Medicare FAQ's

Answers To Medicare Questions

Q: I’m turning 65 this year and I plan to retire. When am I eligible to enroll into Medicare?

A: Assuming you have met the work-related eligibility requirements, you have an initial enrollment period of three months prior to your birth month, the month of your birth, and three months after your birth month to enroll in Medicare.

Q: Can my dependent spouse be on my Medicare plan?

A: Medicare does not have spousal or dependent coverage. Medicare is individual. If your spouse has reached age eligibility (65), then they can enroll in Medicare of their own accord 90 days in advance of the month they turn 65.

Q: Can I keep my employer coverage?

A: Maybe. If the employer group has 20 eligible employees or more, and you’re going to continue to work, then yes it’s an option. But there are many things to consider.

Q: Do I need to enroll in Part “A” and Part “B” of Medicare?

A: Part “A” is typically in place, and a paid-up benefit when you turn 65. Part “B” is not, unless you have enrolled in Social Security prior to age 65. If you have not filed to receive Social Security benefits, then you need to proactively enroll in Part “B” benefits and begin paying for them.

Q: Can I just have “Original Medicare” A+B as my health insurance at retirement?

A: Yes. and, you will be responsible for the 20% that medicare does not pay. You will also not have prescription coverage. You will face unlimited exposure to those costs due to the gaps in Original Medicare and incur a penalty from your eligibility date to the date you eventually enroll on a PDP plan.

Q: Can I keep all my same doctors when I’m on Medicare?

A: You usually can. To be sure it is advisable to check with your doctor.

Q: Does Medicare cover me if I’m in a skilled nursing facility?

A: Yes, The first 20 days, after a required three-midnight hospital stay. Then there is a copay for up to 100 days. You must be coded as an inpatient, not under observation and the three midnights cannot include the day of discharge.

Q: Does Medicare have dental plans?

A: No. But some Medicare Advantage plans offer limited dental coverage. You may also purchase dental plans through some carriers offering ancillary products.

Q: I am entitled to retiree benefits. Does that mean I won’t need Medicare?

A: No, a retiree plan will typically be secondary with Medicare as the primary insurer.

Q: What happens if I miss my designated enrollment window into Medicare?

A: In addition to having a huge gap in coverage, you will likely face penalties from Medicare.  A Part “B” penalty can be 10% of your Part “B” premium for each 12-month period outside of Medicare, and up to 1% of the national average of a Part “D” plan for each month without Part “D”.

Q: What is a Part “D” plan?

A: Part “D” is the Prescription Drug plan Medicare introduced in 2006. That is available as a stand-alone plan or included in the Medicare Advantage Prescription Drug Plan.  (MAPD)

Q: Where do I go to get signed up for Medicare?

A: Online at SSA.gov or in person at a local Social Security office. I will be happy to assist you with this enrollment

Q: What is creditable coverage?

A: This is a Medicare term that establishes previous coverage being at least as good as Medicare’s. Typically is in play for Part “D” to avoid penalty.

Q: Should I have both a Medicare Advantage Plan and a Medicare Supplement Plan?

A: You cannot have a Medicare Advantage and a Medicare Supplement plan by law.

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