Question 1

Where can I find legal assistance for seniors?

Accepted Answer

The Older Americans Act funds legal assistance through local Area Agencies on Aging (AAAs), helping seniors access public benefits, address housing issues, combat elder abuse, and navigate estate planning. Contact your local AAA via the Eldercare Locator at eldercare.acl.gov or call (800) 677-1116.

Question 2

How can I find local support groups or meal delivery services?

Accepted Answer

Access local resources at connect2affect.org. Enter basic information and what you are looking for to get a list of local resources that can help.

Question 3

How can I get help with meals?

Accepted Answer

Visit Meals on Wheels at mealsonwheelsamerica.org/find-meals and enter your zip code to find local organizations that can help with meal delivery. Alternatively, find food banks and pantries through Feeding America at feedingamerica.org/find-your-local-foodbank.

Question 4

Where can I access free meditation sessions?

Accepted Answer

UCLA Health offers free virtual meditation sessions through its Mindful Awareness Research Center. Visit their website at uclahealth.org/uclamindful/free-drop-ins for schedules and participation details.

Question 5

Where can I find exercise resources tailored to seniors?

Accepted Answer

Check out Go4Life by the National Institute on Aging at nia.nih.gov/health/topics/exercise-and-physical-activity for well-organized articles and resources to find exercises tailored to your needs.

Question 6

What is the Annual Enrollment Period (AEP)?

Accepted Answer

The Annual Enrollment Period allows you to switch from Original Medicare to a Medicare Advantage Plan or vice-versa. You can also modify your standalone Prescription Drug Plan (Medicare Part D).

Question 7

When is the Annual Enrollment Period (AEP)?

Accepted Answer

The AEP runs from October 15 to December 7 each year.

Question 8

What is the Medicare Advantage Open Enrollment Period (OEP)?

Accepted Answer

The Medicare Advantage Open Enrollment Period allows you to change to another Medicare Advantage Plan or return to Original Medicare and enroll in a Prescription Drug Plan (Medicare Part D).

Question 9

When is the Medicare Advantage Open Enrollment Period (OEP)?

Accepted Answer

The OEP runs from January 1 to March 31 each year.

Question 10

What is the 5-Star Special Enrollment Period?

Accepted Answer

The 5-Star Special Enrollment Period allows you to switch to a 5-Star Medicare Advantage Plan or Prescription Drug Plan if one is available in your area.

Question 11

When is the 5-Star Special Enrollment Period?

Accepted Answer

The 5-Star Special Enrollment Period runs from December 8 to November 30.

Question 12

What are Special Enrollment Periods (SEP)?

Accepted Answer

Special Enrollment Periods allow you to make changes to your Medicare plans outside regular enrollment periods due to specific life events, such as moving, losing current coverage, or plan changes.

Question 13

When are Special Enrollment Periods (SEP)?

Accepted Answer

Special Enrollment Periods depend on specific life events that qualify you for them.

Question 14

What is the Initial Enrollment Period (IEP)?

Accepted Answer

The Initial Enrollment Period is a 7-month window when you first become eligible for Medicare.

Question 15

When is the Initial Enrollment Period (IEP)?

Accepted Answer

The IEP starts 3 months before your eligibility month and ends 3 months after it.

Question 16

What is the 2026 Medicare Part B prior authorization pilot?

Accepted Answer

It is a test program where Medicare requires advance approval for a short list of outpatient procedures before they are performed. It applies only in six states starting in 2026.

Question 17

Which states are included in the 2026 prior authorization pilot?

Accepted Answer

Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.

Question 18

Which services will need prior authorization under the pilot?

Accepted Answer

Knee arthroscopy for osteoarthritis; implantation of spinal cord stimulators; implantation of peripheral nerve stimulators; and application of skin or tissue substitutes for certain chronic wounds.

Question 19

Does the pilot change what Medicare covers?

Accepted Answer

No. It does not add or remove benefits. It only adds a review step for specific services in the pilot states.

Question 20

I do not live in one of the six pilot states. Does this affect me?

Accepted Answer

No. As of 2026, the pilot is limited to the six named states. If you receive care outside those states, the pilot does not apply.

Question 21

Will my doctor handle the prior authorization request?

Accepted Answer

Yes. Your provider submits the request to Medicare or its contractor. You may be asked for supporting medical information.

Question 22

Can prior authorization delay my procedure?

Accepted Answer

It can add time for review. Decisions are typically made within set time frames, and urgent cases can be expedited.

Question 23

What happens if prior authorization is denied?

Accepted Answer

Your provider can submit more information or you can appeal. You should not be billed for services Medicare would not cover without your consent.

