Medicare FAQ

Medicare FAQs text overlaying image of a pile of blue question marksWhen can I enroll in Medicare?

As you probably already know, you become eligible when you turn 65. Around the time you turn 65 you will enter an Initial Enrollment Period (IEP). This IEP starts 3 months before your 65th birthday and ends 3 months after. If you are eligible but missed your IEP, you can enroll during the General Enrollment Period (GEP). The GEP is an annual 3-month window from January 1st to March 31st where anyone that qualifies can enroll in a Medicare plan.


How soon after I enroll will my Medicare benefits begin?

If you sign up within the first three months of your IEP, your coverage starts the month that you turn 65. When you sign up in your birth month or the following 3 months, your benefits will begin the following month. 


Do I need to enroll in Medicare if I’m still working at 65?

You can actually delay enrolling in Part B if you are covered by your employer’s plan. Allowing you to avoid your Part B premium until you need Part B. This is possible if your employer has at least 20 employees and you are still working and covered by their plan at age 65. If you lose your job or your employer stops providing health insurance. You have eight months from the date you lost coverage to enroll during the Special Enrollment Period that will open up to you. Your coverage will then begin the first of the month following the end of your employment. Or the first of the month following the termination of your employer’s group health insurance.


Does Medicare cover assisted living?

Most care in a nursing home is not covered by Medicare. This includes custodial care. Which is when someone helps you do things like bathe, dress, eat, or go to the bathroom. Part A may pay for care in a skilled nursing facility. But the care must be licensed and medically necessary. Some home health care may be covered by Parts A and B as well.

Parts A and B cover the following types of home health care:

  • Injectable osteoporosis drugs for women
  • Occupational therapy
  • Part-time or intermittent home health aide services providing personal, hands-on care
  • Part-time or intermittent skilled nursing care
  • Physical therapy
  • Speech-language pathology services


Can I use Medicare anywhere in the country?

Medicare is accepted by most providers in the U.S., but not by every doctor or hospital. So, make sure you check that your provider accepts Medicare assignment. It’s also important to note that while Original Medicare is available everywhere in the country, Medicare Advantage plans have local networks of doctors and hospitals that you will have to use. 


Can I keep my HSA when I enroll in Medicare?

If you have a private high-deductible health insurance plan (HDHP), you are eligible to open a HSA. Which can help you save tax-free money for medical expenses. But once you enroll in Parts A and B, you will no longer be eligible to make HSA contributions. If you want to avoid paying a tax penalty. You should stop making HSA contributions at least six months before you plan to enroll.


Do I have to be on social security to get Medicare?

You do not need to be on Social Security to get Medicare. But if you aren’t on Social Security you have to sign up manually. If you are already getting benefits from Social Security or the RRB. You will be automatically enrolled in both Parts A and B on the first day of the month you turn 65. If your birthday is the first of the month, both Part A and Part B will begin on the first of the month before. If you are under 65 and have a disability, you will get Part A and Part B automatically after 24 months of receiving disability benefits from Social Security. In addition, if you get certain disability benefits from the RRB, you’ll automatically get Parts A and B. If you have ALS, you will automatically get Part A and Part B when your SSDI benefits start.


Who is eligible for a Medicare Supplement Plan?

Anyone who has both Part A and Part B is eligible for a Medicare Supplement Plan. You will have to purchase one of these plans from a private insurance company.


When can I enroll in a Medicare Supplement Plan?

Medicare Supplement Plans also have an Open Enrollment Period. During this window, you can choose a plan or make a change to an existing one. This six-month period begins on the first day of the month that you enroll in Part B. This is the best time to enroll in a plan because you will be given guaranteed issue rights. Which means you cannot be subject to medical underwriting. That means insurance companies will not be able to consider your health status or claims history when deciding whether to accept your application or how much to charge you. 


Do Medicare Supplement Plans have prescription drug coverage?

No, Medicare Supplement Plans just cover the gaps in Parts A and B. For prescription drug coverage, you can enroll in Part D. Part D, which is also known as prescription drug coverage, is an optional plan that helps people with Medicare pay for prescription drugs that they take on their own. Meaning prescriptions you take at home, not the ones administered in a hospital. Most prescription drugs are covered by Part D. You can get Part D through a private insurance company as a stand-alone plan or as an add-on to a Medicare Advantage plan.


