FAQ
You’ve Got Questions - We’ve Got Answers
Who is eligible for Medicare?
Medicare is generally available to people age 65 or older who meet the applicable citizenship or lawful-residency requirements. Some people may qualify before age 65, including:
• People who have received qualifying Social Security disability benefits for 24 months
• People diagnosed with Amyotrophic Lateral Sclerosis (ALS)
• People with End-Stage Renal Disease (ESRD) who meet Medicare’s requirements
Eligibility rules can vary by situation. Visit Medicare.gov, contact Social Security, or speak with Christopher for help understanding the next steps.
Do I need to apply for Medicare?
Some people are enrolled in Medicare automatically, while others need to sign up.
If you’re receiving Social Security or Railroad Retirement Board benefits at least four months before turning 65, you’ll generally be enrolled automatically in Medicare Part A and Part B.
If you aren’t receiving those benefits, you’ll usually need to sign up. Your Initial Enrollment Period generally lasts seven months: the three months before your 65th-birthday month, your birthday month, and the three months afterward.
Your situation may be different if you have current employer coverage or qualify for Medicare because of disability, ALS, or End-Stage Renal Disease. You can apply through Social Security or ask Christopher for help understanding when you should enroll.
Are Medicare supplement and Medicare Advantage the same?
No. Medicare Supplement Insurance and Medicare Advantage work in different ways.
Medicare Supplement Insurance, also called Medigap, works alongside Original Medicare. It can help pay some of the out-of-pocket costs left after Original Medicare pays, such as certain deductibles, copayments, and coinsurance. New Medigap policies generally don’t include prescription drug coverage, so a separate Part D plan may be needed.
Medicare Advantage, also called Part C, is another way to receive your Medicare Part A and Part B benefits through a private Medicare-approved insurance company. Plans may use provider networks, require prior authorization for certain services, and have different costs. Most include prescription drug coverage, and some offer additional benefits such as routine dental, vision, or hearing coverage.
You can’t use Medigap and Medicare Advantage together. The right choice depends on your doctors, prescriptions, travel needs, budget, and preferred way of receiving care.
How much does Medicare cost?
Medicare costs vary depending on your coverage, income, work history, location, and the plans you choose.
Most people don’t pay a monthly premium for Medicare Part A because they or their spouse worked and paid Medicare taxes long enough. Most people pay a monthly premium for Medicare Part B, and some pay more based on income.
Medicare Advantage, Part D prescription drug plans, and Medicare Supplement policies may have additional premiums and other out-of-pocket costs. These amounts vary by plan and can change each year.
For current costs, visit Medicare.gov or contact Christopher for help reviewing the options available in your area.
Do I need to renew my Medicare every year?
Usually, you don’t need to re-enroll in Medicare every year.
Original Medicare generally continues as long as you remain eligible and pay any required premiums. Medigap policies are generally guaranteed renewable as long as you pay the premium and follow the policy’s terms.
Medicare Advantage and Part D plans usually renew automatically if the plan continues to be offered and you remain eligible. However, plans can change their costs, benefits, provider networks, covered prescriptions, and service areas each year.
Review your plan’s Annual Notice of Change every fall. If your current plan will no longer be offered or no longer meets your needs, you may need to choose different coverage.
Do I need Medicare if I have VA benefits?
VA health care and Medicare are separate programs, and many veterans choose to have both.
VA benefits generally cover care received at a VA facility or care that the VA authorizes in advance. Medicare can help cover Medicare-approved care from non-VA doctors and hospitals. The two programs generally don’t pay one after the other for the same service.
Medicare may provide access to non-VA providers and services that aren’t covered or authorized by the VA. Delaying Medicare Part B could also result in a coverage gap or late-enrollment penalty if you decide to enroll later.
VA prescription drug coverage is generally considered creditable for Medicare Part D. CHAMPVA has different rules, so anyone with CHAMPVA should review those requirements separately.
Because each veteran’s situation is different, check with the VA and Social Security before delaying Medicare.
Will Medicare cover all of my medical bills?
No. Medicare doesn’t cover every health care service or pay 100% of every covered medical bill.
With Original Medicare, you may be responsible for premiums, deductibles, copayments, and coinsurance. Original Medicare also doesn’t cover certain services, such as most routine dental care, routine vision exams, hearing aids, and long-term custodial care.
Some people choose Medicare Supplement Insurance to help pay certain out-of-pocket costs left by Original Medicare. Others choose a Medicare Advantage plan, which has its own copayments, coinsurance, provider rules, covered benefits, and annual out-of-pocket limit.
Your actual costs depend on the care you receive and the coverage you choose.
What is the difference between Medicare A, B, C, & D?
• Part A — Hospital insurance. It helps cover inpatient hospital care, skilled nursing facility care, hospice care, and certain home health services.
• Part B — Medical insurance. It helps cover doctors’ services, outpatient care, preventive services, durable medical equipment, and certain home health services.
• Part C — Medicare Advantage. It is another way to receive your Part A and Part B benefits through a private Medicare-approved insurance company. Most plans include Part D prescription drug coverage, and some provide additional benefits.
• Part D — Prescription drug coverage. It can be purchased as a separate plan for someone with Original Medicare or included in many Medicare Advantage plans.
For current, official Medicare information, visit Medicare.gov.
Still have questions? Contact Christopher for clear, personal guidance.