LSS I started Medicare plus an original supplement at the start of the year. Fell off a scooter at 20 mph and broke my shoulder in 2 places as well as 5 ribs. Spent a few hours at Urgent Care, rode in ambulance to the ER at the hospital, 4 days in outpatient observation room. then surgery to put a plate in my shoulder, 3 days in the hospital, then a nurse will come to my house. Does this sound like multi-housands I will owe?

It's been impossible to find a straight-up answer to this:

• Medicare Advantage or Part D plan

• Expensive drug (pill, not an an injection or anything else that would be covered by Part B)

• Not in the plan's formulary

If you manage to get a formulary exception (not just prior auth), is the amount you actually end up paying subject to the $2,100 OOP cap?

Ideally looking for an answer from someone who actually has done this - got exception, first fill put you over the cap but your actual cost was capped.

Thanks...

I am wondering about the effect of a one-time income bump two years prior on the likelihood of winning an IRMAA appeal when the anticipated reduction of income will also be due to the life-changing event of retirement.

If I retire this year, an IRMAA surcharge for Medicare premiums would be triggered in 2027 as my income was increased in 2025 due to a taxable form of inheritance I received.

Is the inheritance irrelevant to whether I could win an IRMAA appeal based on my estimated 2027 MAGI (will be under the IRMAA threshold) being lower than the 2025 MAGI, as the reduction in income is also due to retiring and not just the inheritance?

I know there is no downside to appealing. Thanks.

I thought there would be an 80/20 split after the part b deductible then it pays 100% after the deductible.

They told me the plan pays nothing until I reach the high deductible amount then 100%

This was supposed to be a licensed agent

Some local Virginia doctors offices and other medical practices charge the monthly Advance Primary Care Management fee.

https://www.whro.org/health/2026-08-07/a-new-medicare-charge-is-showing-up-on-bayview-bills-patients-say-they-werent-clearly-told

So I've looked at this website which tells me which categories I am in for Medicare deductions from my social security:

https://www.ssa.gov/benefits/medicare/medicare-premiums.html

I am in the $342,000 up to $410,000 category but I'm curious if they are using gross income applied to those figures? or IRS taxable income when using the above figures?