Frequently Asked Questions

Medicare Basics

  • What is Medicare?

    Medicare is a U.S. federal program that offers health insurance to American citizens and other eligible individuals.

  • Who is Medicare for?

    Medicare is available for U.S. citizens and legal residents that meet certain requirements:


    65 years old or older


    Younger than 65 years old with qualifying disability


    Any age with a diagnosis of end-stage renal disease or ALS


    IMPORTANT: Legal residents must have lived in the U.S. for at least 5 years in a row before applying for Medicare.

Turning 65 Years Old

  • What does 'New to Medicare' mean?

    "New to Medicare" refers to people who have never been enrolled in Medicare before and are now about to or have already qualified. This is typically referring to people who are about to turn 65, but can also be relevant to people who qualify for other reasons, such as disability, certain medical conditions, and more.

  • When do I qualify for Medicare?

    You qualify for Medicare once you turn 65 years of age. In some cases, you can qualify at a younger age depending on your qualifying disability.

  • What if I work past 65?

    You still have your IEP (Initial Enrollment Period), where you have to make decisions regarding Medicare and the coverage provided by your employer (or your spouse’s).




    You may be able to delay enrolling in Medicare without penalty if:

    • The employer has 20 or more employees.
    • The employer-provided health insurance is considered "creditable.”
    • The employer doesn’t require covered spouses to enroll in Medicare at age 65 in order to remain on the employer’s plan.

  • I'm 65 but my spouse isn't, what do we do?

    Even though you qualify for Medicare, unfortunately your spouse does not and cannot be on the same plan. However, we have access to over 20 carriers and will be more than happy to provide them with amazing health insurance that is perfect for their needs up until they turn 65. Then, we can help them make the seamless transition into Medicare once they qualify, pairing them with the best plan possible.

Medicare Plans

  • What's Part A?

    Part A covers inpatient hospital and skilled nursing care. It has a deductible of $1,632 for 2024, every 60 days (per benefit period). This deductible is usually increased yearly.

  • What's Part B?

    Part B covers doctor visits and outpatient care. It has a monthly premium of $174.70 for 2024, an annual deductible of $240 for 2024, and 20% coinsurance for all medical-related benefits.

  • What's Part C?

    Part C, also known as Medicare Advantage plans, combine Part A, Part B, and often prescription drug coverage (Part D). Some plans may offer additional benefits, like coverage for routine vision and dental care. Most Part C plans help with Parts A and B insurance costs, like deductibles and coinsurance.



    You may be able to delay enrolling in Medicare without penalty if:

    • The employer has 20 or more employees.
    • The employer-provided health insurance is considered "creditable.”
    • The employer doesn’t require covered spouses to enroll in Medicare at age 65 in order to remain on the employer’s plan.

  • What's Part D?

    Part D, also known as Medicare prescription drug plans, helps pay for medications prescribed by a doctor or other health care professional.

  • What's Medigap?

    Medigap, also known as Medicare supplement insurance plans, helps pay some or most of the out-of-pocket costs that Original Medicare (Parts A and B) doesn't cover, such as the 20% co-insurance.

  • What plan is best for me?

    The plan you choose will depend on any conditions you may or may not have or any medications your doctor prescribes you. We understand it is a difficult and complex decision to make, which is why we are here to help. You can contact one of our licensed insurance agents at (833) 407-1110.

  • Can I have Medicare Supplement AND Medicare Advantage?

    Unfortunately, no. Medicare Advantage plans are made to completely replace Original Medicare and Medicare Supplement. If you want to have a Medicare Supplement plan, you cannot add a Part C plan with it.

Coverage

  • Premium

    Medicare Part B has a monthly premium. Some people also pay a premium for Medicare Part A. Medicare Advantage (Part C), Part D, and Medigap plans may also have premiums, and amounts will vary by provider and plan.

  • Deductible

    A set amount you pay for covered services before your plan pays.

  • Copay

    A fixed amount you pay at the time you receive a covered service.

  • Coinsurance

    A percentage of the cost you pay for a covered service.

  • How much does Medicare cost?

    Medicare isn't free. The amount you'll pay depends on the coverage you choose and the health care services you receive.


    These are some of the costs you may pay with Medicare:


    • Premium
    • Deductible
    • Copay
    • Coinsurance

  • What are my coverage options?

    Original Medicare


    Original Medicare covers Parts A and B automatically (see above for specifics).


    Medicare Supplemental


    Medicare Supplement is an add-on to Original Medicare, which helps cover prescription drug costs and out-of-pocket payments.


    Medicare Advantage


    Medicare Advantage (Part C) replaces Original Medicare and provides benefits that help cover what supplement insurance assists with. Many plans come with built-in prescription drug coverage as well as offer perks regarding vision, dental care, and more.

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