text me when you need me, even about something small. I don't sell your information, and I don't give it to other agents or marketing companies.
Real or scam?
- Probably real
- Your “Medicare & You” handbook comes in the mail in the fall. Medicare mails it each fall to people with Medicare, unless you chose to get it online.
- Your plan’s Annual Notice of Change arrives by September 30. If you have a Medicare Advantage or drug plan, it sends this so you can see next year’s changes before October 15.
- A letter from Social Security about your Part B premium. If you get Social Security benefits, it sends a notice each year with your new amount and what comes out for Medicare.
- Probably a scam
- A caller asks for your Medicare number to “renew” your card. Medicare won’t call you out of the blue to ask for your number.
- A caller says you’ll lose your benefits unless you pay right now. Medicare and Social Security won’t threaten your benefits or rush you to pay.
- Someone offers you a gift for your Medicare number. Never trade your number for a gift. Give it only to your doctor or people you know should have it.
Not sure about a letter or a call? Send me a photo of the letter with your Medicare number covered, or tell me what they said. I’ll help you check it.
Still have questions? That's what I'm here for.
No question is too small. I'll explain it as many times as you need, in English or Spanish. My help costs you nothing.