Medicare General Information.
Medicare General info
Medicare is the federal health insurance program for people age 65 and older, as well as certain individuals with disabilities. Most people become eligible at age 65 and can enroll during their Initial Enrollment Period, which begins three months before their birthday month and ends three months after. Enrolling on time is important, as missing this window can lead to lifetime penalties for certain parts of Medicare.
Medicare is made up of several parts that work together to provide coverage. Part A helps pay for hospital care, while Part B covers doctor visits, outpatient care, preventive services, and testing. Many people also choose Part C (Medicare Advantage), which bundles Parts A and B and often includes extra benefits like dental, vision, and prescription drugs. Part D provides standalone drug coverage for those not enrolled in a Medicare Advantage plan, and Medigap (Supplement Insurance) helps pay deductibles and out-of-pocket costs not covered by Original Medicare.
Every year, Medicare offers specific enrollment periods, including the Annual Open Enrollment Period from October 15 to December 7, when beneficiaries can change or adjust their coverage. Medicare does not cover everything—such as long-term care, most dental work, and routine vision or hearing services—so additional coverage may be needed. A licensed professional can help you review your doctors, prescriptions, and budget to determine which Medicare option best fits your needs.
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Medicare Frequently asked questions
1. What is Medicare?
Medicare is a federal health insurance program for people age 65+, certain younger individuals with disabilities, and those with qualifying medical conditions like End-Stage Renal Disease.
2. When am I eligible for Medicare?
Most people become eligible at age 65. Your Initial Enrollment Period lasts 7 months: 3 months before your birthday month, your birthday month, and 3 months after.
3. What are the parts of Medicare?
• Part A: Hospital coverage
• Part B: Medical/doctor coverage
• Part C: Medicare Advantage (private plans bundling A, B, often D)
• Part D: Prescription drug coverage
• Medigap: Supplement insurance to help pay deductibles and copays
4. Does Medicare start automatically?
If you're already receiving Social Security at 65, you are automatically enrolled in Parts A and B. Otherwise, you must enroll through Social Security.
5. What does Medicare Part A cover?
Hospital stays, skilled nursing facility care, hospice, and limited home health care. Most people pay no premium for Part A.
6. What does Medicare Part B cover?
Doctor visits, outpatient care, lab work, X-rays, durable medical equipment, and preventive services. Part B has a monthly premium.
7. What is Medicare Advantage (Part C)?
Private plans that include Part A, Part B, often Part D, and additional benefits like dental, vision, hearing, and wellness programs.
8. What is Medicare Part D?
Prescription drug coverage offered as a standalone plan or included in many Medicare Advantage plans.
9. Do I need Medicare if I’m still working at 65?
Possibly not. If your employer coverage is “creditable,” you may delay Parts B and D without penalties. Always confirm before delaying.
10. What are the Medicare enrollment periods?
• IEP: Around your 65th birthday (7 months)
• Annual Open Enrollment (AEP): Oct 15 – Dec 7
• Medicare Advantage Open Enrollment: Jan 1 – Mar 31
• General Enrollment: Jan 1 – Mar 31 (if you missed IEP)
11. What happens if I don’t sign up on time?
• Part B penalty: 10% for every 12 months delayed (lifetime)
• Part D penalty: Permanent monthly penalty
• Part A penalty: Applies only if you must purchase Part A
12. Does Medicare cover dental, vision, and hearing?
Original Medicare does not. Some Medicare Advantage plans include these benefits.
13. What is Medigap?
Supplement insurance that helps pay deductibles, copayments, and coinsurance under Original Medicare (A & B). Does not include drug coverage.
14. Can I change my Medicare plan later?
Yes. During AEP (Oct 15 – Dec 7), you can change Advantage plans or Part D plans, or switch between Medicare Advantage and Original Medicare.
15. How do I choose the right Medicare plan?
Consider your doctors, medications, budget, travel needs, and desired extra benefits. A licensed professional can help compare options.
16. How much does Medicare cost?
Costs vary by plan choice, income, location, and whether you select a Medigap or Medicare Advantage plan.
17. Can Medicare be combined with employer insurance?
Yes. With large employers, the employer plan usually pays first; Medicare pays second.
18. Does Medicare cover long-term care?
No. Medicare does not cover assisted living, nursing home custodial care, or long-term daily support.
19. Does Medicare cover emergency care while traveling?
Original Medicare covers emergencies only in the U.S. Some Medigap and Medicare Advantage plans offer limited foreign travel benefits.
20. Where do I enroll?
Through Social Security: SSA.gov, your local Social Security office, or 1-800-772-1213. A licensed agent can help you review options before enrolling.
