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Medicare FAQ

Q: When should I enroll in Medicare Part A & B?
A: When you first become eligible for Medicare there is a 7-month initial enrollment period. In the 7-month period you can sign up three months before your 65th birthday, on your birthday month, or three months after your birthday month.
Q: When Should I enroll in Medicare Supplement Insurance Plans?

A: Enrolling in a Medicare supplement plan is greatly dependent on whether the plan is the right fit for you. This must be explored prior to enrolling.

If you decide that a Medicare Supplement Plan is for you, we recommend enrolling as soon as possible to avoid any underwriting implications. Typically 3 months before your 65th birthday is what we would advise.

Q: Can I still enroll in Medicare Part A or B if I missed the initial enrollment period?

A: If you miss the initial enrollment period for Medicare Part A and B, you can still enroll in Medicare A or B at a later time, but there may be enrollment periods that you have to abide by depending on your situation. All is not lost, but we recommend you connect with one of our office staff to ensure you have the right understanding of your options.

Q: When does my coverage start if I enroll for Medicare Part A & B during the initial enrollment period?

A: Your Medicare, part A, and Part B insurance will typically begin on the first day of your birth month that you turn 65. There are exceptions when this is not the case, however.

Q: When can I change my Medicare plans?

A: If you desire to make changes to your Medicare plan, your ability to do so will greatly depend on what type of Medicare plan you have. If you have a Medicare Advantage plan, you will typically be confined to the Medicare annual election period, which is from October 15 through December 7 each year.

If you have a Medicare supplement insurance policy, you can make changes whenever you would like as long as you can qualify for underwriting for that HEALTH Plan or if you have a guaranteed issue election Available to you.

Q: What is Medicare?
A: This is considered Part A & B with no other health care coverage. Medicare will cover approx. 80% of your medical expenses.
Q: What is Medicare Supplement Insurance or Medigap?
A: You can purchase Medicare supplement insurance as long as you are enrolled in Medicare Part A & B. This additional coverage will cover the other 20% that Medicare Part A & B don’t.
Q: What is the Medicare Advantage Plan?

A: Medicare vantage plan is a HEALTH Plan that is approved by the federal government to provide healthcare for Medicare beneficiaries. These plans have a contract with Medicare and are allowed to customize coverages for beneficiaries as long as these coverages meet Medicare’s standard requirements of complete coverage.

Medicare Advantage Plans are not allowed to deny the coverages that Medicare would approve if you had original Medicare.

Q: What if my employer or spouse’s employer already offers a Medicare Plan?

A: Yes, it’s recommended to enroll in Original Medicare because your employer-provided Medicare will serve as secondary insurance to Original Medicare.

Q: What is Medicare Part A?
A: Medicare Part A covers your inpatient hospital care, nursing facility, hospice, and home health care.
Q: What is Medicare Part B?
A: Medicare Part B covers your doctor’s visits and services.
Q: What is Medicare Part C?
A: Medicare Part C offers additional medical coverage through external providers like HMO or PPO. This plan doesn’t usually cover prescription drugs.
Q: What is Medicare Part D?
A: Medicare Part D covers your prescription drugs.
Q: What is Medicare Supplement Insurance or Medigap?
A: Medicare Supplement Insurance is an optional coverage that can help pay for your medical expenses that Medicare Part A & B don’t cover.
Q: How much does Medicare Part A Cost?

A: If you have worked for ten years or more, you are eligible for free Medicare Part A. However, if you have worked in the United States for less than ten years, a premium will be charged.

Q: How much does Medicare Part B Cost?

A: The cost of Medicare Part B varies depending on your household’s gross income, which is updated annually and may fluctuate.

Q: How much does Medicare Part D Cost?
A: Medicare Part D costs is also based on income. There can be around 20 different plans to choose from.
Q: How much does Medicare Supplement Insurance Cost?
A: Premiums for Medicare Supplement Insurance can vary greatly depending on the company and plan that you go with.
Q: What is the difference between Medicare Supplement Insurance and Medicare Advantage?
A: Medicare Supplement covers the gaps that your regular Medicare doesn’t cover while Medicare Advantage is contracted through private insurance companies that contract with Medicare and they cover additional services not paid by original Medicare.
Q: Can your employer pay for your Medigap plan?

