Medicare FAQs
Find answers to frequently asked questions about Medicare, Medicare Parts & Plans, Medicare enrollment, and more.
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General Medicare Questions
What do the different parts (A, B, C, D) mean?
Sometimes we refer to Medicare coverage as a puzzle, with multiple pieces that fit together to create the coverage you need. But we can also think of Medicare parts as a restaurant dinner menu, in which you can choose the perfect meal for what you want.
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- Part A (Hospital Insurance): Part A is like the soup or salad, or starter that comes to the table as soon as you sit down. This is your hospital coverage. It helps pay for inpatient care in a hospital, skilled nursing facility care (following a hospital stay), hospice care, and home health care. For most people, Part A is premium-free if you or your spouse paid Medicare taxes for at least 10 years.
- Part B (Medical Insurance): Part B is one of the entrees on the menu. This is your day-to-day medical coverage. It helps pay for services from doctors and other healthcare providers, outpatient care, preventive services, and medical equipment. You will pay a monthly Part B premium.
- Original Medicare: This is the name for the combo of Part A and Part B.
- Part C (Medicare Advantage): This is an "all-in-one" alternative to Original Medicare. It comes with a soup/salad starter and an entree, and dessert (prescription coverage). These plans are offered by private insurance companies approved by Medicare. They bundle Part A, Part B, and usually Part D into a single plan. Many also offer additional benefits like dental and vision. [Learn more about the pros and cons of Medicare Advantage Plans.]
- Part D (Prescription Drug Coverage): Part D can be thought of like dessert or a beverage. This part helps cover the cost of prescription drugs. These plans are also sold by private insurance companies. You can get Part D as a standalone plan to add to your Original Medicare/Medicare Supplement combo. [Find out how to choose the right Part D Plan for your needs.]
- Medicare Supplement: Medicare Supplement isn't an official part of Medicare, but it is an option. Medicare Supplement (or Medigap) is like the 'Sides' part of the menu that you can add to your Original Medicare combination, so you can ensure you get the meal you really need. It can include coverage for international travel, pay for Part B co-insurance, or pay for equipment and services that Medicare Part B does not cover. Note that you cannot add a Medicare Supplement plan to a Medicare Advantage plan.
Who is eligible for Medicare? (Age, residency, disability, etc.)
Generally, you are eligible for Medicare if you are a U.S. citizen or a legal resident who has lived in the United States for at least five consecutive years and one of the following applies to you:
- You are 65 or older.
- You are under 65 but have a qualifying disability. You typically become eligible after receiving Social Security Disability Insurance (SSDI) benefits for 24 months.
- You have End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a transplant) or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease.
What are Medicare Supplement (Medigap) plans?
A Medicare Supplement plan, also known as Medigap, is extra insurance you can buy from a private company to help pay your share of costs in Original Medicare. Original Medicare pays for much, but not all, of the cost of covered healthcare. A Medigap policy can help pay for the "gaps," such as:
- Copayments
- Coinsurance
- Deductibles
Medigap plans are standardized, meaning that a Plan G, for example, offers the same basic benefits regardless of which insurance company sells it. This makes it easier to compare prices. To buy a Medigap plan, you must have Medicare Part A and Part B.
Medigap plans are a popular choice for those who want predictable costs and the freedom to see any doctor in the country that accepts Medicare.
What is a Medicare Advantage plan?
A Medicare Advantage plan, or Part C, is an alternative way to receive your Medicare benefits. Instead of the federal government paying for your services (as with Original Medicare), a private insurance company that is contracted with Medicare provides your coverage.
These "all-in-one" plans bundle Part A, Part B, and usually Part D drug coverage. A key difference is that they often operate with a local or regional provider network, like an HMO or PPO. Many Medicare Advantage plans also offer attractive extra benefits not covered by Original Medicare, such as routine dental, vision, hearing, and gym memberships.
It's important to remember: you cannot have a Medigap plan and a Medicare Advantage plan at the same time. You choose one path or the other. [See our complete breakdown of Medigap vs. Medicare Advantage.]
How do Prescription Drug Plans (Part D) work?
Medicare Part D plans help you pay for your prescription medications. You can get this coverage either through a standalone Part D plan that works alongside Original Medicare or as part of a Medicare Advantage plan.
