Medicare FAQs
Medicare Questions (FAQ)
Find answers to commonly asked Medicare questions.
Questions about Medicare Enrollment
I’m turning 65, when do I need to enroll for Medicare?
You can sign up for Medicare beginning three months before you turn 65, and coverage can start as soon as the first day of your birthday month. The Initial Enrollment Period (IEP) lasts until three months after your 65th birthday.
Am I eligible for Medicare Coverage?
Medicare eligibility begins at age 65 (or younger with certain disabilities) An individual is eligible to receive Medicare benefits regardless of income or medical history as long as they or their spouse have worked in the US for 10 years and are eligible to receive social security benefits.
What are the differences between each of the enrollment periods?
There are 5 Medicare Enrollment Periods that Medicare beneficiaries should be aware of. A comparison of each of those including what they cover, when they are, and who they are intended for can be found here: Understanding Medicare Enrollment Periods.
Can I be rejected by Medicare because I have a pre-existing condition?
A Medicare beneficiary cannot be denied coverage or charged more due to a pre-existing condition. However, if the beneficiary is acquiring supplemental insurance coverage, such as a Medigap policy outside of the Annual Enrollment Period, then some pre-existing conditions can be subject to review.
Am I automatically enrolled in Medicare Part A and Part B if I file for social security?
Yes, IF you have been receiving social security benefits for at least 4 months before your 65th birthday. IF YOU HAVE NOT been receiving social security benefits at least 4 months before turning 65, then you will need to complete the Medicare Benefits application: https://www.ssa.gov/benefits/medicare/.
Do I need to sign up for Medicare at 65 if I’m still working?
If you are still working at age 65 and have health insurance through your employer or your spouse’s employer, you may choose to delay enrolling in Medicare as long as the employer has 20 or more employees. However, it is important to check with your employer to ensure that your current coverage will continue and that it will be considered as primary coverage. If your employer coverage ends or becomes secondary coverage, you will have a limited time to enroll in Medicare without penalty through a Special Enrollment Period.
Questions about Medicare Coverage
What is Medicare?
Medicare is a federally funded health insurance program for individuals 65 years or older or those with certain disabilities. All U.S. citizens are eligible to receive Medicare coverage regardless of income or medical history.
Can I keep my doctor and/or specialist?
Keeping your doctors an/or specialists is the number one priority of our agents. We will always try our best to find a plan which your doctor accepts. Each situation is different and our agents can discuss your options in further detail at your benefit review.
Will all my medications be covered?
AGA Medicare Options agents will always look up your medications on Medicare.gov to ensure you are placed on a plan that covers your specific drugs.
Is there a cost for your service?
Our services are no cost to you and there is no fee or extra charge for working with an AGA Medicare Options agent. We are a free, providing knowledgeable public service for Medicare beneficiaries.
Does Medicare pay for ambulance trips?
Medicare Part B will cover ambulance transportation to a hospital, critical care hospital, or a skilled nursing facility when it is NEEDED. If an ambulance is ordered and the hospital does not think it was an emergency or necessity, you could be liable for those charges.
When can I change my Medicare Plan?
If you have a Medicare Advantage plan, you can switch during the Annual Enrollment Period (October 15 – December 7) or during the Medicare Advantage Open Enrollment Period (January 1 – March 31). If you have a Medicare Supplement plan, changes should be made during the Annual Enrollment Period. However, changes can be made in most states outside the AEP if you are able to pass medical underwriting. We highly recommend talking to a licensed independent agent before making changes.
Questions about Medicare Costs
Is Medicare free?
No, Medicare is not free. It is a government-funded healthcare program for people over the age of 65 and certain eligible individuals with disabilities, but beneficiaries are responsible for paying premiums, deductibles, and coinsurance for the coverage they receive. However, most individuals will qualify for premium free Part A as long as they or their spouse have worked at least 10 years.
What are my options to cover the 20% gap that original Medicare leaves me?
The two most common options are either a Medicare Advantage or Medicare Supplement. Medicare Supplement plans are PPO’s (preferred provider organizations) with a monthly premium, and Medicare Advantage plans are primarily HMO’s (health maintenance organization), sometimes a PPO, it may have lower out of pocket costs. An AGA Medicare Options agent can explain the differences in these plans to you at no cost or obligation.
Which pays first, Medicare or my employer's insurance?
It depends on the size of the employer group. Groups with under 20 members, Medicare generally pays first. Groups with over 20 members generally will be primary to Medicare. There are a few exceptions to this like self-funded plans or union plans.
Questions about Medicare Supplements
What is a Medicare Supplement insurance plan?
A Medicare Supplement insurance plan, also known as Medigap, is a private insurance plan that can help cover some of the out-of-pocket costs that Original Medicare (Part A and Part B) does not cover. These costs include things like deductibles, coinsurance, and copayments. Medigap plans are sold by private insurance companies and are designed to supplement Original Medicare.
Can I buy more than one Medicare Supplement?
No. The only exception is if you are changing policies. Under this circumstance you are afforded a 30-day window to transition from one Medicare Supplement plan to another.
Can I be dropped from my Medigap Plan if my expenses get too high?
You cannot be dropped from a Medigap Plan once your medical expenses reach a certain amount. Medicare Supplements are guaranteed renewable, as long as you pay your plan premium you will continue to have coverage.
Questions about AGA Life and Health
How do you get paid?
Our agents are compensated by the health plan. Our services are always at no cost to you and there is no extra fee or charge for working with an AGA Medicare Options agent.
Is there a cost for your service?
Our services are no cost to you and there is no fee or extra charge for working with an AGA Medicare Options agent. We are a free, providing knowledgeable public service for Medicare beneficiaries.
Do you represent all Medicare plans?
AGA Medicare Options brokers represent most Medicare plans on the market. We are happy to give you our experience and knowledge on all available plans and we won’t hesitate to recommend a plan we don’t represent if it’s the best fit for you.