Frequently Asked Questions
What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, or those under 65 who may qualify because of a disability or another special situation. Medicare helps millions of American seniors and disabled individuals cover some of their health care costs. Medicare is individual insurance and doesn’t cover spouses or dependents.
Am I eligible for Medicare?
You are eligible for Medicare if you are a U.S. citizen or Legal resident. Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare. If you are eligible due to a disability, your Medicare eligibility begins after 24 months of receiving Social Security disability benefits.
When can I enroll in Medicare?
You are eligible to enroll in Medicare 90 days before your 65th birthday. If you are receiving Social Security or Railroad Retirement Board benefits when you become eligible, you will be automatically enrolled in Medicare Parts A and B. You’ll receive your Medicare card in the mail. If you’re not receiving benefits, you need to sign up for Medicare when you become eligible. Go to socialsecurity.gov to enroll online, or call or visit your local Social Security office.
You will receive a letter stating your effective date for parts A & B. At that time, you can enroll in a Medicare Advantage plan, Medicare Supplement plan or a stand alone Prescription Drug plan.
What happens if I want to work past age 65?
Depending on the employer coverage you have, you may be able to delay enrolling in Medicare without penalty. Talk with your employer’s benefits administrator to understand your options and to determine if your coverage is considered “creditable.”
How do I enroll in a Medicare Advantage plan, Medicare Supplement plan or Prescription Drug plan?
Call me, and I would be happy to make an appointment with you to go over the different plans.
When can I enroll in a Medicare Advantage plan?
Initial Enrollment Period
Your Initial Enrollment Period (IEP) is 7 months long. It includes your 65th birthday month plus the 3 months before and the 3 months after. It begins and ends 1 month earlier if your birthday is on the first of the month.
The annual enrollment period is October 15 – December 7. During this time, you can make any plan changes for the upcoming year.
Medicare Advantage Open Enrollment
The Medicare Advantage Open Enrollment period is January 1 - March 31. During this time, you may disenroll from your current plan and either switch to a different Medicare Advantage plan one time, or go back to Original Medicare during this period.
Special Enrollment Periods
Depending on certain circumstances, you may be able to enroll in a Medicare plan outside of initial enrollment or annual enrollment.
These may include:
• When you retire and/ or lose your employer coverage
If you leave coverage from your employer or union (including COBRA coverage), you can join a Medicare Advantage Plan or Medicare drug plan. Your chance to join lasts for 2 full months after the month your coverage ends.
• Move out of the plan’s service area
• Qualify for Extra Help
• Have been diagnosed with certain qualifying chronic health conditions
How can a Medicare Advantage plan have a $0 monthly premium?
Private insurance companies that offer Medicare Advantage Plans are contracted with the Federal Government to become the administrator of your health plan. Through negotiated rates, these private insurance companies are able to offer additional benefits above and beyond what you would receive from Original Medicare alone.