Medicare 101

Medicare FAQ

When do I qualify for Medicare?

You’re turning 65 and retiring soon – what a milestone! It’s a great time in your life. 

Now that you’re here, it’s crucial to learn more about your Medicare benefits and that all of your medical needs are taken care of. When you’re turning 65 you have an initial enrollment period (IEP) to enroll in a Medicare plan, this lasts from three months before your birth month to three months following your birth month. After this, you may face late enrollment penalties so it’s important to plan and be ready when your birthday is approaching.

What is the monthly premium for Medicare Part B?

Medicare Part B Premium for Medicare Part B enrollees will be $174.70 for 2024.

What are Medicare late enrollment penalties?

You'll pay an extra 1% for each month (that's 12% a year) if you: Don't join a Medicare drug plan when you first get Medicare. Go 63 days or more without creditable drug coverage.

Do I need Part B if I am still working and have coverage through my employer?

You may be required to get Medicare Part B even when you're still working. There are two situations in which you must get Part B when you turn 65. If your employer has fewer than 20 employees. If you're covered by a spouse's employer, and the employer requires covered dependents to enroll in Medicare when they turn 65.

How can I get help with my Part A & B premiums?

There are programs run by the states that can help lower your Medicare costs. Find out if you qualify, for a Medicare Savings Programs which might pay your Part A and Part B deductibles, coinsurance, and copayments.  To apply for Extra Help or get more information, contact Social Security.  You may visit https://secure.ssa.gov to apply online and get more information.  You may also call Social Security on 1-800-772-1213.  TTY users may call 1-800-325-0778.

What is Medigap?

Medigap is a supplemental insurance policy sold by private companies that can be used along with Medicare Parts A and B to fill the gaps in their coverage. It can help you cover costs related to deductibles, copayments, coinsurance, and more.

How do I get a replacement Medicare card?

Go to medicare.gov and log into (or create) your secure Medicare account to print or order an official copy of your Medicare card.

You can also call 1-800-MEDICARE (1-800-633-4227) to order a replacement card to be sent in the mail. TTY users can call 1-877-486-2048.

What is the difference between Original Medicare & Medicare Advantage?

Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B.

Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D). Additionally, Medicare Advantage plans each offer extra benefits, which while they vary by plan and provider, may include coverage for dental, vision, hearing, fitness programs, rides to doctor appointments and more.

Do I need a Part D, Prescription Drug Plan?

It’s worth considering. You never know when you might develop a medical condition that requires you to take expensive prescription medication; some medicines can cost thousands of dollars a month.  

If you don’t have Part D in place, you may have to pay the full price. And worse, you’ll still be accumulating penalties that will be payable when you do decide to enroll in a Part D plan.  That’s because you can sign up for a Part D plan only at certain times, such as when you first enroll in Medicare or lose creditable coverage, or during the annual open enrollment period from Oct. 15 to Dec. 7, with coverage starting Jan. 1.

What is the difference between HMO and PPO?

HMO stands for Health Maintenance Organization. A Health Maintenance Organization is a network of doctors, hospitals and other healthcare providers who agree to provide care at a reduced rate. To keep costs low, HMOs may require you to select a primary care physician (sometimes called a primary care provider or PCP), who can refer you to specialists when needed.

PPO stands for Preferred Provider Organization. Like an HMO, a Preferred Provider Organization is a network of doctors, hospitals and healthcare providers who agree to provide care at a certain rate. Unlike an HMO, you are not limited to providers who are in network, though your copay or out-of-pocket cost for out-of-network visits may be higher than for in-network providers.

What is the difference between Medicare & Medicaid?

What's the difference between Medicare and Medicaid? Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.

By submitting this form I agree to be contacted via email, phone, or text message. I agree to be contacted regarding Medicare Advantage, Medicare Supplement, Prescription Drug Plans (PDP), Dental Insurance, Life Insurance, and other Insurance Products.

Medicare can be confusing!

But it doesn't have to be.

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We do not offer every plan available in your area. Currently we represent 8 organizations which offer 76 plans in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options."

Sylvia Brown is not connected to the Federal Medicare Program. This is a solicitation for insurance.