Frequently asked questions.
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Medicare's Annual Enrollment Period (AEP) runs from October 15 through December 7 each year. During this time, people with Medicare can review their current coverage and make certain changes to their Medicare Advantage or Part D prescription drug coverage for the following year.
Plans, premiums, drug formularies, provider networks, and benefits can change from year to year, so it's a good idea to review your coverage even if you're happy with your current plan.
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For most people, Medicare eligibility begins at age 65. Your Initial Enrollment Period generally lasts seven months: the three months before the month you turn 65, your birthday month, and the three months afterward.
Your situation may be different if you're already receiving Social Security benefits or if you or your spouse are still working and you have employer-sponsored health coverage.
Before enrolling, it's helpful to understand when your Medicare coverage should begin and whether you need Medicare Parts A and B right away.
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Medicare Advantage plans are an alternative way to receive your Medicare benefits through a private insurance company. Plans often include prescription drug coverage and may offer additional benefits such as dental, vision, hearing, or fitness benefits. Provider networks and plan rules may apply.
Medicare Supplement (Medigap) policies work alongside Original Medicare and help pay certain out-of-pocket costs that Original Medicare doesn't cover. You'll generally need a separate Part D plan for prescription drug coverage.
Neither approach is right for everyone. Your doctors, prescriptions, travel habits, budget, and preferences can all influence which option may be a better fit.
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You may still want to consider Part D coverage even if you currently take few or no prescription medications.
If you go without Part D or other creditable prescription drug coverage after becoming eligible, you could face a late-enrollment penalty if you decide to enroll later. That penalty can potentially continue for as long as you have Part D coverage.
It's worth looking at your individual circumstances before deciding to go without prescription drug coverage.
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It depends on the type of Medicare coverage you choose.
With Original Medicare, you can generally see providers nationwide who accept Medicare. Medicare Advantage plans typically use provider networks, and those networks vary by plan.
That's why checking your doctors and other healthcare providers is an important part of comparing Medicare options. I routinely review provider participation along with prescriptions and other coverage priorities when helping clients evaluate plans.
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Original Medicare generally doesn't cover most routine dental care, routine eye exams for glasses, hearing exams, or hearing aids, although Medicare does cover certain medically necessary services involving your eyes, ears, and dental care in specific circumstances.
Some Medicare Advantage plans include additional dental, vision, and hearing benefits. Separate dental and vision coverage may also be available.
The benefits and limitations vary considerably, so it's important to look beyond the headline benefit and understand what a particular plan actually covers.
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Often, yes—but Medicare has specific enrollment periods and eligibility rules governing when changes can be made.
The Annual Enrollment Period is one opportunity, and certain people may qualify for a Special Enrollment Period because of circumstances such as moving, losing other coverage, or meeting other eligibility requirements.
If something changes during the year, don't assume you have to wait until the next Annual Enrollment Period. It's worth checking whether your circumstances give you another opportunity to make a change.
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Turning 65 doesn't necessarily mean you must leave your employer's health plan.
Whether you should enroll in Medicare Parts A and B at 65 can depend on factors such as the size of the employer, whose employment provides the coverage, and whether the coverage is considered current employer coverage.
This is an area where getting the timing right matters. Before delaying Medicare enrollment, it's important to understand how your existing employer coverage coordinates with Medicare and whether delaying enrollment could result in a penalty or coverage gap later.
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There is no additional cost to you for my Medicare insurance brokerage services. When I help someone enroll in a plan, I may receive compensation from the insurance carrier.
As an independent broker, I can represent multiple insurance companies rather than working for just one carrier. My goal is to help you understand the options available to you and evaluate them based on your individual healthcare needs and priorities.
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Having a few things ready can make your Medicare review much more productive. I recommend gathering your Medicare card or Medicare information (if available), current insurance information, doctors and healthcare providers, prescription medications and preferred pharmacies.
It's also helpful to think about what's most important to you—such as keeping particular doctors, prescription costs, travel, monthly premiums, or limiting unexpected healthcare expenses.
Already scheduled with me? Use the Prepare for Your Medicare Meeting link to provide this information before we meet.