Medicare FAQs – Frequently Asked Questions

Navigating Medicare Made Easy: Your Essential Medicare FAQs Guide

Welcome to your go-to Medicare FAQs resource. As you approach or navigate through your golden years, understanding Medicare’s intricacies is key to securing your healthcare future and a strong quality of life. At My Senior Health Plan we are committed to transforming the complex into clarity, ensuring you can embrace your retirement with confidence and peace of mind.

Unraveling Medicare’s Mysteries

Medicare Frequently Asked Questions Uncovered: Whether you’re turning 65 and newly eligible for Medicare, considering a change, or simply seeking to broaden your Medicare knowledge, our comprehensive FAQ guide is designed with you in mind. We delve into the heart of Medicare, offering clear, expert answers to your most pressing questions.

Empowering Your Medicare Journey

From understanding the foundational components of Medicare, making sense of how to navigate Medicare eligibility and Medicare enrollment periods, exploring coverage beyond the basics, we’re here to illuminate the path. Our guide isn’t just about answering questions; it’s about empowering you with the knowledge to make informed decisions that align with your unique healthcare needs and lifestyle.

Your Medicare, Your Questions Answered

  • Understanding Medicare’s Components: Our Medicare FAQs guide dives into the nuances of Parts A, B, C, and D and helps beneficiaries learn what each part covers and how they work together to protect your health.
  • Enrollment Guidance Made Simple: Timing is everything. Discover when and how to enroll in Medicare to avoid penalties and ensure your coverage is seamless and doesn’t introduce any coverage gaps.
  • Beyond the Basics: Does Medicare cover prescription drugs, dental, vision, and hearing aids? We explore additional coverage options to ensure your healthcare plan is as comprehensive as your life demands.

Choosing the Right Medicare Plan for You

Medicare Advantage vs. Original Medicare: Each offers unique benefits and limitations. Our guide helps you compare and contrast, enabling you to choose the plan that best fits your healthcare preferences and needs.

Maximizing Your Medicare Benefits

Understanding Costs and How to Ensure You’re Maximizing Your Medicare Benefits: Medicare’s cost structure explained. Navigate premiums, deductibles, and copays with our expert insights to plan your healthcare budget effectively.

Staying with Trusted Providers: Learn how Medicare affects your choice of healthcare providers and how to ensure continuity of care with the doctors you trust.

Supplementing Your Coverage

Exploring Medigap: Discover how Medicare Supplement Plans can fill the gaps in your coverage, offering you peace of mind and control over unexpected healthcare expenses. Our Medicare FAQs guide helps make sense of what these plans offer, and how they can help pay for part, or all, of Medicare’s co-payments and deductibles.

Ensuring Comprehensive Care

Addressing Medicare Exclusions: We highlight what Medicare doesn’t cover and present solutions to ensure you’re protected from head to toe.

Coordinating with Other Insurance: Seamlessly integrate Medicare with your existing insurance plans for complete coverage without overlap or gaps.

Support for Every Step

Assistance for Low-Income Beneficiaries: Explore available programs designed to support those with limited income and resources, ensuring Medicare is accessible to all.

Begin Your Informed Medicare Journey with Us

At My Senior Health Plan, we believe that an informed beneficiary is an empowered one. We’re dedicated to offering you not just answers to common Medicare FAQs but comprehensive solutions tailored to your unique healthcare journey. Our team of trusted Medicare advisors is ready to provide personalized guidance and support, at no cost to you.

Ready to navigate Medicare with confidence? Contact My Senior Health Plan today at or call us at 877-255-6273. Let us be your guide to a worry-free healthcare experience.

If you are turning 65 and receiving Social Security or Railroad Retirement benefits, you may be automatically enrolled. If you are not automatically enrolled, you can enroll by calling Social Security at (800) 772-1213, visit the web site (, or apply at your local Social Security office. Apply three months before your 65th birthday. That way, you can be sure that your benefits will start on time.

If you are under 65 and disabled:
You automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the Railroad Retirement benefits for 24 months.

If you have ALS:
You automatically get Part A and Part B the month your disability benefits begin.

If you’re automatically enrolled, you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

No, Part B is optional.

If you or your spouse are still working and you are covered by your employer group health plan, you may not need this part of Medicare until you or your spouse retire. You should contact that employer or benefits administrator to find out how your coverage works with Medicare. You can sign up for Part B without paying a penalty any time you have health coverage based on current employment. COBRA and retiree health coverage doesn’t count as current employer coverage.

Once your employment or coverage ends (whichever happens first):

You have 8 months to sign up for Part B without a penalty. If you don’t enroll in Part B during this 8 month period, you may have to pay a penalty after you enroll for as long as you have Part B. You won’t be able to enroll until the next General Enrollment Period and you’ll have to wait until July 1st for your coverage to begin.

When you enroll in Part B your Medicare Supplement Open Enrollment Period begins.

You usually do not pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. If you aren’t eligible for premium free Part A, you may be able to pay for Part A if:

1) You’re 65 or older, you have enrolled (or are enrolling) in Part B, and meet citizenship & residency requirements.
2) You’re under 65, disabled, and your premium free Part A coverage ended because you returned to work.

If you are receiving Social Security benefits at the time you enroll in Medicare, your Part B premium will be deducted automatically from your monthly check. The standard monthly premium is $164.90 (in 2023) for beneficiaries with individual incomes of $85,000 or less.

