Medicare FAQ's

Fact:
Most people do not pay a premium for Part A (hospital insurance), but Part B (doctor visits and outpatient care) and Part D (prescription drugs) come with monthly premiums. You may also have deductibles, copays, and coinsurance.

Fact:
Medicare does NOT cover routine dental, vision, hearing aids, long-term care, or custodial care. You will need additional coverage or pay out-of-pocket for these.

Fact:
You are only automatically enrolled in Medicare if you are already receiving Social Security benefits. Otherwise, you must enroll yourself — and if you miss your window, you could face penalties.

Fact:
If you do not enroll in Part B or Part D during your Initial Enrollment Period (unless you have other credible coverage), you could face lifetime late enrollment penalties.

Fact:
Medicare Advantage (Part C) is an alternative to Original Medicare, offered by private insurers. It often includes extra benefits, but has different networks, rules, and costs. It is not the same plan run by Medicare.

Fact:
Plans and drug formularies change every year — and so do your health needs. Reviewing your plan annually can save money and improve coverage.

Fact:
It depends on the size of your employer. If you work for a small employer (<20 employees), you may need to enroll in Medicare as your primary insurance — otherwise, you may face coverage gaps or penalties.

Fact:
You can make changes every year during the Annual Enrollment Period (Oct 15–Dec 7) or during special enrollment periods. You are not locked in forever.

Fact:
They are very different. Medigap (Medicare Supplement) works with Original Medicare to cover out-of-pocket costs. Medicare Advantageis a replacement for Original Medicare with its own rules and networks.

Fact:
You are eligible for Medicare at age 65, whether you are still working or not. You can also qualify earlier if you have certain disabilities or end-stage renal disease.