What services does MyMedicareMike.com offer?

We help individuals understand, compare, and enroll in Medicare plans. Our team provides personalized guidance on Medicare Advantage, Medicare Supplement (Medigap), and Prescription Drug Plans so you can make informed decisions with confidence.

Do you charge for Medicare consultations?

No, our services are completely free to you. As licensed and independent Medicare advisors, we’re compensated by the insurance carriers, not our clients.

What’s the difference between Medicare Advantage and Medicare Supplement Plans?

Medicare Advantage (Part C) replaces your Original Medicare and often includes extras like dental or vision. Medicare Supplement (Medigap) works with Original Medicare to help cover out-of-pocket costs such as copays and deductibles.

Can you help me review my current Medicare plan?

Absolutely. We provide free annual plan reviews to ensure your coverage still fits your healthcare needs and budget, since plans and costs can change each year.

When can I enroll or make changes to my Medicare plan?

The Annual Enrollment Period runs from October 15 to December 7 each year. During this time you can switch, drop, or enroll in new Medicare plans. Special Enrollment Periods may apply after certain life events.

Do you represent specific insurance companies?

No. We’re an independent agency and work with multiple top-rated carriers to find the plan that best fits your needs.

Can you assist if I’m turning 65 soon and new to Medicare?

Yes. We specialize in helping first-time enrollees understand their options, avoid penalties, and get started with the right coverage before their 65th birthday.

Do you offer in-person or virtual appointments?

We offer both. You can schedule a face-to-face meeting at our New York office or connect virtually from anywhere for the same personalized guidance.

What if I’m on Medicaid or have other health coverage?

We can help you coordinate your Medicare benefits with existing coverage—including Medicaid or employer plans—so you maintain important benefits and avoid gaps.

How can I get started with MyMedicareMike.com?

Call us or fill out the contact form on our website to schedule a free consultation. We’ll walk you through your options and help you choose coverage that gives you peace of mind.

My Medicare MRI Was Not Approved — What Are My Options?

Key Takeaways

● Why would Medicare deny a test my doctor ordered?
● Does this mean I can’t get the MRI at all?
● Is this a permanent decision or can it be appealed?
● Should I consider changing my Medicare plan?

Why MRIs Are Commonly Denied

MRIs are high-cost diagnostic tests. Because of this, some Medicare plans use prior authorization rules to ensure the test meets specific criteria before it is approved.
A denial may occur when:
● Required documentation is missing
● Clinical guidelines are not clearly met
● A less intensive test is expected first
These denials are administrative, not personal.

How Medicare Coverage Type Affects MRI Approval

Not all Medicare coverage operates the same way. Some coverage types require prior authorization for advanced imaging, while others do not.
Understanding which type of coverage you have explains why two people with Medicare can have very different experiences with MRI approvals.

What a Denial Actually Means

An MRI denial usually means “not approved yet,” not
“never approved.”
In many cases, it signals that:
● Additional information is needed
● A different diagnostic step is expected first
● The request needs to be reviewed again
This distinction matters.

Options to Explore After an MRI Denial

Possible next steps may include:
● Having the provider submit additional clinical documentation
● Requesting a peer-to-peer review between physicians
● Filing a formal appeal
● Discussing alternative diagnostic tests
The right option depends on timing, urgency, and coverage rules.

Why Immediate Plan Changes Are Rarely the Answer

It’s natural to feel that a denial means the plan is wrong.
However:
● Plan changes are restricted by enrollment rules
● A new plan may have similar authorization requirements
● Denials are often resolvable within the current plan
Understanding the process usually leads to better outcomes than reacting quickly.

Q & A: MRI Denials and Medicare

Does Original Medicare require prior authorization for MRIs?

Generally no, though other rules still apply.

Do Medicare Advantage plans require prior authorization?

Often yes, particularly for advanced imaging.

Can MRI denials be appealed?

Yes. Appeals and reviews are commonly available.

Should I switch plans because of one denial?

Usually no. One denial alone is not a reason to change coverage.

A Calm Takeaway

An MRI denial feels alarming — but it is usually part of a review process, not a judgment about your care. Understanding how authorization works, and what options exist, helps people move forward with clarity instead of stress.
Medicare is complex, but most denials are procedural — and many are resolvable.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:

Original Medicare (Parts A & B): Allows you to see any doctor or
hospital that accepts Medicare but does not include prescription drug
coverage (Part D) or additional benefits.
Medicare Advantage (Part C): Offers bundled coverage with
potential extra benefits but may require using a network of providers.
Medigap (Medicare Supplement Insurance): Helps cover
out-of-pocket costs not covered by Original Medicare, such as
copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:

Initial Enrollment Period (IEP): A seven-month window starting
three months before your 65th birthday month.
General Enrollment Period (GEP): From January 1 to March 31
each year for those who missed their IEP.
Annual Election Period (AEP): From October 15 to December 7,
allowing you to switch or enroll in Medicare Advantage and Part D
plans.
Open Enrollment Period(OEP): From January 1 to March 31 for
those who missed AEP and want to make certain changes.
Special Enrollment Period(SEP): Can be used anytime during the
calendar year for those that meet certain criteria such as moving to a
new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.

By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.

Do I have to sign up for Medicare?

It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.

Does Medicare cover Prescription Medications?

No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.

I want to be able to go to any doctor/hospital, are there networks with Medicare?

There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.

Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.

Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.