A: If you opt for Medicare as your primary insurance over your employer’s group insurance plan, your employer generally cannot cover the costs of your Medigap plan. However, there is one exception outlined in section 105; please reach out to us for a more detailed explanation.

Q: Can your employer kick you out of your group health insurance when you turn 65?
A: No, but your employer doesn’t have to provide a retire plan after age 65 or the premium can be different.
Q: If I have employer coverage should I also get Medigap?
A: No, Medigap only covers you if Medicare is your primary insurance.
Q: Can you have private insurance and Medicare?
A: Yes, but there are many factors to consider. Deciding all of these things requires some careful cost analysis between the costs for Medicare and the costs, copays and deductibles of your group coverage. A J&J Medicare Solutions agent can walk through all of this and advise you on the parts you need to consider. If it makes sense for you to stay with your employer coverage, we will be the first to tell you.
Q: What does Independent Insurance Agency mean for me?
A: We are a team of independent agents that allow you to speak with a Medicare expert and compare all your insurance choices in one location.
Q: Do I need Medicare Part B if I have Retiree or COBRA insurance?
A: Part B is optional and not required for you to be enrolled. Although it is important to check how your current insurance will work with Medicare and if additional insurance is needed.
Q: Do I need to change my Medicare after I enroll in it?
A: Insurance companies make changes to their policies every year, so it is always a good idea to go over the changes and if any of your medical requirements have changed.
Q: Is waiting to get Medigap at a later time better?
A: The best time to enroll in Medigap is when you are first eligible since they don’t count any preexisting or current medical conditions against you. If you purchase Medigap at a later time the costs could be significantly higher, or you could be denied since they can count preexisting and current medical conditions against you.
Q: I don’t take prescriptions drugs so why get Medicare Plan D?
A: Unfortunately, medical illness can happen at any time it is better to be covered then be stuck with expensive prescription costs.
Q: Should I wait till I retire to enroll in Medicare?
A: No, retirement age is 66 and going up. It is better to enroll at age 65.
Q: Do I have to wait to change my Medicare Supplement Plan till Annual Election Time?
A: No, you don’t have to wait for the annual election time, you can change anytime.
Q: I haven’t earned the 40 work credits do I still qualify for Medicare?
A: You don’t have to have work credits for Medicare Part B and D, also there are options with premiums depending on how many work credits you have.
Q: Can I have an HSA and Medicare Part A?
A: You can’t contribute to a health savings account if you have signed up for Medicare.
Q: Can I change my Medicare plan during Open Enrollment?
A: Open Enrollment is a great time to evaluate your coverage and potentially change them.
Q: Does Medicare cover everything?
A: Although many services are covered many plans do not cover dental, vision, or hearing.
Q: When should I enroll for Medicare Advantage?
A: You can enroll in Medicare Advantage when you become eligible for Medicare parts A & B. There is also the annual election time during October 15th through December 7th which you can enroll or make changes to your current plan for Medicare Advantage.
Q: Does Medicare Advantage cover prescriptions?
A: Some plans do have prescription coverage, but it is important to make sure you select the right plan since not all plans do cover prescriptions. You also want to make sure you select the plan that covers prescriptions you currently take.
Q: Do I still use my Medicare card if I have Medicare Advantage?
A: No, you only need to present your Medicare Advantage card, but make sure to keep it in a safe place.
Q: Does Medicare Advantage Cover Preventative Care?
A: Yes it will cover any preventative care.
Q: Will my current doctor take Medicare Advantage?
A: Most health care providers do take Medicare Advantage, but it is always important to check with us to make sure your provider does accept Medicare Advantage.
Q: Is Dental & Vision Covered by Medicare Advantage?
A: It is not typically covered but there can be some things covered or options to add on, check with us to see what the right plan would be for you.
Q: Am I covered if I go to the Emergency Room?
A: Yes, You are covered in the event of an emergency. Costs can be different between in-network and out-of-network.
Q: Does Medicare Advantage cover gym memberships?
A: Most plans will include benefits like Silver Sneakers or even some local gyms. Check with us to see if you are covered.
Q: Can I have both Medicare Advantage and Medicare Supplement Plans?

A: Unfortunately, No. Medicare Supplements and Medicare Advantages are separate plans and you can only have one or the other. Contact our office to get more details on the right plan for you is.