Medicare FAQ

Do you have Medicare questions?

Who is eligible for Medicare?

Most people qualify at age 65. You may also qualify under 65 if you’ve received Social Security Disability Insurance (SSDI) for 24 months, or if you have certain conditions like ESRD or ALS. If you’re not sure which rule applies, we can confirm eligibility based on your situation.

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When can I enroll in Medicare?

Your Initial Enrollment Period (IEP) is a 7‑month window around your 65th birthday (3 months before, your birthday month, and 3 months after). There are also Special Enrollment Periods (SEPs) for certain life events, and annual periods like AEP for plan changes.

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What’s the difference between Medicare Parts A, B, C, and D?

Part A generally covers inpatient hospital care. Part B covers outpatient/medical services. Part C (Medicare Advantage) is a private-plan alternative that bundles A & B (often with extras). Part D helps cover prescription drugs. The “best” mix depends on doctors, prescriptions, and budget.

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Medicare Advantage vs. Medigap: which one is better?

Neither is universally “better”—they’re different strategies. Medicare Advantage often has lower monthly premiums and includes extra benefits, but may use networks and copays. Medigap helps reduce out-of-pocket costs with Original Medicare and can offer broader provider access, but typically has a higher premium. We’ll compare both based on your needs.

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How much does Medicare cost?

Costs can include Part B premiums, deductibles, copays/coinsurance, plus any plan premiums (Advantage/Medigap/Part D). Some plans have $0 premiums, but you still pay as you use care. We’ll estimate your total cost using your doctors, prescriptions, and typical medical usage.

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Will I be able to keep my doctor?

It depends on the option you choose. With Original Medicare (and many Medigap plans), you can typically see any provider that accepts Medicare. Medicare Advantage plans may have networks (HMO/PPO). We’ll verify your preferred doctors and hospitals before recommending a plan.

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Do my prescriptions get covered?

Prescription coverage usually comes through Part D or an Advantage plan that includes drug coverage. Each plan has a formulary (drug list) and preferred pharmacies. We’ll check your medications and dosages to find the best coverage and lowest estimated annual cost.

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Can I change my plan later?

Yes. Many plan changes happen during the Annual Enrollment Period (AEP), and some people qualify for Special Enrollment Periods (SEPs). If you have Medicare Advantage, you may also have opportunities to switch during specific windows. We’ll tell you what’s possible based on your current coverage.

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What if I’m still working and have employer coverage?

Working past 65 can affect when you should enroll in Part B and how to avoid penalties. The right approach depends on whether your employer coverage is considered “creditable” and the employer size. We’ll review your employer plan and help you time enrollment correctly.

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How do I get a personalized Medicare plan recommendation?

Schedule a quick call and we’ll compare options based on your doctors, prescriptions, budget, and preferences (networks vs. flexibility). We’ll walk you through the pros/cons in plain language and help you choose a plan you feel confident about.

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