Frequently Asked Questions

You can enroll during your Initial Enrollment Period (IEP), which begins 3 months before you turn 65 and ends 3 months after your birthday month. There's also an Annual Enrollment Period (AEP) from October 15 to December 7 each year, and Special Enrollment Periods for qualifying life events such as moving to a new area, losing other coverage, or qualifying for Extra Help.

Missing your Initial Enrollment Period may result in late enrollment penalties that increase your premiums permanently. However, you can still enroll during the General Enrollment Period (January 1 to March 31) with coverage starting July 1. We recommend contacting us immediately if you've missed your deadline so we can explore your options and help minimize penalties.

Yes, you can switch plans during the Annual Enrollment Period (October 15 - December 7) or the Medicare Advantage Open Enrollment Period (January 1 - March 31). You may also qualify for a Special Enrollment Period if you experience certain life changes. Our advisors can help you determine when you're eligible to switch and guide you through the process.

Original Medicare (Parts A and B) is provided by the federal government and covers hospital and medical services. Medicare Advantage (Part C) is offered by private insurance companies approved by Medicare and often includes additional benefits like prescription drug coverage, dental, vision, hearing, and fitness programs in one convenient plan. Medicare Advantage plans may have network restrictions but typically offer lower out-of-pocket costs and extra benefits not covered by Original Medicare.

If you don't have other creditable prescription drug coverage, you should enroll in Part D when you're first eligible. If you delay enrollment without creditable coverage, you may face a late enrollment penalty that increases your premiums permanently. The penalty is calculated as 1% of the national base beneficiary premium for each month you were eligible but didn't enroll.

Most Medicare Advantage plans have networks of doctors and hospitals. You'll typically pay less when you use in-network providers. Some plans, like PPOs, offer out-of-network coverage at a higher cost, while HMO plans generally require you to use in-network providers except for emergencies. We can help you find a plan that includes your preferred doctors and specialists in its network.

Medigap (Medicare Supplement Insurance) is sold by private companies and helps pay some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. You can only have a Medigap policy if you have Original Medicare, not Medicare Advantage. Medigap policies offer standardized coverage and are guaranteed renewable as long as you pay your premiums.

Original Medicare generally does not cover routine dental, vision, or hearing services. However, many Medicare Advantage plans include these benefits as extras. Coverage varies by plan and may include routine eye exams, eyeglasses, dental cleanings, fillings, and hearing aids. We can help you find a plan that includes the extra benefits you need.

Medicare costs vary depending on your plan choices. Part A is usually premium-free if you or your spouse paid Medicare taxes for at least 10 years. Part B has a standard monthly premium that changes annually. Medicare Advantage plans may have $0 premiums or low monthly costs, while Medigap policies have varying premiums based on your location, age, and the plan type you choose. We can provide personalized cost estimates based on your situation.

An out-of-pocket maximum is the most you'll pay for covered services in a year. Once you reach this limit, the plan pays 100% of covered services for the rest of the year. Medicare Advantage plans are required to have out-of-pocket maximums, while Original Medicare does not have a cap on your costs. This is one reason many people choose Medicare Advantage or add a Medigap policy to Original Medicare.

Yes, several programs can help reduce Medicare costs. Extra Help with Medicare prescription drug costs assists low-income beneficiaries with premiums, deductibles, and copays. Medicare Savings Programs help pay Part B premiums and sometimes Part A and B deductibles and copays. Medicaid can also help cover Medicare costs for those who qualify. We can help you determine if you're eligible for any assistance programs.

In Medicare Advantage plans that include prescription drug coverage, drug costs typically do not count toward the plan's medical out-of-pocket maximum. However, standalone Part D plans have their own separate out-of-pocket thresholds. Once you reach the Part D catastrophic coverage threshold, you'll pay significantly reduced costs for your medications. We can explain how drug costs work in different plan types.