Frequently Asked Questions

    1. What is Medicare?
        • Medicare is a federally funded health plan for individuals age 65 and older as well as individuals under the age of 65 who have a disability or End Stage Renal Disease. Its basic coverage, called Original Medicare, is divided into two parts—Medicare Part A (Hospital) and Medicare Part B (Medical/Doctors).


    2. When do I sign up for Medicare?
        • A Medicare beneficiary’s “Initial Enrollment Period (IEP)” starts 3 months prior to the beneficiary’s birth month extends through that month and continues 3 more months after that lasting a total of 7 months.


    3. How do I sign up for Medicare?
        • Social Security is the gatekeeper of Medicare enrollments so to enroll in Medicare one needs to visit a Social Security office, call its toll-free number, or enroll online. Ideally, this should be done 3 months prior to a beneficiary’s birth month.


    4. Is there a premium for Medicare?
        • Part A does not have a premium for most people as you’ve been paying into Medicare your entire working life. The requirement is 40 quarters of payroll taxes (10 years) to be eligible. Once eligible, Part A does not have a premium. Part B, though, does has a premium that is based on your level of income. For most people that premium in 2016 is $121.80 and will be deducted from your Social Security benefit check before you receive it. If you are not taking your Social Security benefit, the amount will be billed on a quarterly basis.


    5. I’ve signed up for Medicare, now what do I do?
        • You should receive two things in the mail from Social Security – a red, white, and blue Medicare card and an award letter stating when your Medicare benefits start. Either one is sufficient to enroll in a plan.


    6. Why do I need to sign up for additional coverage if I have Original Medicare?
        • Both Medicare Parts A and B have deductibles and coinsurance. After you satisfy the deductibles, Medicare only covers roughly about 80% of cost. That leaves 20% of the cost on your shoulders and there is no limit to how much that 20% could amount to.


    7. If I have employer coverage, do I need to take Medicare?
        • Not necessarily, but this is a complicated issue because each employer plan is different and is therefore subject to different rules both in reference to Medicare Part B as well as Medicare Part D. If you have questions, please contact our office at 859-291-6600.


    8. Why is it important to have an agent?
        • It is extremely important to have an agent even if it’s not The Medicare Strategy Center. An agent’s job is to understand your medical needs and financial goals, simplify and clarify your options, understand the differences between each plan and carrier, facilitate the transition into the plan that best suits your needs, and be your advocate to the insurance company once your plan goes into effect. It does not cost any more to have an agent and an agent has many more resources at his/her disposal to help if there is an issue.


    9. How often can I change my coverage?
        • You can change your coverage every year during the Annual Enrollment Period from October 15 – December 7. You may be able to qualify for a Special Enrollment Period during the year if you have a change in life circumstance. If you wish to see if you are eligible for a special enrollment please call our office at 859-291-6600.


    10. How do I sign up for prescription drug coverage?
        • Medicare Prescription Drug coverage – also called Medicare Part D – is not offered by Medicare itself but by independent insurance companies. These companies who choose to offer Part D plans have specific rules and regulations that need to be adhered to in their offerings and each plan must be approved by Medicare before it is ready to be sold on the open market


    11. Are all prescription drug plans the same?
        • No, there are 4 things that make drug plans unique:
          1. Premiums
          2. Deductibles
          3. Copays
          4. Drug List.
          Each carrier decides yearly on how it’s going to offer its plans with those factors in mind.


    12. What is Medicare Advantage (Part C)?
        • Medicare Advantage Plans (also called Part C) are health plans offered by independent insurance carriers that many times combine your Medicare Parts A, B, and D together for a very low and, in some cases, no additional premium over what you are paying for Medicare Part B. They take the place of your Original Medicare coverage (even though you are still part of the Medicare program) and you become subject to the terms and conditions that are set by the plan. These plans can be modified on a yearly basis by the carrier but each year the plan must be submitted to Medicare for approval


    13. Are all Medicare Advantage plans the same?
      • No, like Medicare Part D plans, Medicare Advantage plans can be molded in many different ways which is why it is important to find a knowledgeable agent to review each plan’s strengths and weaknesses with you.