Medicare FAQs

Medicare FAQs

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When do I apply for Medicare Part B?

The majority of the time there are two time frames you'll want to follow to apply for Part B.

1. You can apply up to three months before you turn 65. If you are either retired, planning to retire, not receiving social security benefits yet, or if your employer requires you to enroll in Medicare Part B.
2. If you have worked past age 65 and were not required to have been on Medicare Part B by your employer, then you'll apply in person at a local social security office. Have your Part B start the month following your retirement. There is a two-part form to be completed. One form for your HR department to prove you had credible medical insurance coverage. The other form, you complete and submit to the social security office.

Additionally, if you are already drawing social security benefits before you turn 65 you'll be automatically enrolled in Part B. You'll receive your Medicare card showing Part A and Part B in the mail approximately 3 months prior to the effective date of coverage.

When do I become eligible for Part A and how much does it cost?

As long as you have worked in the United States for ten years (40 quarters) and paid into Medicare taxes, you will be enrolled into Part A at no cost. Part A will start on the first day of the month of your 65th birthday. However, if your birthday falls on the 1st day of the month, then your benefits will start on the first day of the previous month. If you do not qualify for Part A at no cost, e.g. you didn't work here long enough to pay into it, then it can be purchased in 2017 for $413 a month.

What is the Medicare Part B penalty and how to avoid it?

The Part B penalty is a 10% higher Part B monthly payment for every 12-month period that you could have had Part B but didn't sign up for it. The best way to avoid this is to either sign up for Part B when you are first eligible to or make sure that you have credible medical coverage through your employer.

I enrolled in a Medicare Advantage plan with a $0 premium, so do I still need to pay my monthly Medicare Part B premium?

Yes. In order to enroll in a Medicare Advantage plan, you must be covered by Medicare Part A and Medicare Part B.

What is the Medicare Part D penalty and how to avoid it?

The late enrollment penalty is calculated by multiplying the number of months you did not have credible prescription drug coverage when you were eligible to, under a Part D plan, by 1% of the national average drug price. Medicare will contact your Medicare prescription drug plan and tell them the proper penalty to charge you. This penalty never goes away, it's permanent. As long as you have a Medicare drug plan, you will have to pay this penalty, in addition to the monthly Part D premium. The best way to avoid this penalty is to make sure that when you are first eligible you either enroll in a Medicare Advantage plan that includes drug coverage, enroll in a Stand Alone Prescription Drug Plan, or make sure your employer drug coverage qualifies as credible drug coverage with Medicare. You have 63 days once your Part A or Part B starts to enroll in a credible prescription drug plan to avoid paying the penalty.

What is the difference between a Medicare Advantage Plan and a Medicare Supplement (Medigap)?

The easiest way to describe this is to say that a Medicare Advantage Plan is a primary insurance plan and you do not need any other plan with it. They take over your Medicare benefits and agree to pay all of your claims, so Medicare can no longer be billed. Some Medicare Advantage plans will also include drug coverage for no extra cost. A Medicare supplement plan is a secondary insurance plan and is billed secondary to Medicare. Supplement insurance plans will only cover Medicare covered medical items and, depending on which plan you choose, help either cover some or all of the deductibles or co-insurance Medicare that doesn't cover. Supplement plans do not include drug coverage. If you want prescription drug coverage then you will need to enroll in a Stand-Alone Prescription Drug plan.

We represent multiple insurance companies. We can help you select a Medicare Advantage, Medicare Supplement (Medigap) or Prescription Drug Plan that will fit your needs, budget and one that is accepted by your doctor.

What is the difference between Medicare and Medicaid?

Medicare is administered by the federal government. Medicare is for anyone who qualifies at age 65, under age 65 upon collecting Social Security Disability Income for 24 months, or anyone with ALS (Amyotrophic Lateral Sclerosis, more commonly known as Lou Gehrig's Disease), or ESRD (End Stage Renal disease).

Medicaid is administered by the state. Medicaid provides medical assistance for those who qualify based on income and asset requirements. Based on your qualification, the state may help pay your Part B premium or some or all of your medical co-pays or co-insurance.

What is a Medicare Savings Program?

Medicare Savings Programs help Medicare recipients pay for all or part of their Medicare premiums for those that meet income and resource requirements.

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