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Frequently Asked Questions

These FAQs provide a general overview, but individuals should consult with qualified professionals or refer to official Medicare resources for personalized guidance.

What is Medicare?

Medicare is a federal health insurance program primarily for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

What is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare offered by private insurance companies. These plans often include additional benefits such as vision, dental, and prescription drug coverage.

Who is eligible for Medicare?

Generally, individuals who are 65 or older and U.S. citizens or permanent residents qualify for Medicare. Certain younger people with disabilities and those with End-Stage Renal Disease (ESRD) may also be eligible.

When can I enroll in Medicare?

Initial Enrollment Period (IEP): This is the seven-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months after your birthday month.

Annual Enrollment Period (AEP): This period is from October 15th to December 7th each year, during which you can switch Medicare Advantage plans or enroll in one if you haven’t already.

Special Enrollment Periods (SEP): These occur during certain life events, such as moving, losing employer coverage, or qualifying for Medicaid.

What does Medicare cover?

Medicare typically covers hospital stays (Part A), medical services (Part B), and prescription drugs (Part D). There are also options to get additional coverage through Medicare Advantage plans (Part C).

What is not covered by Medicare?

Medicare does not cover certain services such as long-term care, dental care, eye exams related to prescribing glasses, cosmetic surgery, acupuncture, and hearing aids.

How much does Medicare cost?

Costs vary depending on the specific plan and individual circumstances. Generally, Part A may be premium-free for most individuals, while Part B and Part D have monthly premiums. Medicare Advantage plans often have premiums in addition to the Part B premium.

What is the difference between Medicare Advantage and Medicare Supplement (Medigap) plans?

Medicare Advantage plans provide coverage through private insurance companies and often include additional benefits not covered by Original Medicare, whereas Medigap plans help pay for some of the out-of-pocket costs not covered by Original Medicare.

Can I switch from Original Medicare to a Medicare Advantage plan, or vice versa?

Yes, you can switch during certain enrollment periods, such as the Annual Enrollment Period (AEP) or Special Enrollment Period (SEP).

How do I find the right Medicare plan for me?

It’s essential to consider factors such as your healthcare needs, budget, prescription drug coverage and preferred doctors or hospitals. You can compare plans online, speak with insurance agents, or contact Medicare directly for assistance.