Medicare FAQ
New to Medicare
You can enroll in Medicare through the Social Security Administration website, by calling Social Security, or by visiting your local Social Security office.
Yes, most people need both Part A and Part B to get full coverage. Part A covers hospital services, and Part B covers outpatient medical services.
Low-Income Subsidy and Extra Help
The Low-Income Subsidy (Extra Help) program helps individuals with limited income and resources pay for Medicare Part D prescription drug costs, including premiums, deductibles, and co-payments. Eligibility is based on income and asset limits.
You can apply for Extra Help through the Social Security Administration by filling out an application online, calling their toll-free number, or visiting your local Social Security office.
Enrollment Periods and Penalties
- Initial Enrollment Period (IEP): Starts three months before you turn 65, includes the month of your 65th birthday, and ends three months after.
- General Enrollment Period (GEP): January 1 to March 31 each year, for those who missed their IEP.
- Annual Enrollment Period (AEP): October 15 to December 7 each year, for making changes to your Medicare Advantage and Part D plans.
- Special Enrollment Period (SEP): Available for certain life events, like losing employer coverage.
- Part B Late Enrollment Penalty: Your monthly premium may increase by 10% for each 12-month period you were eligible but didn’t enroll.
- Part D Late Enrollment Penalty: Calculated by multiplying 1% of the “national base beneficiary premium” by the number of full, uncovered months you didn’t have Part D or other creditable coverage.
VA Benefits and TRICARE for Life
Medicare and VA benefits do not coordinate, but you can use both. VA benefits cover care at VA facilities, while Medicare covers services at non-VA facilities.
TRICARE for Life is a health care program for retired military personnel and their families. It works with Medicare to provide comprehensive health coverage. You must be enrolled in Medicare Part A and Part B to receive TRICARE for Life benefits.
General Medicare Questions
Medicare is a federal health insurance program primarily for individuals aged 65 and older, but it also covers some younger people with disabilities or specific diseases.
Medicare has four parts:
- Part A: Hospital Insurance
- Part B: Medical Insurance
- Part C: Medicare Advantage Plans (offered by private companies)
- Part D: Prescription Drug Coverage
Medicare does not cover certain services, including:
- Long-term care (custodial care).
- Most dental care.
- Eye exams related to prescribing glasses.
- Dentures.
- Cosmetic surgery.
- Acupuncture.
- Hearing aids and exams for fitting them.
- Routine foot care.
Types of Medicare Plans
Medigap (Medicare Supplement Insurance) helps pay for some of the healthcare costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles. Medigap policies are sold by private companies and can only be used with Original Medicare.
Medicare Advantage Plans are an alternative to Original Medicare. They are offered by private companies and include all Part A and Part B benefits, often with additional benefits like dental, vision, and hearing care. Some plans also include Part D prescription drug coverage.
- Part D: Prescription Drug Coverage
Part D is an optional prescription drug coverage plan offered by private insurance companies. It helps cover the cost of prescription drugs and is available to anyone enrolled in Medicare Part A or Part B.
Health Plan Information
Choosing the right plan depends on your healthcare needs, budget, and preferences. It’s helpful to compare plans based on coverage, costs, and provider networks.
Additional Resources
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