FAQ: New to Medicare

When do I need to enroll in Medicare?
At age 65 unless the enrollment involves a disability claim when under 65 years of age.

How can I avoid late enrollment penalties?
By enrolling during the 7 month initial enrollment period which is 3 months before your birth month and 3 months after. Early enrollment means no delay in coverage past your birth month and more time for the important decisions concerning Medigap (supplement) policies and Medicare Part D prescription drug plans.

Will Medicare pay for all of my medical costs?
Most but not all costs. After any deductibles, Medicare pays about 80% of your medical costs. There are also some restrictions concerning how much or how long Medicare will pay in certain instances. Secondary coverage like a Medigap or supplement policy will help with the deductibles and remaining 20% of your medical costs.

Does Medicare cover dental expenses?
Medicare does not cover dental expenses.

Does Medicare cover vision expenses?
Medicare will only cover vision expenses if related to certain conditions such as after cataract surgery. Routine eye exams or glasses are not covered.

Will Medicare pay for all of my prescription drug costs?
Not necessarily. Though Medicare Part D prescription drug plans vary you can expect to be responsible for about 25% of your prescription drug costs. Plan premiums, deductibles and copayments for medications all factor into this percentage.

Can you help me sort through all of the information I’ve been bombarded with in the mail?
Yes. Once you become Medicare eligible many companies are trying to compete for your business. We will try to answer any questions about these mailings.

What is official?
Anything that comes from Social Security or from CMS (Centers for Medicare and Medicaid Services) is official. Some companies will send information that looks official but it is not. Ask us first before discarding any mailings you may receive.

If I am eligible for Medicare, do I need to keep employer coverage?
That depends on several factors. Today the trend by companies or organizations is to offer fewer benefits to Medicare eligible prospective or current retirees. This involves a very important discussion about your options.

Can you help me identify health insurance costs for retirement planning?
Yes. We provide our clients with a cost benefit analysis of current coverage compared to leaving current coverage altogether or adding partial benefits with Medicare enrollment to current coverage if it continues for Medicare eligible retirees.

 

Click the links below for other FAQs

General FAQ

What is a Patient Advocate?

What is an Insurance Consultant?

FAQ: Patients and Family

FAQ: Healthcare Professionals

FAQ: Businesses

FAQ: Prescription Drug Assistance

 

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