Each plan has its own list of covered drugs, called a formulary. It's crucial to check that your specific medications are on a plan's formulary before enrolling. These plans also have different cost-sharing stages you may move through during the year, including a deductible, an initial coverage phase, the coverage gap (or "donut hole"), and catastrophic coverage.
Are all Medicare services accepted everywhere? How do networks work in Medicare Advantage vs. Medigap?
This is one of the biggest differences between the two main Medicare paths.
- With Original Medicare and a Medigap plan, you have the freedom to go to virtually any doctor or hospital in the entire United States that accepts Medicare. There are no restrictive networks, which is a major advantage for travelers or those who want the widest possible choice of providers.
- With a Medicare Advantage plan, you will typically need to use doctors and hospitals that are in the plan's network, especially with an HMO plan. PPO plans offer more flexibility to see out-of-network providers, but it will almost always cost you more. These networks are usually based in a specific county or region.
Will my existing doctor accept Medicare?
The vast majority of doctors in the U.S. do accept Medicare. The best way to be 100% sure is to simply call your doctor's office and ask if they "accept Medicare assignment." This means they agree to accept the Medicare-approved amount as full payment for covered services. If your doctor accepts Medicare, they must accept your Medicare Supplement plan as well, even though it's a private plan.
If you are considering a Medicare Advantage plan, you'll need to take an extra step and ask if your doctor is "in-network" for that specific plan.
Where is Medicare accepted?
Original Medicare provides health coverage nationwide. Whether you're in your hometown or traveling across the country, you can receive care from any facility or provider that accepts Medicare. This is also true for Medicare Supplement plans.
Medicare Advantage plans, however, have defined service areas. Your plan will generally only cover you within that specific geographic area (like a county or group of counties), except for emergencies.
What are copayments, coinsurance, deductibles under Medicare?
These are all forms of out-of-pocket costs you might pay for your care.
- Deductible: This is the amount you must pay for your healthcare before Medicare starts to pay its share. For example, there's a Part A deductible for each hospital stay and an annual Part B deductible for medical services.
- Coinsurance: This is your share of the cost of a service, calculated as a percentage. For example, after you meet your Part B deductible, you typically pay 20% of the Medicare-approved amount for most doctor services.
- Copayment (Copay): This is a fixed amount you pay for a service, like $25 for a doctor's visit. Copays are more common with Medicare Advantage plans.
Medicare Supplement (Medigap) plans are specifically designed to help cover your deductible and coinsurance costs, making your expenses more predictable.
How much do Medicare premiums cost? What determines the premium?
Your Medicare premium costs will depend on the coverage you choose and, in some cases, your income.
- Part A Premium: Most people get Part A premium-free due to satisfying the work history requirement.
- Part B Premium: Everyone pays a monthly Part B premium, which is set by the federal government each year. The amount can be higher for individuals with higher incomes (see IRMAA below). This premium is often deducted directly from Social Security benefits.
- Part C (Medicare Advantage) Premium: These vary widely by plan and location. Many plans have a $0 monthly premium, though you must still continue to pay your Part B premium.
- Part D (Drug Plan) Premium: These also vary by plan. Higher-income individuals may also pay an extra adjustment amount for their drug coverage.
- Medigap Premium: Premiums are set by the private insurance carriers and vary based on the plan you choose, your age, location, and other factors.
I need help paying my Medicare premiums. Are there financial programs or savings plans?
Yes. There are programs to help people with limited income and resources afford Medicare:
- Medicare Savings Programs (MSPs): These are state-run programs that can help pay your Medicare Part A and/or Part B premiums, and sometimes even deductibles and coinsurance.
Extra Help (or Low-Income Subsidy - LIS): This is a federal program that helps pay for Medicare Part D prescription drug plan costs, including premiums, deductibles, and coinsurance.
What is IRMAA ("income-related monthly adjustment amount")?
IRMAA is an important concept for those with higher incomes. It stands for Income-Related Monthly Adjustment Amount. If your modified adjusted gross income as reported on your IRS tax return from two years ago is above a certain amount, you'll pay a higher premium for your Medicare Part B and your Medicare Part D plan.
