Medicare/ Medicare Supplements/Medicare Advantage FAQ’s

Medicare:
• When am I eligible for Medicare? You are eligible for Medicare part A and part B on the
1st day of the month of your 65th Birthday.
• What is the difference between Medicare part A and part B?
o Medicare part A is free, and you are not required sign up, and is hospital
coverage.
o Medicare part B is approximately $170 a month (is based on your income so it can
differ person to person) covers doctor appointments, and you must complete
enrollment forms at the Social Security Office or at Medicare.gov.
• Do I have to buy Medicare part B if I have group health/retiree group health? You are
not required to buy Medicare part B, nor will you be penalized if you decide to sign up
for Medicare part B after the age of 65 if you have qualifying health coverage such as
group health.
• Do I have to buy a Medicare Advantage or Medicare Supplement? You are not required
to have a Medicare Advantage plan or a Medicare Supplement. Some people prefer to
only use Medicare part A and B and a part D plan for medical and prescription
insurance.
Medicare Advantage or part C:
• What is a Medicare Advantage plan? An Advantage plan is similar to regular health
insurance due to it having a deductible, max out of pocket, and network requirements.
Most plans also include dental, vision, and prescription drug coverage. A Medicare
Advantage plan will void Medicare, and if you decide to want Medicare instead you will
have to complete paperwork to enroll with the Social Security Office.
• Does The Insurance Shop sell Medicare Advantage plans? The Insurance Shop does not
sell Medicare Advantage plans because we have found the plans have higher out of
pocket costs, network requirements, and other fine print. We have found them
confusing, frustrating, and have opted not to sell them.
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• Is there an open enrollment for Medicare Advantages? Yes, every year there is an open
enrollment that gives you the opportunity to switch plans.
• How much do Medicare Advantage plans cost? Generally, Medicare Advantage Plans
cost start around $10 per month, but depending on the benefits you chose the monthly
premium will increase.
Medicare Supplement or Medigap:
• How does a Medicare Supplement work? With a Medicare Supplement you will have
Medicare part A and part B. A Medicare Supplement is meant to help cover medical
costs that Medicare doesn’t pay but has approved.
• When can I buy a Medicare Supplement? There is only one open enrollment for
Medicare Supplements
o 1) The 1st day of the month you turn 65
o 2) The 1st day of the month you retire after the age of 65 if you had group health
insurance.
• What if I want to switch Medicare Supplement plans or companies? You will have to
complete an application and it will be reviewed by an underwriter to determine if you
are eligible for coverage.
• How much does a Medicare Supplement cost? The cost is normally $65-$200 per month.
Part D or prescription plan:
• Do I have to have a part D plan? If you do not buy a part D plan when eligible, you could
be penalized with higher monthly premiums when you purchase a part D plan.
• Is there an open enrollment for part D plans? Yes, there is an open enrollment each year
from October 15
th
– December 7th. During the open enrollment you can switch plans that
will take effect on January 1st of the next year.
• How do I sign up for a part D plan? The Insurance Shop does not sell part D plans, but if
we write your Medicare Supplement, we can assist you in identifying a drug plan that is
based on your current prescriptions and preferred pharmacy. We utilize medicare.gov
to find the lowest out of pocket drug plan from the prescription list and preferred
pharmacy.