Making Medicare Make Sense

Frequently Asked Questions

The Basics

What You Should Know!

1. What is Medicare?

Medicare is a federal health insurance program primarily for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

  • Medicare Part A: Hospital insurance that covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Medicare Part B: Medical insurance that covers doctors’ services, outpatient care, medical supplies, and preventive services.

  • Medicare Part C (Medicare Advantage): Plans offered by private companies approved by Medicare that include what Part A and Part B cover and usually other benefits not included with original Medicare and prescription drug coverage.
  • Medicare Part D: Prescription drug coverage that can be added to Original Medicare. People may also add a Supplement (Medigap) plan to reduce out of pocket costs found with Part A and B.
  •  Initial Enrollment Period (IEP): You can enroll when you first become eligible which is 3 months before, the month of, and 3 months after your 65th birthday.
  •  Special Enrollment Period (SEP): You may qualify for a special enrollment period if you have certain life events, like losing credible health insurance from your employer or moving out of your plans service area.
  •  General Enrollment Period (GEP): If you missed your IEP, you can enroll in part B during the GEP from January 1 to March 31 each year.

It depends. Some people have both Medicare and other coverage like employer-sponsored insurance (working for an employer of 20 or more employees) or Medicaid. Review the Medicare website, contact your local SHIPs counselor, or speak to a licensed insurance agent who specializes in Medicare plans.

Costs can vary based on the parts of Medicare you choose. Part A is usually premium-free if you or your spouse paid Medicare taxes for 40 quarters while working. Part B and Part D have monthly premiums and may be higher depending on your income. There also may be deductibles, copayments, and coinsurances.

No, Medicare doesn’t cover all healthcare costs. There may be gaps in coverage, such as certain dental, vision, and long-term care services. Many people choose to get supplemental insurance (Medigap) or a Medicare Advantage plan to help cover these costs.

Consider factors like your health needs, prescription drug needs, budget, and preferred doctors or healthcare providers. You can compare plans on the official Medicare website, contact your local SHIPs counselor, or speak to a licensed insurance agent who specializes in Medicare plans (like me!).

Medicare is a federal health insurance program primarily for seniors and certain disabled individuals. Medicaid is a state and federal program that provides health coverage to eligible low-income individuals and families.

Yes, you can make changes to your Medicare coverage during certain enrollment periods. One example is the Annual Enrollment Period (AEP) which runs from October 15 to December 7 each year, during which you can switch plans or make other changes.

You can visit the official Medicare website at www.medicare.gov, call 1-800-MEDICARE (1-800-633-4227), your State Health Insurance Assistance Program (SHIP) for personalized assistance and resources, or a licensed insurance agent that offers Medicare plan options.

Are you ready to start your journey?

Call or write to me today and let’s find the right solution just for you!