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General Medicare Questions

Medicare Basics

  1. Part A - Hospital coverage

  2. Part B - Medical coverage

  3. Part C - Also known as “Medicare Advantage.” Combines hospital (Part A) and medical (Part B) coverage in one plan. In addition, you may have access to:

    • Low or $0 monthly premiums
    • Prescription drug coverage (Part D)
    • Extra benefits that are not available through Original Medicare such as vision benefits, dental benefits, hearing benefits, or fitness or gym membership

  4. Part D - Prescription drug coverage that is only available when you enroll in a Medicare Advantage plan that includes prescription drug coverage (MAPD) or purchase a separate Prescription Drug Plan (PDP).

Medicare Supplement plans are an alternative to Original Medicare or Medicare Advantage plans.

Medicare Supplement plans:

  • are designed to fill gaps left by Original Medicare.
  • generally cost more per month and offer more comprehensive coverage than Medicare Advantage plans.
  • do not include prescription drug coverage. If you want that important option, you must purchase it separately.
  • allow you to see any provider who accepts Medicare.
  • may not be combined with a Medicare Advantage plan.

Medicare Coverage

Once you enroll in Medicare, you’ll have three basic choices for receiving your health coverage:

  • Original Medicare (Part A and Part B)
  • Medicare Advantage (Part C)
  • Medicare Supplement

Original Medicare DOES NOT cover all of your medical expenses.

It’s important for you to know that Original Medicare covers only about 80% of your eligible expenses. You are responsible for the rest. Also remember that Original Medicare does not include prescription drug coverage.

No, prescription drug coverage is NOT INCLUDED with Original Medicare or Medicare Supplement Plans.

Medicare Part D prescription drug coverage is an important option that is available either as a standalone plan or as part of a Medicare Advantage Plan.

Just remember, if you do not sign up for prescription drug coverage during your Initial Election Period you may encounter a penalty if you sign up at a later date.

You can select Medicare Part D prescription drug coverage as a standalone plan or as part of Medicare Advantage Plan.

Prescription coverage is NOT INCLUDED with Original Medicare or Medicare Supplement Plans.

Enrolling in Medicare

Most people are automatically enrolled in Medicare Part A when they turn 65. You can enroll in Medicare Part B as early as the first day of the month, three months before your birth month.

As soon as you enroll in Part B, you can choose what type of additional coverage you want—a Medicare Advantage plan or a Medicare Supplement Plan.

Don’t forget to also enroll in a prescription drug plan (Part D) if it’s not already included with your plan. This way, you can protect yourself from the high cost of prescription drugs.

Keep in mind that if you do not enroll in Medicare Part B AND choose prescription drug coverage during this Initial Enrollment Period, you may be subject to a penalty if you enroll later.

You can choose a new plan each year. All Medicare beneficiaries have an opportunity to choose or change plans each year during the Medicare Annual Enrollment Period, which begins on October 15 and ends on December 7.

The choices you make during the Annual Enrollment Period will take effect on January 1 of the upcoming year.

Between January 1 and March 31 of each year, you will have a single opportunity to switch your Medicare Advantage plan or return to original Medicare. Please note this opportunity is available only one time during this period.

Yes. A Medicare Special Enrollment Period allows you to enroll in Medicare or change your plan at other times of the year. Such circumstances include:

  • When you first become eligible for Medicare.
  • If you are on both Medicare and Medicaid.
  • If your current plan is terminated.
  • If you move to a community not served by your current plan.
  • Other circumstances as defined by the Centers for Medicare and Medicaid Service.