FAQs

Who is Eligible for Medicare?

To be eligible for Original Medicare, you must be a permanent legal resident (green card holder) or an American citizen who has lived in the United States for at least five years AND one of the following:

• Age 65 or older
• Under age 65 and receiving Social Security Disability Income for 24 months
• Diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis

To enroll in Original Medicare, you may be required to reach out to your local Social Security office in some circumstances.

Will I automatically be enrolled in Medicare when I turn 65?

You will automatically be enrolled in Medicare at age 65 if you are receiving Social Security benefits or railroad retirement board benefits at least four months before you enroll in Medicare.

If you are not collecting Social Security or RailRoad retirement income, you must contact your local Social Security office to sign up for both Part A and Part B. Once you complete the application and provide the required documentation, you will begin receiving benefits on the first day of your 65th birth month. You can also do this online at www.ssa.gov.

Do I need to enroll in Medicare if I work past 65?

While it is not mandatory, we recommend you enroll in Medicare Part A coverage as soon as you become eligible if you qualify for premium-free Part A coverage. However, if you delay Medicare Part A, you will be able to enroll later during the General Enrollment Period or a Special Enrollment Period if you qualify. But, if you delay enrollment to the General Enrollment period, you will be required to pay late enrollment penalties.

If your employer offers creditable health coverage, you do not need to enroll in Medicare Part B if you are working past age 65. Creditable coverage is healthcare coverage that provides at least equal benefits to Original Medicare. Suppose you do not have creditable coverage and do not enroll in Medicare Part B when you first become eligible. In that case, you may have to pay the Medicare Part B late enrollment penalty as long as you have Medicare Part B.

How much does Medicare cost?

For most, the Medicare Part A premium is $0 per month. To qualify for zero premium, you must have worked at least 40 quarters or ten years paying Medicare taxes. If you did not meet this qualification, you would be required to pay the Medicare part A premium.

The standard Medicare Part B premium in 2023 is $164.90. This can increase based on income. This difference in premium reflects your Income Related Monthly Adjustment Amount (IRMAA).

Do I need to renew Medicare every year?

Original Medicare coverage is automatically renewable each year you are eligible. Thus, you do not need to renew your Medicare parts each year.

Medicare Supplement plans work the same way, once you are accepted, the plan is automatically renewable as long as you continue to pay the monthly premium.

Medicare Advantage plans are contracted on an annual basis. If the plan renews, you can choose to have it automatically renewed. If you choose to evaluate a change, you can do so during the Annual Enrollment Period.

What happens to my Medicare plans when I move?

If you move to a new city or state, you will need to change your address with Social Security. If you have a private plan such as a Medicare Supplement, Medicare Advantage or Part D plan, you maybe required to change your plan based on the new location.

What is the Medicare deductible?

Medicare Part A and Medicare Part B have deductibles and costs that change annually.

In 2023, the Medicare Part A per occurrence deductible is $1,600, and the Medicare Part B annual deductible is $226.

Does Medicare cover prescription medications?

Original Medicare does not cover prescription drugs. If you wish to have coverage for prescription Medications, you will need to enroll in Medicare Part D. Medicare Part D helps cover the cost of prescription medications. Additionally, some Medicare Advantage plans provide prescription drug coverage as well.

If you do not enroll in Medicare Part D, you may be subject to the Medicare Part D late enrollment penalty. This penalty is for those who delay Part D benefits without creditable coverage. You will be required to pay the additional cost as long as you have Medicare Part D.

What is the difference between Medicare HMO and Medicare PPO?

Medicare HMO and PPO plans are Medicare Advantage plans.

HMO plans are in network only and typically require referrals to see a specialist. PPO plans have a preferred and non-preferred network which typically give you a larger network to work with.

Will Medicare cover all my medical bills?

Original Medicare does not cover 100% of your medical costs once you enroll in coverage. Medicare Part A requires you to pay a per occurrence deductible and copayments. Then, Medicare Part B requires an annual deductible and a coinsurance of 20%.

Do Medicare benefits change each year?

Original Medicare benefits do not change each year. However, the premiums, deductibles, and covered services may change each year.