Frequently Asked Questions
At ABC Medicare, we understand that Medicare can be confusing. We are here to help you! Below are some frequently asked questions. If you have other questions that are not answered here, feel free to contact us.
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
The different parts of Medicare help cover specific services.
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Part D adds prescription drug coverage to:
- Original Medicare
- Some Medicare Cost Plans
- Some Medicare Private-Fee-for-Service Plans
- Medicare Medical Savings Account Plans
These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.
The Medicare Annual Enrollment Period is October 15 - December 7 every year.
Effective January 1, 2019, Medicare is replacing the Medicare Advantage Disenrollment Period with the Open Enrollment Period.
The Medicare Advantage Open Enrollment Period will run from January 1 – March 31 every year. If you’re enrolled in a Medicare Advantage plan, you’ll have a one-time opportunity to:
- Switch to a different Medicare Advantage plan
- Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if you return to Original Medicare). Most Medicare Advantage plans include prescription drug coverage already. Usually you can’t enroll in a stand-alone Medicare Prescription Drug plan if you already have a Medicare Advantage plan, but there are some situations where you can. Call your Medicare Advantage plan if you have questions.
- Drop your stand-alone Medicare Part D Prescription Drug Plan
For Original Medicare - Part A and Part B - a simple way to determine your exact Medicare effective date is to refer to the lower right corner of your Medicare Card or to refer to your letter from either the Social Security Administration or the Railroad Retirement Board.
No. Medicare Supplement insurance policies help cover Medicare Part A & B out-of-pocket costs. Medicare Advantage Plans are an alternative way to get your Medicare coverage and, in some cases, additional benefits.
Any time after you are enrolled in Medicare Parts A & B. You do not have to wait for Open Enrollment to buy a policy. The best time to buy is in the first 6 months after you are 65 years old and enrolled in Medicare Parts A & B.
The best time to enroll is during the open enrollment window around your 65th birthday – preferably in the three months before the month you turn 65 so that you’ll have Medicare coverage by the time you turn 65.
Your income and resources determine the level of help you receive. In 2018 eligibility is limited to an annual income of $18,210 for an individual and $24,690 for married couples. In addition, resources must not exceed $14,100 for an individual and $28,150 for married couples.
Policies help pay for Medicare Part A & B deductibles, co-payments, and co-insurance. Some policies also include coverage for certain health services not covered by Medicare.
If you have medical coverage through an employer, or you’re covered under your spouse’s employer plan, you can delay enrolling in Medicare Part B, which covers medical services, without paying a penalty. Many people don’t enroll in Medicare Part B until they stop working. Once you’re not covered under your employer plan (or your spouse’s), you’ll have eight months to enroll in Medicare Part B without paying a penalty.
Choosing a Medicare plan can be a long process. There’s a lot to consider and it takes time to find the right plan for you. We recommend starting your search about six to nine months before your retirement date. This gives you enough time to look into the plans that interest you.
If you don't sign up for Medicare during your initial enrollment window, you'll face a 10% increase in your Part B premiums for every year-long period you're eligible for coverage but don't enroll. Therefore, it generally pays to sign up for Medicare at 65 -- unless you happen to qualify for one major exception.
Medicare doesn't cover everything. Some of the items and services Medicare doesn't cover include:
- Long-term care (also called custodial care)
- Most dental care
- Eye exams related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
If you need services Medicare doesn't cover, you'll have to pay for them yourself unless you have other insurance or a Medicare health plan that covers them.
Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don't need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65.
Have Private Insurance and Are Turning 65? You Need Sign Up for Medicare Part B. If you are paying for your own insurance, you may think you do not need to sign up for Medicare when you turn 65. However, not signing up for Medicare Part B right away can cost you down the road.