1. Who is eligible for Medicare?

U.S. citizens and legal residents living in the U.S. for at least 5 years in a row including the 5 years prior to applying for Medicare, and meet one of the following requirements:

-Age 65 or older,

-Younger than 65 with a qualifying disability, or

-Any age with a diagnosis of End-stage renal disease or ALS

 

  1. When can I enroll in Medicare?

The best time to enroll is during your Initial Enrollment Period which is the

7- month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after you turn 65.

 

*If you are collecting Social Security or Railroad Retirement Benefits, you will automatically be enrolled at age 65 and your Medicare card will be mailed to you.

 

  1. What are the different parts of Medicare? 

There are four parts to Medicare:  Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage), and Part D (Prescription Drug Coverage).

 

  1. What is Original Medicare and what services does it cover?

Parts A and B are referred to as Original Medicare.

 

Part A helps cover inpatient hospital care, skilled nursing care, hospice and home health care.

 

Part B helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and many preventive services.

 

*You can find coverage details by visiting Medicare.gov and downloading the      Medicare & You Handbook found under Forms, Help and Resources.

 

  1. What if I or my spouse work past age 65 and have employer coverage?

You may want to enroll in Part A only and decline Part B until you no longer have employer coverage.  Once you (or your spouse) retire, you will be eligible for a “Special Enrollment Period” and will have 8 months to sign up for Part B after employer coverage ends.

 

  1. Is there a discount for couples who sign up for the same Medicare plan?

Some carriers (not all) do offer household discounts for Medigap policies.  However, policies are sold on an individual basis, so each spouse will need a separate plan.  And, depending on health conditions, it may not always make sense.  This applies to Medicare Part D plans as well.

 

  1. What is the General Enrollment Period? 

If you didn’t sign up for Part A and/or Part B during your Initial Enrollment Period and you don’t qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1 – March 31 each year. Your coverage won’t start until July 1 of that year, and your Part B premium may go up 10% for every 12 months that you could have had Part B, but did not enroll. This penalty remains for as long as you are enrolled in Medicare.

 

*You can find details regarding qualifying Special Enrollment Periods and late enrollment penalties on Medicare.gov.

 

  1. What is the Annual Enrollment Period? 

You can join, switch or drop Medicare Advantage and Prescription drug plans during the Annual Enrollment Period (open enrollment) every year between October 15th and December 7th.

 

*You can change Medigap plans anytime during the year.  However, in most cases if you’ve had your current plan longer than 6 months, you may be subject to underwriting where an insurance company can deny or charge higher premiums for certain health conditions.

 

  1. What is the Initial Enrollment Period? 

This is when you are first eligible for Medicare and begins three months prior to your 65 birthday and lasts seven months.

 

  1. Can I still receive Medicare benefits if I’m not collecting Social Security?

Yes.  You can still enroll in Medicare if you’re not yet collecting Social Security or Railroad Retirement benefits.

 

  1. Can I get help with prescription drug costs and/or my Part B Premium?

Beneficiaries may quality for help with prescription drug costs and/or Medicare Part B premiums if their income and resources are below certain limits.  Qualifying criteria is based on federal poverty level guidelines.

 

*Details and qualifying criteria can be found on Medicare.gov under Forms, Help and Resources.