Social Security determines if you owe IRMAA based on the income you reported. It's not a penalty; it's simply a surcharge for higher earners. Read our in-depth guide to understanding and managing IRMAA for 2025.
Does Medicare cover dental, vision, hearing?
Original Medicare (Part A and Part B) does not cover most routine care for dental, vision, or hearing. This means cleanings, fillings, eyeglasses, contact lenses, and hearing aids are generally not covered.
You can get coverage for these services in one of two ways:
- Enroll in a Medicare Advantage (Part C) plan that includes these benefits.
- Purchase a separate, standalone insurance policy for dental, vision, or hearing.
What rules apply for people who are under 65 and have Medicare (due to disability or ESRD)?
If you qualify for Medicare under age 65 due to a disability such as end-stage renal disease or Lou Gehrig's disease, you have the same Medicare rights and coverage choices as those who qualify by age. However, there is one key difference regarding Medigap plans. Federal law does not require insurance companies to sell Medicare Supplement policies to people under 65, though many states have their own laws requiring it. This can make finding an affordable Medigap plan more challenging. When you turn 65, you will get a new Medigap Open Enrollment Period, which is often a great time to re-evaluate your coverage.
What happens if I move to a different state? Can I keep my Medicare plan, or will I need a new one?
Your coverage options after a move depend on the type of plan you have.
- If you have Original Medicare with a Medigap plan, your coverage moves with you. You can continue to see any doctor in the U.S. that accepts Medicare. You may want to check Medigap prices in your new location, as you might find a better rate.
If you have a Medicare Advantage or a Part D plan, you will likely need to enroll in a new plan. These plans are tied to specific service areas. Moving qualifies you for a Special Enrollment Period, giving you a window of time to choose a new plan in your new location without penalty.
What if I have Medicare and am still working, or have employer-sponsored insurance? How do the different plans interact?
This is a very common situation. Rules vary by employer's size.
- If you work for a large employer (20 or more employees): Your employer's group health plan is the primary payer, and Medicare is secondary. In this case, many people choose to enroll in premium-free Part A but delay enrolling in Part B to avoid paying the premium, since their employer plan already provides medical coverage. You can then enroll in Part B later without a penalty when you stop working.
If you work for a small employer (fewer than 20 employees): Medicare is primary, and the employer plan is secondary. You will generally need to sign up for Part A and Part B when you first become eligible to ensure you have full coverage.
Important Note on HSAs: Once you enroll in any part of Medicare (including Part A), you can no longer legally contribute to a Health Savings Account (HSA)
Does Medicare cover me during international travel? Will I be covered by Medicare during travel to foreign countries?
In almost all cases, Original Medicare does not cover health care you get while traveling outside the United States.
To get coverage for international travel, you have a few options:
- Some Medigap plans (specifically C, D, F, G, M, and N) offer a foreign travel emergency benefit, which covers emergency care when you are traveling abroad.
- Some Medicare Advantage plans offer a similar benefit for emergency care outside the U.S.
Purchase a separate travel medical insurance policy for your trip.
How do I know which Medicare Part I need? How do I choose which Medicare Parts to combine into my unique plan?
Choosing your Medicare path comes down to your priorities regarding cost, choice, and convenience. There are two main roads you can take:
Path 1: Combining Four Parts
- Medicare Part A (Hospital)
- Medicare Part B (Medical)
- Medicare Part D (Prescription Drugs)
- A Medigap Plan (Supplemental)
This combination is often preferred by those who want predictable costs and the ability to see any Medicare-accepting doctor in the country without referrals.
Path 2: Medicare Advantage (Part C) Plan
This single plan provides your Part A, Part B, and usually Part D benefits (though this depends on the options in your area). It often includes additional coverage like dental and vision. The trade-off is that you must typically use providers within the plan's network.
If I have Medicare Supplement, do I still need a Medicare Part D drug plan?
Yes. Medicare Supplement plans work with Original Medicare to cover your hospital and medical costs (your Part A and B benefits). But they do not include coverage for prescription drugs.
To get coverage for your medications and avoid a potential late enrollment penalty, you must purchase a separate, standalone Medicare Part D Prescription Drug Plan.
Medicare Enrollment
How do you apply for Medicare? What is the typical Medicare sign up process?
