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Frequently Asked Medicare Questions

If you’re confused about Medicare and not sure where to start, you aren’t alone. We’re here to help. It’s very common to have an overwhelming amount of questions when starting your Medicare journey. However, whether you have a couple questions, or twenty questions, we’re confident you’ll find this FAQ page resourceful. Our team of Medicare experts compiled a list of some of our most commonly asked questions when entering the world of Medicare to help answer those confusing questions.

Medicare doesn’t need to be as complicated and confusing as it’s cut out to be. Since there are several different topics when it comes to Medicare, we’ll categorize the topics into sections to make it easier on you. For the questions that require a more in-depth explanation, we’ll provide a link to a page with all the information you’ll need to know. Our overall goal is to SIMPLIFY the process of joining Medicare… 

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If you have any questions that are not listed below, please feel free to give us a call at 1-888-321-6361, and one of our agents would be more than happy to answer all your questions. You can always send us an email at help@medicarehero.com, or simply fill out the contact form HERE and we will be in contact with you shortly. 

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Medicare FAQ's

Medicare is a federal health insurance program designed for only people who are 65 or older. People who are under 65 are not able to join Medicare, unless they have been on Social Security disability for more than 24 months, and have surpassed the waiting period for Medicare coverage. Additionally, people who can also benefit from this program are people with certain disabilities such as end-stage renal disease, and other permanent disabilities.

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Medigap is just another name for a Medicare Supplement Plan. They are the same exact thing and can be used interchangeably. Medigap policies are sold by private insurance companies and will pay some or all of the health care costs that Original Medicare (Medicare Part A & B) doesn’t cover. These costs can include copayments, coinsurance, deductibles and excess fees. These types of plans help make your annual health care budget very predictable and lower your out-of-pocket spending.

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Medicare Advantage Plans, also known as Medicare Part C, are a type of health plan offered through private companies that contract with Medicare to provide you with your Part A (Hospital) and Part B (Medical) benefits. Medicare Advantage plans work much like insurance during our working years with networks for doctors and hospitals, deductibles, and co-pays. In addition to their full Medicare benefits, Medicare Advantage plans may also include vision, dental, drug coverage, and more.

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The Foundation of Medicare Coverage is Comprised of Four Parts. “Original Medicare” consists of Part A and Part B. Together, they provide the foundation for your health insurance coverage.

1) PART A • This is commonly known as hospitalization insurance. This mostly covers the cost of your time in the hospital (inpatient care), skilled nursing facility care, hospice care, home health care, and more.

2) PART B • This helps cover your doctors visits and other services including: outpatient procedures, x-rays, lab tests, and preventative services.

3) PART C • These plans are offered by private insurance carriers who have a contract with Medicare and are required to offer the same benefits as Original Medicare. You may enroll in this option to replace your “Original Medicare” (Part A and Part B). “Medicare Advantage Plans are known as Part C. This combines Part A and Part B coverage.

4) PART D • This is your prescription drug coverage. This is offered to everyone with Medicare. Most Part C plans cover prescription drugs; however, you may be able to add drug coverage to some plans, if they are not already included.

PART A • This is commonly known as hospitalization insurance. This mostly covers the cost of your time in the hospital (inpatient care), skilled nursing facility care, hospice care, home health care, and more.

PART B • This is typically known as “medical insurance”. This helps cover your doctors visits and other services including: outpatient procedures, x-rays, lab tests, and preventative services.

PART C • These plans are offered by private insurance carriers who have a contract with Medicare and are required to offer the same benefits as Original Medicare. You may enroll in this option to replace your “Original Medicare” (Part A and Part B). “Medicare Advantage Plans” are known as Part C. This combines Part A and Part B coverage.

PART D • This is your prescription drug coverage. This is offered to everyone with Medicare. Most Part C plans cover prescription drugs; however, you may be able to add drug coverage to some plans, if they are not already included.

One of our licensed, experienced, insurance agents would be happy to provide you with a side-by-side comparison from the leading top insurance companies, and help find the plan that is right for you. Simply follow this link HERE, fill out the quote form, and one of our friendly agents will be in contact with you shortly. It’s that simple!

You have two options if you are still planning on working after you turn 65. You can either join Medicare, or keep your current coverage. We recommend weighing your options to see which coverage will provide you with the best benefits for the lowest premiums.

From our experience, approximately 50% of the time it is best to stay on group coverage, and the other 50% of the time, it is better to join Medicare. This decision should be based on comparing what you currently pay for your health insurance versus what you would pay for Medicare. Additionally, comparing a few of the major benefits such as the deductible and copays.

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Thinking about additional costs when you’re about to retire can be daunting and additional costs you might not anticipate or plan for. Questions like: How much is it? Can I afford it? What will my premiums be? These are all very common questions. 

Big picture, Medicare coverage works a little differently then how we paid our health insurance premiums during our working years… During our working years, most people paid one large premium for all of our healthcare coverage including doctor visits, hospitalization, and drug coverage.  However, Medicare coverage is paid in several smaller amounts for individual parts of coverage. 

For more information on Medicare costs and specific premiums, Click Here 

Unfortunately, most dental services such as cleanings, fillings, and crowns are not covered by Original Medicare. However, there is a great “all-in-one” plan that covers dental, vision and hearing that you can add onto your Medicare plan for a monthly affordable rate.

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Most people become eligible and apply for Medicare at age 65. When approaching turning 65, it’s important to know what your Initial Enrollment Period or (IEP) is. This is a seven-month period, which begins three months before the month of your 65th birthday, your birthday month, then extends for three months after your birthday month. 

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There are (4) ways you can apply for Medicare. The most popular way is online through the Social Security website. Other ways you can apply for Medicare is by phone, by mail, or in-person at the SS office. To learn more about when, where and how to apply for Medicare, Click Here.

After Plan F was phased out in 2020, Plan G now offers the highest level of coverage in 2021. The only out-of-pocket expense you will have with Plan G is the Part B deductible of $203 in 2021. After this deductible is met, all your cost- sharing expenses will be covered for the rest of the year.
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Plan N is the second best option when it comes to the 10 Supplement Plan Options. Plan N covers mostly everything Plan G covers, except the most notable difference which is that Plan N doesn’t cover Part B excess charges (such as copays up to $20 for doctor visits and $50 for hospital visits), in addition to the Part B deductible.

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Our New to Medicare Webinar is a great way to learn about Medicare in simple and easy terms. We recommend it to everyone turning 65! You can sign up for this free Medicare 101 Webinar by clicking the link HERE.

Founded in 1985, Medicare Hero is a family-owned and operated insurance brokerage in Dallas, Texas. Over the past 30 years, our professional, friendly agents have helped thousands of Medicare beneficiaries nationwide with their Medicare coverage. We built our company from the ground up to ensure that our goals were the same as our client’s goals. Unlike other insurance agencies that offer several insurance products, we specialize in Medicare; and have made it our mission to know everything there is about Medicare, so you can make an informed decision when it comes to your healthcare coverage.

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