Welcome back to Real Easy Medicare with Al Kushner! In this special Wisdom Wednesday episode, Al draws on forty years of expertise to share insider tactics and lesser-known tips that can transform your Medicare experience from merely surviving to truly thriving.

1. Strategic Plan Switching
   • Shop every year during Annual Open Enrollment (Oct. 15–Dec. 7)
   • Compare Maximum Out-of-Pocket (MOOP) limits, not just premiums and deductibles
2. Hidden Medigap Enrollment Rights
   • Guaranteed issue periods when retiree coverage ends or you move out of plan service areas
   • Act promptly to avoid medical underwriting
3. Network Realities in Medicare Advantage
   • “Acceptance” doesn’t guarantee availability—call providers to confirm they’re taking new patients
   • Specialist access can be particularly limited
4. Part D Formulary Vigilance
   • Research a plan’s history of formulary changes
   • Use appeals and exception requests to lower drug tier costs
5. Dual Eligibility Maximization
   • Leverage Special Needs Plans (SNPs) for extra benefits
   • Understand Medicare-first vs. Medicaid-first payment rules
6. Appeals and Reviews Unveiled
   • Level 1 redetermination vs. Level 2 independent review—don’t stop after the first denial
   • Expedite reviews for medically necessary services in Medicare Advantage
7. Coordination with Social Security
   • Align Part B enrollment with Social Security claiming strategy to optimize benefits
8. Skilled vs. Custodial Care
   • Document medical necessity to qualify for covered skilled services in long-term care settings
9. Technology Tools
   • Use Medicare.gov Plan Finder for network, mail-order, and coverage-gap insights
   • Track claims and plan changes via MyMedicare.gov
10. Employer Coverage Nuances
    • For companies with 20+ employees, employer plans may pay first even after age 65
    • Get payment-order agreements in writing
11. State Assistance Programs
    • SHIP counseling, pharmaceutical assistance, and Medicare Savings Programs with higher income limits
12. Annual Medicare Checkup Ritual
    • Conduct a full benefits review every November with your healthcare, legal, and tax advisors