Does it cost to use a Medicare broker?

No. Licensed Medicare brokers like Anthony Orner are paid by insurance carriers, not by you. There's no fee for plan comparisons, enrollment help, or ongoing support. The plans cost the same whether you enroll directly or through a broker.

Can I get Medicare if I have asthma?

Yes. Medicare eligibility is based on age (65+) or qualifying disability, not your health conditions. Asthma does not disqualify you. In fact, choosing the right plan matters more when you have a chronic condition because drug formularies and provider networks vary widely.

Will Medicare Part D cover my rescue inhaler and maintenance medications?

Most Part D plans cover common inhalers, but the tier placement and copay amounts differ significantly between plans. A rescue inhaler like albuterol might be $10 on one plan and $45 on another. I compare formularies side by side so you get the lowest total cost for your specific prescriptions.

What's the difference between Medicare Advantage and Medigap for asthma care?

Medicare Advantage bundles hospital, doctor, and often drug coverage into one plan, usually with copays per visit. Medigap (Medicare Supplement) covers cost-sharing from Original Medicare, giving you broader provider access but requiring a separate Part D plan. The best fit depends on how often you see specialists and use the ER.

Medicare Broker for Asthma Sufferers — Because Breathing Shouldn't Be a Luxury

A Medicare broker for asthma sufferers does one thing most plan-finder tools can't: compare formularies drug by drug so your inhalers don't drain your bank account. I'm Anthony Orner, a licensed Medicare broker, and I help people with asthma find Part D and Advantage plans that actually cover what they use.

You already know the feeling. The inhaler running low, the refill price higher than last time, the insurance company requesting a “prior authorization” for medication your doctor prescribed months ago. That's what I fix.

Call for Free Advice — 855-559-1700

Why some Part D plans make inhalers affordable and others don't

Every Part D plan has a formulary, and every formulary groups drugs into tiers. Your albuterol rescue inhaler might sit on Tier 1 (low copay) with one carrier and Tier 3 (high copay) with another. Same drug, different price.

Plans also negotiate different prices with pharmacies. A $10 difference per refill adds up to $120 a year on just one medication. Multiply that across a maintenance inhaler and a rescue inhaler and the gap widens fast.

Rescue vs. maintenance medications: how formulary tiers affect your costs

Rescue inhalers (albuterol, levalbuterol): Usually Tier 1 or 2, but some plans require specific brands. Generic albuterol is widely covered; name-brand alternatives often cost 3-5x more.
Maintenance inhalers (fluticasone/salmeterol, budesonide/formoterol): Often Tier 3 or higher. Some plans require step therapy, meaning your insurer makes you try a cheaper drug first before covering what your doctor actually prescribed.
Biologics (for severe asthma): Specialty tier. Copays can reach hundreds per month without the right plan.

Step therapy is the reason some people get denial letters after their pulmonologist already prescribed something specific. I check for these restrictions before you enroll.

Supplement vs. Advantage plans for pulmonologist and ER coverage

If you see a pulmonologist regularly and occasionally need the ER for severe attacks, the plan structure matters. Medicare Advantage plans usually charge copays per specialist visit ($20-$50) and ER visits ($90-$250). Medigap plans cover the cost-sharing from Original Medicare, so your out-of-pocket is more predictable.

Advantage plans often include Part D coverage built in. Medigap requires a separate Part D plan, but gives you wider provider access. There's no single right answer. It depends on your medications, your doctors, and how often your asthma lands you in urgent care.

The 2025 Medicare Prescription Payment Plan can help

Starting in 2025, Medicare introduced the Prescription Payment Plan under Part D. It lets you spread your out-of-pocket drug costs into predictable monthly payments instead of paying large amounts at the pharmacy counter. This is especially helpful if you use expensive maintenance inhalers.

You can opt in through your Part D or Advantage plan. I'll tell you if it makes sense for your medication list.

What I check when reviewing plans for asthma patients

Formulary tier for every inhaler and oral medication you take
Prior authorization and step therapy requirements
Preferred pharmacy pricing (retail vs. mail-order)
Pulmonologist and allergist network inclusion
Annual out-of-pocket maximums for both drugs and medical
ER and urgent care copay structure

Get a free plan check so your next refill isn't a financial panic

Call me with your medication list. I'll run the numbers across available plans in your area and show you exactly what each one costs for your drugs, your doctors, and your situation. No fee. No obligation. No pressure.

Open Enrollment for Medicare Advantage and Part D runs October 15 through December 7. But you can call anytime to start planning.

Ready for a plan that covers what you breathe?

Call 855-559-1700 or Get a Free Quote

Anthony Orner, Licensed Medicare Broker