Frequently Asked Questions
What is Medicare and when am I eligible to get it?
Medicare is a federal health insurance program that provides benefits to American citizens and permanent legal residents (of at least five continuousyears) aged 65 and older, or who have aqualifying disability or illness. Most people are automatically enrolled into Original Medicare,Part A and Part B, when they become eligible; however, some people need to manually enroll in Medicare. If you or a loved one are turning 65 or have a qualifying disability and ARE NOT collecting Social Security benefit please reach out to us
Do I need Medicare Part A or Part B if I am still working?
This depends on your situation. Remember, if you don't sign up for Medicare when you're first eligible and don't have other coverage based on current employment, you could have to pay a late-enrollment penalty later when you do enroll. We typically suggest contacting your employer/HR office first with this question followed by a call to us to review any options needed.
I have Medicare now; do I need to do anything else?
If you've recently enrolled in Original Medicare, congratulations! Now is a good time to learn about the different parts of Medicare, so you can understand what your benefits include and decide if you want to sign up for additional coverage. It's important to understand that Original Medicare, Part A and Part B, only covers a percentage of medical costs and doesn't include most prescription drug coverage. You’ve got decisions to make regarding what types of coverage are available to you. Get personal guidance through the Medicare maze by scheduling an appointment with a member of our team.
How do I get a new Medicare card if my card is
damaged, lost, or stolen?
If your Medicare card is lost, stolen or damaged, you can request a replacement Medicare card through the Social Security Administration in the following ways:
- Online at www.ssa.gov.
Can I get a Medicare Supplement Plan if I am under 65?
Federal law does not require a company to sell Medicare Supplement plans (also known as Medigap) to those under age 65, although some states require it. Because of this, Medigap insurers may choose to deny you a policy before you turn 65, or they may significantly reduce the number of available plans. Check with our staff to get a quote from available carriers in your state.
How often can i change Medicare plans?
As your health-care needs evolve over time, you may need to change Medicare plans in order to receive the coverage that best fits your health requirements. As a broker we can assist with this transition, helping you find the ideal plan for your needs.
Change from Original Medicare, Part A and Part B, to a Medicare Advantage plan.
Change from a Medicare Advantage plan back to Original Medicare, Part A and Part B.
Switch from one Medicare Advantage plan to another.
Switch from one Medicare Prescription Drug Plan (Part D) to another.
If you're enrolled in a Medicare Advantage plan and want to switch back to Original Medicare, Part A and B, you can do so during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year. You will also have until February 14 to join a Medicare Prescription Drug Plan (Part D), and your coverage will go into effect the first day of the month after your new plan gets your enrollment form.
Some people may qualify for a special window because of particular circumstances. Many of these windows have timelines which makes meeting with a member of our team so vital. The follow are a few SEP circumstances:
Moving to a new address
Losing your current employer/retirement coverage
Qualifying state coverage such as Medicaid
Becoming qualified for Extra Help to pay for Medicare Part D coverage through the Social Security Administration.
Can I have both a Medicare Advantage Plan and a MedicareSupplement at the same time?
No, although Medicare Advantage and Medicare Supplement insurance are options that may sound similar, they're quite different and you generally cannot enroll in both at the same time. Understanding the differences in regards to coverage, costs, networks, and eligibility are crucial in deciding which option best fits your needs. This is where our role as a broker becomes priceless. We get to know your needs, budget, and lifestyle to find the best fit for you.
Does Original Medicare Cover Eye Exams?
Original Medicare, Part A and Part B, does not generally cover routine eye exams for eyeglasses or contact lenses. However, Medicare Part B will cover an annual eye exam every 12 months if you have diabetes or are at high risk for glaucoma. Part B coverage also includes diagnostic tests and treatment for certain eye diseases, such as macular degeneration, cataracts, and glaucoma testing. However, some Medicare Advantage plans may offer additional coverage, which could include routine vision benefits.
What diabetic supplies are covered by Original Medicare?
Original Medicare Part B covers some diabetic supplies, including:
Blood sugar (glucose) test strips
Blood glucose monitors, lancet devices, and lancets
Glucose control solutions for checking the accuracy of test strips and monitors
Insulin if you are using a medically necessary insulin pump (see below)
Therapeutic shoes or inserts (see below) (There may be coverage limits on the quantity and frequency you can get these supplies)
Am I covered by Medicare if I travel outside of the UnitedStates?
Generally, no. If you are a beneficiary of Original Medicare, Part A and Part B, then you are free to travel anywhere in the U.S. without fear of losing your Medicare coverage. If you travel outside of the country, however, your Part A and Part B coverage options are much more limited. Medicare Advantage Plans and Medicare Supplements may offer additional coverage allowing greater travel flexibility outside of the U.S.