Frequently Asked Medicare Questions (FAQ’s)?

What does it cost to use my services?

My services are entirely free to you. Medicare brokers are paid by the insurance companies they represent, and there is no extra fee or cost for enrolling through a Broker. You pay ABSOLUTELY NOTHING for my help and the same rate for your insurance if you use a Medicare consultant (Broker). 

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​​What is the benefit of using an agent as your Medicare insurance broker?

The benefit to you is invaluable. I will explain how Medicare works by breaking it down into easier-to-understand pieces. Therefore, with a new understanding of the many moving parts of Original Medicare, you can use that knowledge to make a good decision about your Medicare options. I will not only offer support with your enrollment but will also provide ongoing support after your enrollment with any issues that you may encounter, such as help with any billing errors, solving pharmacy exceptions when you can’t get your medication, helping you interpret communications that you receive from Medicare or your insurance company that you don’t understand, and more.

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When can I change my Medicare Advantage Plan?

​The Medicare Advantage Annual Enrollment Period (AEP) occurs once each plan year, from October 15 through December 7. During the AEP, Medicare Advantage beneficiaries may change their enrollment from one plan to another or return to Original Medicare. Any changes made during this time will become effective on January 1st of the following year. 

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When Can I Buy a Medicare Supplement Plan?

You can apply for a Medigap plan (Medicare Supplement) at any time of the year. However, in most states, you must answer health questions on your application and go through medical underwriting. The underwriter can decline you for health reasons unless your one-time Open Enrollment window or a guaranteed issue circumstance protects you.

If you are past your one-time open enrollment window, you can apply to change plans at any time of year.  Medicare Advantage and Part D plans can only be changed at certain times of the year, but Medicare supplements are different.

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​​Does Medicare cover dental and vision services?​​

​Original Medicare does not cover routine vision or dental care, and even if you buy a Medicare Supplement (Medigap) plan, you won’t have coverage for these routine services. If you wear glasses and get eye exams every year, you have to pay for them yourself.

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Does Medicare cover long-term care?

​Medicare does not cover long-term care, but 90% of Americans mistakenly believe it does. Medicare may cover short stays in a skilled nursing facility if you’ve been treated in the hospital for a severe illness or injury. It does not, however, cover custodial care in a long-term care facility.

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Do you pay Part B premium with Medicare Advantage?​

Yes, you must enroll in Medicare Parts A and B before you are eligible to add on a Medicare Advantage plan. This is true even if the Advantage plan has a $0 premium. You will still pay your Part B premium to Medicare every month.  ​Note: Medicare offers a Medicare Saving Program for individuals with a low or limited income.  If you qualify for this income-based program (Low-Income Subsidy/Extra Help), you may be eligible to receive assistance with your Part B cost and/or your Part D premiums, but you must apply for the program.  Visit: www.Medicare.gov/ExtraHelp

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Will I have to pay a Late Enrollment Penalty if I don’t select a Part D drug plan when I turn 65?​

Yes, most Medicare Advantage plans include your Part D benefits, and you will not need to purchase a separate Part D Drug plan. However, if you decide to remain on Original Medicare, you must purchase a separate standalone drug plan from a private insurance company to receive your medication. Original Medicare does not cover your prescription cost.

 

Once your Medicare initial enrollment period has passed and you decide to add a Part D later, Medicare will charge you a late enrollment penalty assessment for each month you could have had a Part D plan and choose not to. You will pay this amount for the rest of your life.

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Note:  If you are still working and you decide not to enroll in a Part D plan because you are still covered under your employer’s plan, you are not required to enroll in Part D and will not be charged a late enrollment period penalty for not enrolling when you turn 65.

 

However, it is essential to make your Part D decisions within a specific time after your employer’s plan ends. Do not miss this deadline, or you may be required to pay the penalty for the rest of your life.

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How can Medicare Advantage plans be free?

Medicare Advantage plans are NOT free. Some plans have a $0 premium. This means you pay no premium for the plan itself, but you will still pay the Part B premium to Medicare, and you will pay deductibles, copays, and coinsurance as you use your benefits.

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When you enroll in a Medicare Advantage plan, Medicare pays the Advantage plan private insurance company a monthly fee to take on all your medical risks. That is why some plans can offer you a $0 premium – Medicare already pays them on your behalf.

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Can you enroll in Medicare as soon as you retire?

​Your retirement date has nothing to do with your Medicare enrollment. Unless you have a qualifying disability, you must wait until your 65th birthday for Medicare coverage. If you retire at 62, you need another option for health insurance until Medicare kicks in.

 

The Part B Special Enrollment Period (SEP) is a period outside normal enrollment periods for Part B. The SEP lets you delay enrollment in Part B without penalty if you were covered by job-based insurance when you first became eligible for Medicare. You can enroll in Medicare without penalty for up to eight months after you lose job-based coverage. You can enroll in a Medicare Advantage Plan after you have signed up for both Part A and B coverage.