How many Medicare Supplement Plans are there?

In most states, there are 10 Medicare Supplement Plans available. They are each named by a different letter of the alphabet: A, B, C, D, F, G, K, L, M, and N. 

Plans with the same letter name provide the same minimum coverage regardless of which insurance company is providing them. Most insurance companies will offer most of these plans in most states. But it’s important to note that, as of January 2020, new recipients no longer have access to plans F and C. In addition, there are 3 states that do not offer these standardized 10 plans. These plans are available in different iterations in Minnesota, Michigan, and Wisconsin, but the plans all provide the same benefits. Check out our state-by-state Medicare Supplement Plans guides for more information on the plans available in your area.


Why are Medicare Supplement Plans C and F no longer available?

Newly eligible beneficiaries are no longer able to purchase the Medicare Supplement Plans that cover the Part B deductible as of January 1, 2020. This means that new enrollees cannot purchase Plans C and F. Beneficiaries who became eligible prior to January 1, 2020, but who did not enroll at that time, can still purchase one of these plans.


Will my Medicare Supplement Plan cover my pre-existing condition?

There could be a “waiting period” of up to six months before your policy begins covering medical care for a preexisting condition. But only conditions diagnosed or treated within the six months prior to your enrollment in the Medicare Supplement Plan will be excluded from coverage. You might be able to have your waiting period waived or shortened if you enroll during your Open Enrollment Period. Or if you are replacing another health insurance plan that is considered creditable coverage and you are at least six months into your new policy.


How much is a Medicare Supplement Plan?

The cost of a Medicare Supplement varies and there is no one easy answer. All Medicare Supplement Plans have monthly premiums, which are often directly proportional to the level of coverage provided. Your monthly premium can also vary depending on a variety of factors, including your gender, age, tobacco use, ZIP code, and more. If you would like to see more information about the price of Medicare supplement plans in your state, click here. If you would like to get a quote specific to you enter your zip code in the bar below to get an online quote.


What is Medicare Advantage?

Private insurance companies are contracted by the federal government to offer Medicare Advantage plans. Medicare Advantage, also known as Part C, provides access to all the same medical care benefits available under Original Medicare with the exception of hospice care. Prescription drug coverage is typically included in Medicare Advantage plans. Many Medicare Advantage plans also pay for preventive services like eye exams, dental cleanings, and hearing tests. Fitness programs and other wellness initiatives may also be made available.


Can I have a Medicare Supplement Plan and Medicare Advantage?

These two types of insurance cannot be held at the same time. An insurance company cannot sell you a Medicare Supplement Plan if they know you are enrolled in a Medicare Advantage plan unless you can prove that you are terminating your Medicare Advantage plan (typically in writing).


What is the difference between Original Medicare and Medicare Advantage?

Original Medicare, which includes Parts A and B, is a federal program run by the government, while private insurance companies work with the federal Medicare program to run Medicare Advantage plans.

With Original Medicare, you can go to any doctor, hospital, or other healthcare provider that accepts it. If you go to a provider outside of your Medicare Advantage plan’s network, you may have to pay more or pay the full cost of services out-of-own pocket.

Medicare Advantage plans are required to cover everything that Original Medicare covers, but they may also cover things like vision, dental, hearing, and prescription drugs that aren’t covered by Parts A and B.


Are Medicare Plans & Parts the same thing?

Medicare Supplement Plans and Traditional Medicare both use letters to denote their component parts. Some of these components share the same letter, which can lead to confusion. To clarify, when we refer to ‘parts’ such as Part A, Part B, Part C, and Part D, we mean traditional Medicare. These ‘parts’ provide your foundational protection. Medicare Supplement Plans are referred to when discussing ‘plans’, such as Plan A, B, C, and D. The ‘plans’ are the supplemental coverage that you can purchase to add on to traditional Medicare ‘parts’. 

If you have any additional questions, feel free to reach out to an EZ agent. Our local agents are here to help you compare plans, find plans that fit in your budget, go over your coverage, and keep you up to date with everything you need to know about your plan. To get a Medicare supplement quote online you can enter your zip code in the bar below. To speak to a live agent, you can give us a call at 877-670-3602.

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.