Medicare FAQ

How does Medicare work?

 Medicare is a federally managed healthcare plan for individuals who meet specific eligibility requirements. You must be age 65 and an American citizen or legal resident for the last five years prior to enrollment. If you are on disability, receiving Social Security or Railroad Retirement Board benefits, or have a qualifying medical condition, you may be eligible for Medicare benefits prior to your 65th birthday.

There are various plans under the Medicare system and most individuals receive free hospital coverage under Part A. For a monthly premium, Part B can provide routine medical care, and additional supplements are available to help offset the cost of prescription drugs, dental, and vision expenses.

What Medicare plans are the best? 

Eligible individuals are automatically covered under Part A, and depending on your specific circumstances, you may choose to opt out of Part B if you have health insurance through a spouse or employer. A range of additional Medicare plans are available and should be considered based on a variety of factors including your medical needs and current level of income.

What does Medicare Cost? 

 Medicare Part A is typically free of charge for all eligible individuals. All other plans may have monthly premiums associated with them based upon your income and tax status. Keep in mind that Medicare plans do not entail 100% coverage but rather are designed to offset the expenses associated with a visit to a Medicare provider.

Most Medicare plans will include an annual deductible and many require a coinsurance payment. It’s best to become familiar with your specific benefits so that you have an accurate understanding of what your out of pocket expenses may be for various supplies and services.

How can I change my Medicare Plan? 

 Over time, your medical needs may change and this might necessitate selecting a different assortment of Medicare plans. Individuals who are interested in modifying their coverage should do so during the Annual Election Period which takes place between October 15 and December 7 each year. During this time, you can change from Original Medicare to Medicare Advantage and vice versa, switch between Medicare Advantage plans and make a range of other alterations to your coverage.

Your changes do not go into effect immediately, however, but instead begin on January 1 following the Annual Election Period. Individuals who are currently enrolled in Medicare Advantage and want to change to Original Medicare but did not do so during the specified period can make this change during the Medicare Advantage Disenrollment Period. This runs from January 1 through February 14.