Applying for Medicare is typically handled by the Social Security Administration (SSA), not Medicare itself. For most people, the process is straightforward. If you are already receiving Social Security or Railroad Retirement Board (RRB) benefits at least 4 months before you turn 65, you will likely be enrolled in Medicare Part A and Part B automatically. You'll receive your Medicare card in the mail about 3 months before your 65th birthday.
If you are not yet receiving retirement benefits, you will need to enroll in Medicare yourself. The easiest and fastest way to apply is online.
The typical Medicare sign-up process involves these steps:
- Determine Your Eligibility: You are generally eligible for Medicare when you are turning 65 or have a qualifying disability.
- Choose Your Enrollment Period: You must enroll during a specific timeframe. (We'll cover these in the next section.) Missing your initial window can lead to penalties.
- Gather Your Information: You will need basic documents and personal information to complete the application.
- Apply Online: The most efficient method is through the Social Security website at SSA.gov. The application takes about 10-30 minutes to complete.
Receive Your Card: Once your application is approved, your red, white, and blue Medicare card will be mailed to you.
When can I enroll in Medicare? What are the different Medicare enrollment periods?
Timing is everything with Medicare. Enrolling at the right time ensures your coverage starts when you need it and helps you avoid late enrollment penalties. There are three main enrollment periods.
- Initial Enrollment Period (IEP): This is your primary, seven-month window to sign up for Medicare. It begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months after your birthday month. For example, if your birthday is in July, your IEP runs from April 1st to October 31st. This is the ideal time to enroll in Part A, Part B, and to consider your supplemental coverage options.
- General Enrollment Period (GEP): If you miss your IEP and don't qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period, which runs from January 1st to March 31st each year. However, your coverage won't start until July 1st, and you may face late enrollment penalties.
- Special Enrollment Period (SEP): SEPs are periods outside of the normal timeframes that allow you to enroll in Medicare due to specific life events, such as leaving a job where you had health coverage.
Understanding these dates is crucial for a smooth transition. Learn the specifics of each window on our comprehensive Medicare Enrollment resource page.
What if I don't sign up for Part B when I'm first eligible? Are there penalties or delayed coverage?
Yes, there are significant consequences for not enrolling in Medicare Part B (Medical Insurance) when you are first eligible, unless you have other qualifying health coverage (like from an active employer).
- Part B Late Enrollment Penalty: If you don't sign up for Part B during your Initial Enrollment Period, you may face a lifetime penalty. The penalty is an additional 10% on your monthly Part B premium for each full 12-month period you could have had Part B but didn't. This penalty is added to your premium as long as you have Part B.
- Delayed Coverage: As mentioned above, if you miss your IEP, you will likely have to wait until the next General Enrollment Period (January 1 - March 31) to sign up, with your coverage not starting until July 1st. This could leave you with a dangerous gap in health insurance.
Can I delay enrollment (for example, if I have employer insurance)?
Yes, many people who are still working when they turn 65 can delay enrolling in Medicare Part B without penalty. This is a common scenario for those who have robust health coverage through their (or their spouse's) current employer.
To qualify for a penalty-free delay, the following must be true:
- You or your spouse must be actively working.
- Health insurance must be from a current employer (not COBRA or a retiree plan).
- The employer must have 20 or more employees.
If you meet these criteria, you can delay Part B enrollment. When you eventually retire or lose that employer coverage, you will be granted a Special Enrollment Period to sign up for Part B penalty-free.
A note on Part A: Most people get Part A (Hospital Insurance) premium-free. It's often wise to enroll in Part A during your IEP even if you have employer coverage, as it can coordinate with your current plan. However, if you contribute to a Health Savings Account (HSA), you must stop contributions once you enroll in any part of Medicare.
What is a Special Enrollment Period (SEP)? What are the criteria for the Special Enrollment Period?
A Special Enrollment Period (SEP) is an 8-month window that allows you to sign up for Medicare outside of your IEP without penalty, triggered by a qualifying life event. The most common criterion for an SEP is losing group health plan coverage from a current employer.
Here are some common qualifying life events for an SEP:
- You lose group health coverage from your or your spouse's current job.
- You move out of your current plan's service area.
- You lose Medicaid eligibility.
- Your plan provider ends its contract with Medicare.
