Frequently Asked Medicare Questions
Clear answers to common questions about Medicare enrollment, coverage options, costs, and plan types.
NEW TO MEDICARE FAQ
What is Medicare?
Medicare is a federal health insurance program primarily for individuals age 65 and older, as well as certain younger individuals with qualifying disabilities or medical conditions.
Do I have to enroll in Medicare at age 65 if I’m still working?
It depends on your employer coverage and the size of the employer. Some individuals may delay certain parts of Medicare without penalty if they have qualifying employer coverage.
When can I enroll in Medicare?
Most individuals become eligible during their Initial Enrollment Period, which begins three months before the month they turn 65 and continues for seven months total.
What are the different parts of Medicare?
Part A helps cover hospital services.
Part B helps cover medical services.
Part C (Medicare Advantage) combines coverage through private insurance companies.
Part D helps cover prescription drugs.
What is a Medicare Advantage plan?
Medicare Advantage plans are private insurance plans approved by Medicare that provide Part A and Part B coverage and often include additional benefits.
Can I keep my doctor with a Medicare Advantage plan?
Provider networks vary by plan. It’s important to verify that your doctors and healthcare providers participate in the plan’s network before enrolling.
Do Medicare Advantage plans include prescription drug coverage?
Many Medicare Advantage plans include Part D prescription drug coverage, though not all plans do.
What extra benefits may Medicare Advantage plans include?
Some plans may include dental, vision, hearing, fitness memberships, transportation assistance, or over-the-counter allowances.
MEDICARE ADVANTAGE FAQ
MEDICARE SUPPLEMENT FAQ
What is a Medicare Supplement plan?
Medicare Supplement (Medigap) plans help cover certain out-of-pocket costs associated with Original Medicare.
Do Medicare Supplement plans include prescription coverage?
No. Prescription drug coverage is typically purchased separately through a Part D plan.
Can I see any doctor with a Medicare Supplement plan?
In most cases, you may see any provider nationwide that accepts Medicare.
What is the difference between Medicare Supplement and Medicare Advantage?
Medicare Advantage plans are alternative ways to receive Medicare benefits through private insurance companies, while Medicare Supplement plans work alongside Original Medicare to help cover certain costs.
C-SNP FAQ
What is a C-SNP plan?
A Chronic Condition Special Needs Plan (C-SNP) is a type of Medicare Advantage plan designed for individuals with qualifying chronic health conditions.
What conditions may qualify for a C-SNP?
Eligibility varies by plan but may include conditions such as diabetes, chronic heart conditions, cardiovascular disorders, or chronic kidney disease.
Does my doctor need to verify my chronic condition?
Yes. Most C-SNP plans require verification from a healthcare provider confirming that you have a qualifying chronic condition.
Can I lose eligibility for a C-SNP plan?
If you no longer meet the plan’s eligibility requirements, you may need to transition to another Medicare plan.
D-SNP FAQ
What is a D-SNP plan?
Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for individuals who qualify for both Medicare and Medicaid.
What benefits may D-SNP plans offer?
Benefits vary by plan and county but may include prescription coverage, dental, vision, hearing, transportation, OTC allowances, and additional support services.
Who qualifies for a D-SNP plan?
Eligibility depends on your Medicare status and Medicaid eligibility level.
ENROLLMENT PERIOD FAQ
What is the Annual Enrollment Period (AEP)?
The Annual Enrollment Period runs from October 15 through December 7 each year and allows eligible individuals to review and change Medicare coverage. Changes become effective Jan 1 of the following year.
Can I change my Medicare plan after enrolling?
Depending on your situation, you may qualify for certain enrollment periods that allow plan changes during the year.
What happens if I miss my enrollment period?
Missing enrollment deadlines may result in delayed coverage or late enrollment penalties in some situations.
COSTS & COVERAGE FAQ
Does Medicare cover dental and vision?
Original Medicare generally does not cover routine dental or vision care, though some Medicare Advantage plans may offer these benefits.
What are Medicare deductibles and copays?
Deductibles are amounts you pay before coverage begins, while copays and coinsurance are your share of healthcare costs after coverage applies.
Is there a maximum out-of-pocket limit with Original Medicare?
Original Medicare generally does not include an annual out-of-pocket maximum, which is one reason some individuals explore Medicare Supplement or Medicare Advantage plans.
Still Have Questions About Medicare?
Independent licensed Medicare insurance broker serving Michigan residents. Beachwood Insurance Solutions is not affiliated with or endorsed by the U.S. government or the federal Medicare program. For information on all available Medicare options, visit Medicare.gov or call 1-800-MEDICARE.
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