Medicare Frequently Asked Questions

Original Medicare (Parts A and B) is run by the federal government and lets you see any provider that accepts Medicare. Medicare Advantage plans are offered by private companies approved by Medicare; they provide your Part A and B benefits, usually through a provider network, and often include drug coverage. Costs, networks and extra benefits vary by plan.

Medicare Supplement (Medigap) insurance is sold by private companies and helps pay some costs Original Medicare doesn’t, such as coinsurance and deductibles. It works only with Original Medicare, not with Medicare Advantage, and generally does not include drug coverage.

Most people first enroll during their seven-month Initial Enrollment Period: the three months before the month you turn 65, your birthday month, and the three months after. If you have coverage from your or your spouse’s current employer, you may be able to delay Part B without a penalty.

It depends on your employer’s size and how its coverage coordinates with Medicare. Coverage based on current employment is treated differently than COBRA or retiree coverage. Ask your benefits administrator before delaying Part B, since delaying without qualifying coverage can lead to a lasting penalty.

Yes, during certain times. During Open Enrollment (October 15 – December 7) you can join, switch or drop a Medicare Advantage or Part D plan. If you’re in a Medicare Advantage plan, you can make one change from January 1 – March 31. Special Enrollment Periods may apply after certain life events.

Part D is prescription drug coverage offered by private plans approved by Medicare. You can get it as a stand-alone plan alongside Original Medicare, or through a Medicare Advantage plan that includes drug coverage. Each plan has its own drug list and pharmacy network.

With Original Medicare, you can see any provider that accepts Medicare. Medicare Advantage plans usually have networks, so check whether your doctors participate in the specific plan before enrolling. Networks can change from year to year.

If you have a Medicare Supplement policy in California, each year you have 60 days beginning on your birthday to switch to another Medigap policy with equal or lesser benefits, from the same or a different company, without health questions.

Original Medicare generally does not cover most outpatient prescriptions. You can add a Part D plan, or choose a Medicare Advantage plan that includes drug coverage. Not every Medicare Advantage plan includes drug coverage, so confirm before enrolling.

Generally, no. Independent agents are typically paid by insurance carriers, so using an agent generally does not add to your premium. You can also get information on all of your options from Medicare.gov or 1-800-MEDICARE.

Yes. Plans can change their costs, networks and drug lists each year. Scott is available to review your coverage, especially before the fall Open Enrollment period, and talk through whether it still fits your needs.