Frequently Asked Questions about Medicare
What’s Medicare?
Medicare is health insurance for people 65 or older, certain people under 65 with disabilities, and people of any age with End‑Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)
What’s a Medigap policy?
A Medigap policy is an insurance policy that helps supplement Original Medicare and is sold by private companies
I’m turning 65 this year and I plan to retire. When am I eligible to enroll into Medicare?
Assuming you have met the work-related eligibility requirements, you may begin enrollment into Medicare 90 days in advance of the month you turn 65.
Can my dependent spouse be on my Medicare plan?
Medicare does not have spousal or dependent coverage. Medicare is an individual. If your spouse has reached age eligibility (65), then they can enroll in Medicare of their own accord 90 days in advance of the month they turn 65.
When’s the best time to buy a Medigap policy?
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This period lasts for 6 months and begins on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B. Some states have additional Open Enrollment Periods including those for people under 65. During this period, an insurance company can’t use medical underwriting to Decide whether to accept your application. This means the insurance company can’t do any of these because of your health problems
Do I need to enroll in Part “A” and Part “B” of Medicare?
Part “A” is typically in place, and a paid-up Benefit when you turn 65. Part “B” is not, unless you have enrolled in Social Security prior to age 65. If you have not filed to receive Social Security benefits, then you need to proactively enroll in Part “B” benefits and begin paying for them.
Can I keep my employer coverage?
Maybe. If the employer group has 20 eligible employees or more, and you’re going to continue to work, then yes it’s an option. But there are many things to consider.
Can I just have “Original Medicare” A+B as my health insurance at retirement?
Yes. However, you will not have prescription coverage, and you will face unlimited exposure to those costs due to the gaps in Original Medicare.
Does Medicare cover me if I’m in a nursing home?
Yes, for up to 100 days, after a required three-day hospital stay.
Does Medicare have dental plans?
No. But some Advantage plans offer limited dental coverage.
I am entitled to retiree benefits. Does that mean I won’t need Medicare?
No, a retiree plan will typically wrap around Medicare primary benefits.
What is Part “D”?
Part “D” is the Prescription Drug plan Medicare introduced in 2006.
What happens if I miss my designated enrollment window into Medicare?
In addition to having a huge gap in coverage, you will likely face a penalty from Medicare. A Part “B” penalty can be 10% of your Part “B” premium for each 12-month period outside of Medicare, and up to 1% of the national average of a Part “D” plan for each month absent Part “D”.
Where do I go to get signed up for Medicare?
Online at SSA.gov or in person at a local Social Security office.
Should I have both a Medicare Advantage Plan and a Medicare Supplement Plan?
No.
Frequently Asked Questions about Health Insurance
What is Marketplace (or ACA) health insurance?
All health plans offered on the Health Insurance Marketplace include certain items or services, or Essential Health Benefits (EHBs).
When can I enroll in the Marketplace health insurance?
You are eligible for a Special Enrollment Period when you have a Qualifying Life Event, such as losing a job. Typically this Special Enrollment Period is 60 days. If you miss this Special Enrollment Period, you will have to wait until the next Open Enrollment Period (Nov 1st through Dec 15th) to get coverage via the Marketplace.
How much does the Marketplace health insurance cost?
The cost depends on the type of plan you choose. In order to qualify for a subsidy, you must make between 100% and 400% of the Federal Poverty Level amount. If you qualify, your subsidy is based on your income and family size and helps to defray the cost of your health insurance premium.
Frequently Asked Questions about Short Term Insurance
What is Short Term Insurance?
Short-term insurance may be a low monthly premium health coverage option that can help during a time of transition, such as the loss of a job, and approval can occur as quickly as the next day. You can apply for a short-term health insurance plan outside of the annual Open Enrollment Period.
How do I use my Short Term Health Insurance plan?
Like other health insurance plans, short-term health insurance policies describe their benefits (and how you can use them) in the summary of benefits and product brochure documents. These documents will describe how costs are shared (including deductibles, copays, and coinsurance) and which services are covered.
Can I cancel my Short Term Health Insurance?
Yes. You can cancel a short-term health insurance plan at any time. Additionally, your plan will cancel automatically after the selected coverage period ends.
Can I extend my Short Term Health Insurance?
Yes. Insurance companies can allow you to extend your short-term health insurance or allow you to purchase the same plan after yours has ended.