Frequently Asked Questions About Medicare

On this page, we answer some of the questions people like you have about a variety of issues related to Medicare. Some of the topics we address include:

  • The difference between Medicare and Medicare Advantage

  • The Medicare Advantage Open Enrollment period

  • How to sign up for Medicare

Bookmark this page, as we frequently make updates with more of your questions. Have any questions we haven’t covered? Email us at info@well-advised.com and we will do our best to answer.

What is Medicare?

Medicare is federal health insurance for people who are 65 or older. It is also for some people under 65 with certain disabilities. There are two main types of Medicare: Original Medicare and Medicare Advantage. Both cover services categorized under Parts A and B.

Medicare Part A

Medicare Part A is hospital insurance and covers the following:

  • Inpatient care

  • Nursing facility care

  • Hospice care

  • Home health care

Medicare Part B

Medicare Part B is medical insurance and generally covers:

  • Doctor and other healthcare provider services

  • Outpatient care

  • Preventive and screening services

  • Yearly wellness visit

What is Medicare Advantage?

Think of Medicare Advantage as another way to get Medicare Part A and Part B coverage. Like Original Medicare, Medicare Advantage covers hospital stays and certain doctors’ services. These plans are offered by private insurers and follow the rules set by Medicare. They often include prescription drug coverage, known as Part D. Medicare Advantage is also known as a Part C plan.

The Centers for Medicare & Medicaid Services has published an excellent resource called “Understanding Medicare Advantage Plans.” This booklet lets you easily compare the costs, benefits, and coverage of Original Medicare and Medicare Advantage.

What is Medicare Open Enrollment? 

Open Enrollment, or Annual Enrollment, is a time each year when people on Medicare can review their current plan, compare it with the new plans becoming available for the following year, and make changes that will become effective in the new plan year.  For 2022, Open Enrollment runs between October 15 and December 7 for coverage that begins January 1, 2022.

What is the difference between Medicare Open Enrollment and the Medicare Advantage Open Enrollment period from January to March?

There is a three-month period beginning on January 1 each year called “Medicare Advantage Open Enrollment.” If you are on a Medicare Advantage plan, you can make changes. However, this does not apply to people on Original Medicare.  

I will turn 65 early next year.  Do I have to wait until Open Enrollment next fall before I can get Medicare?

You become eligible to join Medicare the month you turn 65, and you can apply three months before that and up to three months after that to avoid any late enrollment penalty. Apply before your birthday to avoid any delay in being insured.

How do I sign up for Medicare?

You can enroll in Original Medicare through the Social Security website. You can also go to the sites for Medicare Advantage plans to sign up. Medicare.gov has a chart that clearly shows when you can join a Medicare health or drug plan.

What is the Initial Enrollment Period for Medicare?

The Initial Enrollment Period is a seven-month window when you are eligible to sign up for Medicare. It begins three months before the month you turn 65 and ends three months following your birthday month.

What if I miss my Initial Enrollment Period?

You can still enroll in Medicare during the General Enrollment Period, which runs from January 1 to March 31. You might also qualify to enroll, without incurring a late-fee penalty, during a Special Enrollment Period. Learn more about when your Medicare coverage starts.

I have healthcare coverage through my employer and don’t want to make a mistake by moving to Medicare. Can you help?

Yes, Through our Medicare Plan Finder, we’ll compare the available coverage so that you enroll in a plan that best serves your healthcare and financial needs.

I’m not happy with the plan I chose. How do I change it?

If you’re on Original Medicare, you can switch to Medicare Advantage during the Open Enrollment Period from October 15 to December 7. If you’re on Medicare Advantage, you can switch to another Medicare Advantage plan or to Original Medicare from January 1 to March 31.

If I don’t use prescription drugs, why do I need an insurance plan?

Medicare wants you to contribute the premiums to the insurance pool. They say that is it is up to you whether you get a drug plan, but if you delay getting it when you are first eligible, Medicare may penalize you by increasing your premiums when you do eventually sign up.

What is the difference between generic and brand-name drugs?

The brand-name drugs you see advertised in commercials and magazines must pass strict safety standards set by the Food and Drug Administration. Generic drugs are copies of their name-brand counterparts, and are chemically the same in every way. They also must meet the same quality, safety, and effectivness standards. The main difference is that generic drugs cost much less than their brand-name counterparts.

I’m on my employer’s health insurance. How does Annual Enrollment affect me?

This is an opportunity for you to see the benefits and costs of you dropping your employer plan and converting to Medicare in the new year.  It is often less expensive to remain on an employer plan, but not always. Remember, if other family members are on the employer group health insurance and you drop it, then they will need insurance.

What is a Medicare Special Needs Plan?

Medicare Special Needs Plans are designed to support those who are any one of the following:

  • Have a chronic condition such cardiovascular disease, dementia, or diabetes.

  • Eligible for Medicare and Medicaid

  • Receive institutionalized care (live in a nursing or home receiving nursing at home).

You can find more information about the conditions that Special Needs Plans cover at the official Medicare page that explains how SNPs work.

What is a preexisting condition?

A preexisting condition is any health condition a person may have prior to enrolling in health coverage.

Have More Questions?

At the official Medicare website, you’ll find answers to many of your Medicare questions, some of which we’ve covered here.

You can also reach out to us at info@well-advised.com, and our experts will assist you. You can also fill out our contact form if you prefer.