Question 1

When am I eligible for Medicare?

Accepted Answer

You are eligible for Medicare when you turn 65. You may also be eligible under 65 if you have received Social Security Disability Insurance (SSDI) for 24 months, or if you have End-Stage Renal Disease (ESRD) or ALS.

Question 2

When should I enroll in Medicare?

Accepted Answer

Your Initial Enrollment Period (IEP) is a 7-month window: 3 months before your 65th birthday month, your birthday month itself, and 3 months after. Enrolling during the first 3 months ensures your coverage starts on the first day of your birthday month.

Question 3

Can I delay Medicare if I'm still working?

Accepted Answer

Yes. If you or your spouse are actively working and covered by an employer group health plan, you can delay Medicare without penalty. Once that coverage ends, you have an 8-month Special Enrollment Period to sign up.

Question 4

What happens if I miss my enrollment window?

Accepted Answer

If you miss your Initial Enrollment Period without a qualifying Special Enrollment Period, you can enroll during the General Enrollment Period (January 1 – March 31 each year). However, you may face a late enrollment penalty that permanently increases your premium.

Question 5

Is Medicare free?

Accepted Answer

Part A is usually premium-free if you or your spouse paid Medicare taxes for at least 10 years. Part B has a monthly premium (the standard amount changes each year). You also pay deductibles, copayments, and coinsurance for services.

Question 6

What is the Medicare coverage gap ("donut hole")?

Accepted Answer

The coverage gap is a temporary limit on what Medicare Part D pays for prescription drugs. Once you and your plan have spent a certain amount on covered drugs, you enter the gap and pay a higher percentage of costs until you reach the catastrophic coverage threshold. The gap has been significantly reduced in recent years.

Question 7

Does Medicare cover dental, vision, and hearing?

Accepted Answer

Original Medicare (Parts A and B) generally does not cover routine dental, vision, or hearing care. However, some Medicare Advantage (Part C) plans include these benefits. Medicare Supplement plans also do not cover these services.

Question 8

Does Medicare cover prescription drugs?

Accepted Answer

Original Medicare does not include prescription drug coverage. You can add drug coverage through a standalone Medicare Part D plan, or choose a Medicare Advantage plan that includes Part D coverage.

Question 9

What is a Medicare Supplement (Medigap) plan?

Accepted Answer

A Medicare Supplement plan is private insurance that helps pay the out-of-pocket costs that Original Medicare doesn't cover — such as deductibles, copayments, and coinsurance. Plans are standardized by the federal government, so Plan G from one company offers the same benefits as Plan G from another.

Question 10

Which Medicare Supplement plan is the most popular?

Accepted Answer

Plan G is currently the most popular Medigap plan for new Medicare enrollees. It covers nearly all out-of-pocket costs except the Part B deductible. Plan N is also popular for those who want lower premiums and are comfortable with small copayments.

Question 11

When is the best time to buy a Medicare Supplement plan?

Accepted Answer

The best time is during your Medigap Open Enrollment Period — the 6-month window that begins the month you turn 65 and are enrolled in Part B. During this period, insurers cannot deny you coverage or charge you more due to pre-existing conditions.

Question 12

Can I be denied a Medicare Supplement plan?

Accepted Answer

Outside of your Open Enrollment Period, insurance companies can use medical underwriting and may deny coverage or charge higher premiums based on your health history. This is why enrolling during your Open Enrollment Period is so important.

Question 13

Can I switch Medicare Supplement plans?

Accepted Answer

Yes, you can apply to switch plans at any time, but outside of guaranteed issue periods, you may be subject to medical underwriting. If you're in good health, switching to a lower-premium plan may save you money.

Question 14

What is the difference between Medicare Advantage and Original Medicare?

Accepted Answer

Original Medicare is run by the federal government and covers Parts A and B. Medicare Advantage (Part C) is offered by private insurers approved by Medicare. Advantage plans must cover everything Original Medicare covers, but often include extra benefits like dental, vision, and drug coverage.

Question 15

Can I switch from Medicare Advantage back to Original Medicare?

Accepted Answer

Yes. You can switch during the Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31). Keep in mind that if you switch back to Original Medicare, you may not be able to get a Medigap plan without medical underwriting.

Medicare FAQs

Eligibility & Enrollment

Costs & Coverage

Medicare Supplement Plans

Medicare Advantage