If you have not begun to receive Social Security yet, you will receive a quarterly bill for your premium, which you can pay several different ways.

If you enroll in a Medicare Advantage Plan, Prescription Drug Plan, or Medicare Supplement Plan: if there is a plan premium, there is a number of different ways you can pay that premium. The different ways to pay your supplemental insurance premium is just one of the many things our Senior Health Specialist will review with you.

If you are 65 years old or over, and you or your spouse still works, you may have health care coverage from your employer.

If your employer has 20 or more employees, your employer must offer you the same group health plan that is offered to the other employees. If you choose to have both the employer´s group health plan and Medicare, the employer plan will be primary and pay first. Medicare will be secondary and will pay only after the employer plan.

People with disabilities who are on Medicare and who have group health benefits through a family member who is employed, are entitled to the same health benefits as other employees and dependents if the company has 100 or more employees. If you choose the employer´s health plan, it will pay first and Medicare will pay second.

Some people with kidney failure, known as End Stage Renal Disease (ESRD), continue to work and are also eligible for Medicare coverage.

Others are covered by the employer plan even after they are unable to work. If you have ESRD and are covered by an employer group health plan, and you have Medicare, the employer plan is required to pay first for 30 months following the effective date of your Medicare benefits. This is true regardless of the size of the group and regardless of whether the person with ESRD is working or not.

If you have limited income or resources, you may qualify for Extra Help. Extra Help is a Medicare program to help those with limited income and resources pay their Medicare prescription drug costs, like premiums, deductibles, and coinsurance. If you have Extra Help there are supplemental Medicare plans available to you as well.

To apply for Extra Help call Social Security at 1-800-772-1213 or visit your state Medicaid office.

In general, Original Medicare does not cover health care while you’re traveling outside the United States.

There are some exceptions such as if you were to board a ship within the territorial waters adjoining the land areas of the U.S.

Medicare may pay for inpatient hospital care, doctor, or ambulance services in a foreign country in rare cases:

1) If you are in the U.S. when an emergency occurs but the foreign hospital is closer than the nearest U.S. hospital.
2)If you are traveling through Canada from between Alaska and another state when an emergency occurs, and a Canadian hospital is closer than the nearest U.S. hospital.
3) If you live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.

It is important to look into your Supplemental Insurance options as well as Travel Insurance if you are a frequent traveler or are traveling outside of the United States.Travel Insurance can help protect you and your family from unforeseen disaster or emergency.

Call us Toll Free at 1-877-255-6273 to speak with a Specialist about your options today!

Medicare Supplement Insurance, also known as Medigap, can help pay some of the health care costs that Medicare doesn’t cover.

You have a one time, 6 month, Open Enrollment Period that starts the first month you are 65 and enrolled in Part B. During this period, you can enroll into any Medicare Supplement Plan regardless of your health status.

Call us Toll Free at 1-877-255-6273 to speak with a Senior Health Specialist and talk about your Medicare Supplement options.

The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your initial enrollment period is over, there’s a period of 63 days or more days in a row when you don’t have Medicare Part D or other credible prescription coverage.

If you receive Extra Help, you will not pay the late enrollment penalty.

Call us Toll Free at 1-877-255-6273 to speak with a Senior Health Specialist about your Medicare Part D options and avoid paying the enrollment penalty.

Most Prescription Drug Plans have a coverage gap, known as the donut hole. This means that there’s a temporary limit on what the drug plan will cover for drugs. The donut hole begins after you and your drug plan together have spent a certain amount for covered drugs.

For 2023, once you enter the donut hole, you pay 25% of the plan’s cost for covered brand-name drugs and 25% of the plan’s cost for covered generic drugs until you reach the end of the coverage gap. Not everyone will enter the coverage gap because their drug costs aren’t high enough.

Once you get out of the donut hole, you enter catastrophic coverage. Within this stage, you only pay a small coinsurance amount or copayment for covered drugs the rest of the year.

You don’t need to sign up for Medicare each year. However, each year you will have a chance to review your coverage and make changes.

If you are currently on a Medicare Advantage Plan or Prescription Drug Plan, you can change your plan during the Annual Enrollment Period which begins October 15th and ends on December 7th. Also, if you are on an MAPD or PDP you may change your plan if you qualify for a special election period such as moving counties, losing or gaining Medicaid status, or if you live in an institution (i.e nursing home).

If you are on a Medicare Supplement Plan and want to make a change, you must qualify for a guaranteed issue reason or go through underwriting.

If you would like to know if you are eligible for a special election period or guaranteed issue reason, please contact us Toll Free at 877-255-6273 .

No, that’s one reason why it pays to speak with a knowledgeable long-term care insurance professional.

The cost of long-term care depends on the type and duration of care you need, the provider you use, and where you live. Costs can be affected by certain factors, such as:

  • Time of day. Home health and home care services, provided in two-to-four-hour blocks of time referred to as “visits,” are generally more expensive in the evening, on weekends, and on holidays.
  • Extra charges for services provided beyond the basic room, food and housekeeping charges at facilities, although some may have “all inclusive” fees.
  • Variable rates in some community programs, such as adult day service, are provided at a per-day rate, but can be more based on extra events and activities

Call us Toll Free at 1-877-255-6273 to speak with a Long Term Care Specialist today.

Further questions? Feel free contact us Toll Free at (877) 255-6273.

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