Commonly asked Questions
Eligibility
How can I check my Medicare eligibility?
Visit the "Estimate my Medicare eligibility & premium" page on the US Government Medicare website. This will give you an estimate of when you're eligible for Medicare and your premium amount. If you don't see your situation, contact Social Security (or the Railroad Retirement Board if you get railroad benefits) to learn more about your specific eligibility or premium.
In general, you qualify for Medicare if you are 65 or older, a U.S. citizen, or a permanent legal resident who's been in the United States for at least five years, have worked 10 years, and paid Medicare taxes. You may also qualify if you are younger than 65 but are disabled or have certain medical conditions.
Dental Implants
Will Medicare help pay for dental implants?
Medicare Advantage plans with supplemental dental inclusion that incorporates dental inserts will be generally helpful. You might need to pay an extra charge, and there will constantly be a most extreme dental advantage sum permitted, alongside either a copay or coinsurance.
Few Medicare Advantage plans cover dental inserts, and some explicitly prohibit dental inserts, regardless of whether they offer other dental benefits. Some of these plans provide artificial posts or crowns, but not the surgical placement of the metal post required for an implant.
If you need dental implants, most likely, you'll incur some amount of out-of-pocket expense.
Part D Drug Plans
How Can I Compare Part D Plans?
Comparing Part D plans is crucial to making sure that you have a plan that will cover your medications well, work at your preferred pharmacy and provide you with the lowest overall annual costs. There are 25+ Part D plans in most counties, and the plans vary tremendously both in terms of covered medications, co-pays, and preferred pharmacies. So, how do you compare them?
The easiest way to compare them is at Medicare.gov. Medicare’s Plan Finder Tool allows you the ability to enter your zip code, medications and pharmacy. Then, it rates all available plans in terms of which plan would give you the lowest overall annual costs, taking into account premiums, deductibles and co-pays. How to compare Part D plans on Medicare.gov.
Medigap Plans
Where Can I Use My Medigap Plan?
Medigap or Medicare Supplement plans do not have networks (except for Medicare SELECT plans, which only comprise a very small percentage of Medigap plans and are not available in most locations). On Medigap plans, you can go to any doctor or hospital that accepts Medicare. So, as long as your doctor accepts Medicare, they are required to accept your Medigap plan, regardless of which company that plan is with.
Medicare A & B
What Part A covers:
Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.
What Part B covers:
Learn about what Medicare Part B (Medical Insurance) covers, including doctor and other health care providers' services and outpatient care. Part B also covers durable medical equipment, home health care, and some preventive services.
What Medicare health plans cover:
Medicare health plans include Medicare Advantage, Medical Savings Account (MSA), Medicare Cost plans, PACE, MTM
Preventive & screening services:
Part B covers many preventive services.
What's not covered by Part A & Part B:
Dental, Prescription glasses, hearing aids, and Transportation are some of the larger benefit items not covered. There are still many ancillary benefits that Medicare will not cover and we can discuss those in detail at your appointment.
Late Enrollment
What are Medicare Penalties for Late Enrollment?
Medicare late enrollment penalties can increase your monthly premium substantially for the rest of your life. The government can penalize you each month that you maintain your Medicare coverage.
It's essential to understand your options and how these late enrollment penalties work to avoid costly premiums in retirement. There are certain times you can enroll in Medicare, and the first enrollment period is a seven-month window around your 65th birthday, and this window is three months before and after you turn 65. The good news is if you're receiving Social Security benefits, you will be enrolled in Medicare when you turn 65 automatically. You may be subject to a 10% penalty for each 12-month period you delayed enrollment that you don't enroll in Part B during the initial open enrollment period. You generally cannot remove it once you have a Part B penalty. And for most, this means the rest of their life.
There is good news, though - you may put off enrollment in Medicare Part B and avoid a penalty if you have "creditable coverage."
Research, Shop & Enroll
Ready to Shop plans?
Our PlanEnroll site is designed to research plan materials, review drug cost, and shop popular plans in your area. We can also provide one-on-one assistance by setting up an appointment.