Question 24

Does prior authorization apply to Medicare Advantage plans?

Accepted Answer

Medicare Advantage plans have their own prior authorization rules. The 2026 pilot described here is for Original Medicare (Parts A and B).

Question 25

Does Medigap change how prior authorization works?

Accepted Answer

No. Medigap helps with cost sharing after Medicare approves the claim. It does not replace Medicare’s approval rules.

Question 26

Will I pay more because of prior authorization?

Accepted Answer

No new fees apply for the review itself. Your usual deductibles and coinsurance still apply when the service is approved.

Question 27

How do Medicare telehealth rules change in 2026?

Accepted Answer

Most non-behavioral telehealth returns to Medicare’s original geographic and site rules. Behavioral health from home continues, and people on home dialysis keep some virtual visit options.

Question 28

Can I get mental or behavioral health care from home in 2026?

Accepted Answer

Yes. Tele-mental health remains available nationwide from home when clinically appropriate and properly documented.

Question 29

Are in-person visits required for tele-mental health?

Accepted Answer

Yes. Generally an in-person visit is required within 6 months before the first tele-mental health service and at least every 12 months after, with limited exceptions.

Question 30

Is audio-only telehealth covered in 2026?

Accepted Answer

Audio-only is generally limited to behavioral health when appropriate and documented. Most other services require video and approved locations.

Question 31

For non-behavioral care, can I use telehealth from home?

Accepted Answer

Usually no. For most other services you will need to be at an approved originating site in an eligible geographic area.

Question 32

Do Medicare Advantage plans follow different telehealth rules?

Accepted Answer

They can. Some plans offer broader telehealth. Check your plan’s 2026 Evidence of Coverage and ANOC for details.

Question 33

Does telehealth cost the same as an in-person visit?

Accepted Answer

Your cost sharing depends on the service, setting, and plan. Under Original Medicare, usual deductibles and coinsurance apply.

Question 34

What if I do not have internet for video visits?

Accepted Answer

Ask your provider about phone-based behavioral health options or approved community sites that can host a video visit.

Question 35

How are Medicare Advantage supplemental benefits changing in 2026?

Accepted Answer

Some extras are being narrowed or targeted to people with certain health needs. Availability and dollar amounts vary by plan and county.

Question 36

Will grocery, utility, or OTC allowances still be offered?

Accepted Answer

Many plans still offer them, but amounts may change and some benefits may require a qualifying chronic condition or specific use rules.

Question 37

What is happening to “flex cards” in 2026?

Accepted Answer

Plans are narrowing how flex cards can be used. Broad wallets that cover many categories are less common.

Question 38

Are non-medical extras limited in 2026?

Accepted Answer

Yes. Plans cannot use benefits for alcohol or tobacco, cosmetic surgery, funeral or life insurance, or unhealthy foods.

Question 39

Will transportation, meals, or support services change?

Accepted Answer

Some plans may target these services to certain conditions or reduce quantities. Check your plan’s 2026 materials.

Question 40

Do dental, vision, and hearing benefits change in 2026?

Accepted Answer

They still vary by plan. Annual caps, networks, and copays can differ widely, so compare plan details.

Question 41

Where can I see exactly what my 2026 benefits will be?

Accepted Answer

Review your plan’s Annual Notice of Change (ANOC) and Evidence of Coverage. These show covered benefits and any changes for 2026.

Question 42

If a benefit I rely on is being reduced, what should I do?

Accepted Answer

Compare your current plan with other 2026 options during Open Enrollment. If another plan better fits your needs, you can switch.

Question 43

Can Hesteon help me compare plans and benefits?

Accepted Answer

Yes. As an independent agency, we can review your doctors, prescriptions, and benefit priorities to help you compare 2026 options. There is no cost and no obligation.

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MEDICARE KEY DATES

Annual Enrollment Period (AEP)

Oct 15, 2025 to Dec 7, 2025

Initial Enrollment Period (IEP)

7-month period:

Example:

Medicare Advantage Open Enrollment Period (OEP)

Jan 1, 2026 to Mar 31, 2026

General Enrollment Period (GEP)

Jan 1, 2026 to Mar 31, 2026

Special Enrollment Periods (SEP)

Sign-up period:

5-Star Special Enrollment Period

Dec 8, 2025 to Nov 30, 2026

Medicare Part B

Prior Authorization Pilot in 2026

Services needing prior authorization

Telehealth Services

Medicare Telehealth Rules Tighten in 2026

Supplemental Benefits

Medicare Advantage Supplemental Benefits Changing in 2026