Common Questions and Answers
Q. When is Medicare Open Enrollment?
A. The annual Medicare open enrollment period begins on October 15 and ends December 7. Open enrollment for 2020 coverage has ended. Open enrollment will begin again on October 15, 2020, for coverage changes effective in January 2021.
Q. Do I need to sign up for Medicare at 65 if I’m still working?
A. You are automatically eligible to enroll in Medicare at age 65. Your enrollment window is the seven-month period that begins three months before the month of your 65th birthday and ends three months after that. If you’re working at 65, you have a bit more time that the initial enrolment window to avoid premium surcharges.
Q. When is the best time to enroll in Medicare?
A. During the open enrollment period. The annual Medicare open enrollment period begins on October 15 and ends December 7. Open enrollment for 2020 coverage has ended. Open enrollment will begin again on October 15, 2020, for coverage changes effective in January 2021.
Q. Is there a best time to enroll in a Medicare supplement plan?
A. Yes. The best time to enroll is during your Medigap open enrollment period, a six-month window of time that begins on the first day of the month that you are at least 65 years old and are enrolled in Medicare Parts A and B.
Q. Can I switch between Medicare Advantage and Original Medicare?
A: Yes. During the Medicare open enrollment period from October 15 to December 7, you can switch between Original Medicare and Medicare Advantage, or vice versa. If you are already enrolled in a Medicare Advantage plan, you can drop it and enroll in Original Medicare and a Part D plan during open enrollment, with coverage effective January 1.
Q. Do I need to be on Social Security to get Medicare coverage?
A: While the Social Security and Medicare programs are interrelated, you do not need to be enrolled in Social Security in order to apply for Medicare.
Q. Social Security Eligibility
A: Seniors are eligible to claim Social Security retirement benefits as early as age 62. However, doing so would lower your monthly benefits, potentially for the rest of your life. In order to receive full monthly benefits you are entitled to, you have to wait until full retirement age (66/67) to sign up for Social Security.
Q. Which Medicare Part D plan should I choose?
A: There are two options to choose from for Medicare prescription drug coverage. Both are offered through private health insurance carriers, since most outpatient prescription drugs are not covered under Medicare A or B. You can sign up for a Medicare Part D plan (prescription drug program, PDP) through a private carrier to be used with your Original Medicare plan (Medicare Part A and Part B). Or, you can enroll in prescription drug coverage through a Medicare Advantage plan provided by a private insurance company. Your coverage will include Medicare Part A and Part B, and usually, prescription drug coverage.
Q. What are Medigap plans and how do they work?
A: Medigap plans are Medicare supplement insurance plans and are standardized across all carriers. Meaning, a Plan A in California provides the same coverage as a Plan A in Florida. The only difference is the price you will pay for the plans through different providers. They are offered through private insurance companies that agree to abide by federal Medicare guidelines. Medicare supplement plans include A, B, C, D, F, G, K, L, M, and N (not all plans are available in all areas). A person who is enrolled in Medicare cannot purchase a Medigap plan unless he or she also has Medicare Part A and B. Medigap policies only cover one person, joint policies are not offered. Therefore, a married couple will need two separate policies. Medigap plans cannot be used with Medicare Advantage.
Q. Do Medicare Supplement plans include prescription drug coverage?
A: No. Typical Medicare supplement plans do not include prescription drug coverage. However, Medicare does offer prescription drug coverage plans. If you are enrolled in Medicare, you can get prescription drug coverage in two ways; by switching to a Medicare Advantage plan (most of which include prescription coverage), or by purchasing Medicare Part D (prescription drug plan) which coincides with Original Medicare.
You may have prescription drug coverage through your Medicare Supplement plan if you purchased that policy prior to January 1, 2006 and still have the same plan. Medigap plans H, I, and J included limited prescription coverage for people who purchased them prior to 2006. However, those plans are not sold anymore. If this applies to you and you want to join a prescription drug plan, you will be required to drop the prescription drug coverage from your Medigap policy since you cannot have two separate prescription drug coverage policies at the same time.
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Medicare Key Terms
The amount or percentage of the cost of services you may be required to pay after you pay your deductibles.
An set amount you pay for medical services or supplies. For example, you might only have pay $10 or $20 for a doctor’s visit or prescription drug as your set cost for your copay.
The amount you are responsible for paying for health care services or prescriptions before your insurance plan kicks in.
End-Stage Renal Disease (ESRD)
Permanent kidney failure that requires regular dialysis or a kidney transplant.
A team-oriented approach to caring for people with a terminal illness. Hospice care also can provide support to the patient’s family or caregiver.
Medigap Open Enrollment Period
A one-time only, 6-month period when you can buy any Medigap policy that is sold in your state. It starts in the first month that you receive coverage under Medicare Part B AND you are age 65 or older. During this period, you cannot be denied a Medigap policy or be charged more due to current or pre-existing health problems.
Costs you are responsible for paying due to the fact that they are not covered by your insurance.
Your payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.
Skilled nursing care
Specific care that can only be given by a registered nurse or doctor.
Skilled nursing facility (SNF)
A nursing facility equipped with staff and equipment that enables skilled nursing care and, in some cases, skilled rehabilitative services and other health services.