Frequently Asked Questions

Medicare is a federal health insurance program primarily for people aged 65 and older, as well as certain younger individuals with disabilities or specific conditions. It consists of different parts that cover hospital stays, medical services, and prescription drugs.

Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare offered by private insurers, often including prescription drug coverage. Medicare Supplement (Medigap) works alongside Original Medicare to help pay copayments, coinsurance, and deductibles.

Medicare has four parts: Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing, and hospice care. Part B (Medical Insurance) covers doctor visits, outpatient care, and preventive services. Part C (Medicare Advantage) is an alternative that bundles Parts A, B, and often D. Part D covers prescription drugs.

No, you cannot have both. Medicare Advantage replaces Original Medicare, while Medicare Supplement works with Original Medicare. You must choose one or the other based on your healthcare needs and preferences.

Original Medicare refers to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) provided directly by the federal government. It allows you to see any doctor or specialist nationwide who accepts Medicare, without network restrictions.

Your Initial Enrollment Period begins 3 months before you turn 65 and ends 3 months after your birthday month. There's also an Annual Enrollment Period (October 15 - December 7) when you can make changes to your coverage.

Generally, you're eligible for Medicare if you're 65 or older and a U.S. citizen or legal permanent resident for at least five consecutive years. You may also qualify if you're under 65 with certain disabilities or have End-Stage Renal Disease or ALS.

Missing your Initial Enrollment Period may result in late enrollment penalties and gaps in coverage. You can enroll during the General Enrollment Period (January 1 - March 31), but coverage won't start until July 1, and you may face lifetime premium penalties for Part B and Part D.

Yes, you can switch during the Annual Enrollment Period (October 15 - December 7) or the Medicare Advantage Open Enrollment Period (January 1 - March 31). You may also qualify for a Special Enrollment Period if you move or experience certain life changes.

With Original Medicare and a Medicare Supplement plan, you can see any doctor or specialist who accepts Medicare nationwide. With Medicare Advantage, you typically need to use providers within the plan's network.

Original Medicare does not cover most prescription drugs. You'll need to enroll in a separate Part D prescription drug plan or choose a Medicare Advantage plan that includes drug coverage to help pay for medications.

Original Medicare provides very limited dental, vision, and hearing coverage. However, many Medicare Advantage plans include additional benefits for dental, vision, hearing aids, and wellness programs as part of their coverage.

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facility care (following a hospital stay), hospice care, and some home health care services. Most people don't pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working.

Medicare Part B (Medical Insurance) covers doctor visits, outpatient care, preventive services, durable medical equipment, and some home health services. Part B requires a monthly premium, which varies based on your income.

Original Medicare covers emergency care anywhere in the U.S. and its territories, but generally doesn't cover care outside the United States. Some Medicare Supplement plans (like Plans C, D, F, G, M, and N) include limited coverage for foreign travel emergencies.

Medicare costs vary depending on the parts you have. Most people don't pay a premium for Part A. Part B has a standard monthly premium that adjusts annually based on income. Additional costs include deductibles, coinsurance, and premiums for Part D or Medicare Supplement plans.

A Medicare deductible is the amount you must pay out-of-pocket for covered services before Medicare begins to pay its share. Part A and Part B each have separate annual deductibles. Medicare Supplement plans can help cover these deductibles.

Yes, if your modified adjusted gross income exceeds certain thresholds, you may pay an Income-Related Monthly Adjustment Amount (IRMAA) for Part B and Part D. This is an additional premium on top of the standard amounts, based on your tax returns from two years prior.

Medicare Supplement premiums vary by insurance company, your location, age, tobacco use, and the plan letter you choose. While the benefits are standardized, premiums can differ significantly between insurers, so it's important to compare rates from multiple companies.