Frequently Asked Questions

WHEN WILL MY MEDICARE START?

For most People the earliest you may start your Medicare is the first day of the month you turn 65. If you're born on the 1st of the month you are eligible for the first of the preceding month. If you're receiving social security disability or have certain diseases you may be eligible considerably earlier call for details.

DO I NEED TO SIGN UP FOR MEDICARE?

If you start receiving Social Security Income prior to 65 your Medicare Part A and B will be started for you automatically. You should receive your card with both A & B effective dates between 90 and 100 days prior to your effective date. If you're receiving group coverage [Groups of less than 20 can force you to sign up for Part B] at the time you reach age 65 you have an option not to sign up for Part B. You or your spouse must be at work full-time actively earning your group coverage. COBRA is not a viable option for 65+ individuals. If you currently have “Creditable” drug coverage you have an option not to sign up for Part D coverage. You can collect Social Security and not start your Medicare. Determining if you should stay on group coverage is a big decision and you should talk to a Medicare Professional to determine if you are giving up any options by doing so.

HOW DO I SIGN UP FOR MEDICARE?

1. Apply online at SocialSecurity.gov
2. Visit your local Social Security Office
3. Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)

WHAT IS MEDICARE (PART A), AND WHAT DOES IT COVER?

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, Hospice care, and some Home health care.

Copayments, coinsurance or deductibles may apply for the services listed:

  • Blood

  • Home Health Services

  • Hospice Care

  • Inpatient Hospital Care

  • Skilled Nursing Facility Care

WHAT IS MEDICARE (PART B), AND WHAT DOES IT COVER?

Medicare Part B helps cover medical services like doctor services, outpatient care, ambulance, and other medical services Medicare Part A does not cover. Part B helps pay for covered medical services and items when they are medically necessary. Part B also covers some Preventative Services like exams, lab tests, and screening shots to help prevent, find, or manage a medical problem.

WHAT IS MEDICARE PART C?

A Medicare Advantage Plan like an HMO or PPO is another Medicare health plan choice as part of Medicare. Sometimes called "Part C or MA Plans,” are offered by private companies approved by Medicare.

If you join a Medicare Advantage Plan, the plan will provide all of your Part A and Part B coverage. Most include Medicare prescriptions drug coverage (Part D)

WHAT IS MEDICARE (PART D), AND WHAT DOES IT COVER?

Medicare drug coverage (Part D) helps pay for prescription drugs you need at the pharmacy.

Coverage is offered to everyone with Medicare. If you decide not to get it when you are first eligible, and you do not have other creditable prescription drug coverage from an Employer or get Extra Help, you will likely pay a late enrollment penalty if you join a plan later.

To get Medicare drug coverage, you must join a Medicare-approved stand-alone drug plan or a Medicare Advantage Plan, or another Medicare Health plan with drug coverage.

What is not covered by Medicare Part A and Part B?

Medicare doesn't cover everything. Some of the items and services that Original Medicare doesn't cover include:

  • Most dental Care

  • Eye Exams (for prescription glasses)

  • Dentures

  • Cosmetic Surgery

  • Massage Therapy

  • Routine physical exams

  • Hearing aids and exams for fitting them

  • Long-Term care

  • Concierge care

  • Covered items or services you get from an opt-out doctor

What is covered by Medicare when I am out of the United States?

Original mediocre generally DOESN'T cover care outside the United States. You may enroll in a Medicare Supplement Insurance (Medigap) policy that covers emergency care outside the U.S.

Medicare Advantage (Part C) Plans generally don't cover care outside the U.S. Some plans may offer a supplemental benefit that covers emergency and urgently needed services when traveling outside the U.S.

IF YOU ARE A VETERAN DO YOU NEED A PART B PLAN?

It depends. Not all Veterans can access VA benefits and also the VA has a closed formulary so it is possible that a qualified veteran will need a plan to access that medication.