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Frequently Asked Questions About Medicare

To determine the most suitable Medicare coverage, you need to assess your individual healthcare needs. For example, if you currently take prescription drugs, you should consider acquiring Part D prescription drug coverage through either a standalone Part D plan or a Medicare Advantage plan upon obtaining Medicare. Although it may sound simple, it may not be as easy in practice.

In general, you will be required to pay the Part B premium, and additional costs may include premiums, deductibles, co-pays, and co-insurance depending on the type of Medicare plan(s) you select and the healthcare services you use during the year.
If you intend to continue working beyond 65, you may choose to delay enrolling in Medicare, or you may have to register during your Initial Enrollment Period for Parts A, B, and D if you wish to avoid late penalties. The decision will be based on your employer and if your employer coverage is considered creditable. Some individuals who can postpone Medicare still opt to enroll in just Part A at age 65 in addition to their employer coverage, which is premium-free if they or their spouse worked and paid Medicare taxes for at least ten years. However, obtaining Part A would mean that you can no longer contribute to your HSA.
Original Medicare (Parts A & B) does not cover routine dental or vision care, but some Medicare Advantage (Part C) plans do. These plans usually provide all the coverage offered by Parts A and B, and frequently provide additional benefits like dental, vision, hearing, and gym memberships in one plan.
None of the Medicare parts are mandatory, but if you decide to enroll in any part of Medicare after your Initial Enrollment Period, you may face financial penalties unless you qualify for a Special Enrollment Period with creditable employer coverage.

A Medicare Advantage HMO plan usually covers only the care you receive from providers within the plan network. A PPO plan typically covers care obtained outside the network, but the payment may be less than for the same care received within the network.

There are financial assistance programs for people with limited income and assets, such as Extra Help for prescription drugs, Medicare Savings Programs, and Medicaid, among others. The eligibility criteria for each program and the level of support provided may vary.

Your Medicare coverage selections will remain in effect from year to year unless you alter your plan. This guarantees that your coverage persists, but even if a plan is renewed, the plan benefits and costs may still change each year. It is a good idea to review your Medicare options every year during the Medicare Annual Enrollment Period, which takes place every fall from October 15 to December 7.
While both are government healthcare programs, Medicare is generally for people aged 65 or older, or those with a qualified disability. Medicaid is a state-run program for people with limited income and resources. Some people are eligible for both Medicare and Medicaid and are referred to as “dual eligible,” making them eligible for specialized Medicare plans.
In general, you qualify for Medicare after receiving Social Security disability benefits for 24 months. Exceptions are made for individuals with certain medical conditions. Learn more about Medicare and disability and your enrollment dates.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the United States government or the federal Medicare program.