Medicare FAQ

Q: What is Medicare? A: Medicare is a health insurance program provided by the government for people who are 65 or older, certain younger individuals with disabilities, and those with end-stage renal disease.

Q: How is Medicare different from Medicaid? A: While both Medicare and Medicaid are government programs that assist with healthcare costs, Medicare primarily serves older adults and people with disabilities, regardless of income. Medicaid, on the other hand, is based on financial need and provides health coverage to low-income individuals and families.

Q: What are the different parts of Medicare? A: Medicare is divided into several parts:

• Part A: Hospital insurance that helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
• Part B: Medical insurance that helps cover doctor visits, outpatient care, preventive services, and medical supplies.
• Part C: Also known as Medicare Advantage, it offers an alternative way to receive Medicare benefits through private insurance companies.
• Part D: Prescription drug coverage that helps pay for prescription medications.

Q: When should I enroll in Medicare? A: If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65. If you’re not receiving Social Security benefits, you’ll need to proactively sign up during the Initial Enrollment Period (IEP), which begins three months before your 65th birthday and lasts for seven months.

Q: Do I need to pay for Medicare? A: While most people do not pay a premium for Medicare Part A (if they have paid Medicare taxes while working), there are premiums associated with Medicare Part B and Part D. The amount you pay depends on your income and the plan you choose.

Q: Can I have other insurance along with Medicare? A: Yes, it’s possible to have other insurance alongside Medicare. Many people choose to get additional coverage through a Medicare Supplement Insurance (Medigap) policy to help pay for costs that Medicare doesn’t cover. Others opt for Medicare Advantage plans that provide both Medicare Parts A and B coverage, often with prescription drug coverage as well.

Q: What does Medicare not cover? A: Medicare doesn’t cover everything, and there are gaps in coverage. Some examples of services not covered by Medicare include long-term care, most dental care, eye exams for glasses, hearing aids, and cosmetic surgery.

Q: Can I change my Medicare coverage? A: Yes, there are specific periods when you can change your Medicare coverage. The Annual Enrollment Period (AEP) occurs each year from October 15 to December 7, during which you can switch between Medicare Advantage and Original Medicare, change or add a Part D plan, or move from one Part D plan to another.

Q: How do I find doctors who accept Medicare? A: You can find doctors who accept Medicare by using the “Physician Compare” tool on the official Medicare website or by contacting the doctor’s office directly and asking if they accept Medicare patients.

Q: What if I need help understanding Medicare or making decisions? A: If you need assistance understanding Medicare or making decisions about your coverage, you can contact your State Health Insurance Assistance Program (SHIP) or speak with a licensed insurance agent who specializes in Medicare.