The SEP for losing employer coverage begins the month after your employment or coverage ends, whichever comes first. This gives you 8 months to enroll in Part B. To avoid a gap in coverage, it's best to arrange for your Part B to start the month after your employer plan ends.
When do Medicare Supplement (Medigap) plans allow open enrollment and guaranteed issue?
This is one of the most important questions for those considering a Medigap plan. Your Medigap Open Enrollment Period is a one-time, 6-month window that starts on the first day of the month in which you are both 65 or older and enrolled in Medicare Part B.
During this period, you have guaranteed issue rights. This means an insurance company:
- Must sell you any Medigap policy it offers.
- Cannot charge you more because of pre-existing health conditions.
- Cannot make you wait for coverage to start (except for a very limited pre-existing condition waiting period in some cases).
If you miss this 6-month window, you may have to go through medical underwriting to buy a Medigap policy. Insurers could deny your application or charge you a higher premium based on your health history. This is why acting during your Medigap Open Enrollment Period is so critical.
What is the timeframe for switching plans, or going back to Original Medicare?
Your ability to switch plans depends on the type of coverage you have.
- Medicare Advantage & Part D Plans: The primary time to make changes is during the Annual Election Period (AEP), which runs from October 15th to December 7th each year. During AEP, you can switch from one Medicare Advantage plan to another, switch from one Part D prescription drug plan to another, or switch from Medicare Advantage back to Original Medicare (and pick up a Part D plan).
- Medicare Supplement (Medigap) Plans: There is no annual period to switch Medigap plans with guaranteed issue rights (unless your state has a specific rule). Outside of your initial Medigap Open Enrollment Period or another specific guaranteed issue situation, you typically must answer health questions to switch plans.
Learn more about your options for changing coverage in our breakdown Medicare Supplement 101: When Can I Change Medigap Plans?
What materials do I need for the Medicare enrollment process? What forms of ID and other documents will I need?
When applying for Medicare, especially online, having your information ready will make the process much smoother. You will likely need:
- Your Social Security number.
- Your date and place of birth.
- Your citizenship status.
- If applicable, your spouse's name, Social Security number, and date of birth.
- Information about any current group health plan coverage you have through an employer.
- Your employer's name and address if you wish to delay Part B.
You typically do not need to provide physical documents like your birth certificate or Social Security card if you are applying online, as the SSA can verify most information through its own records.
What else should I do to prepare for Medicare enrollment?
Enrolling is just one step. To prepare effectively, we recommend you:
- Review Your Current Healthcare: How much are you paying now in premiums and out-of-pocket costs? What doctors and hospitals do you use?
- Make a List of Your Prescriptions: This is vital for choosing the right Part D or Medicare Advantage plan. Note the drug names, dosages, and frequency.
- Learn the Difference: Understand the fundamental choice between Original Medicare with a Medigap plan and a Medicare Advantage (Part C) plan. They work very differently.
- Create a Healthcare Budget: Estimate your future costs, including premiums for Part B, a Part D plan, and a Medigap plan, to see how they fit into your retirement budget.
What is the Medigap "birthday rule" for switching Medigap plans? How does it work and when might it apply to me?
The Medigap "birthday rule" is a specific provision available in a handful of states that gives you an annual window with guaranteed issue rights to switch Medigap plans. If you live in a state with this rule, you typically have a 30- to 60-day period around your birthday each year to change from your current Medigap plan to another one without medical underwriting.
Key details about the birthday rule:
- It is state-specific: Only states like California, Oregon, Idaho, and a few others offer this. It is not a federal rule.
- It often has limitations: Usually, you can only switch to a plan with equal or lesser benefits than your current one. For example, you might be able to switch from a Plan G to a Plan N, but not the other way around.
The birthday rule provides valuable flexibility, allowing you to shop for a better rate or a different level of coverage each year without worrying about being denied due to your health.
See if this special provision applies to you. Read our detailed article: Medigap Birthday Rule in these 10 States: What It Is and How to Use It
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Medicare Costs, Renewals & Plan Change Questions
What does Medicare cost?
One of the common misconceptions about Medicare is that it has a single, fixed price. In reality, your total annual healthcare spending with Medicare is a combination of several factors. There is no one-size-fits-all answer, and your costs will be unique to your situation.
The primary variables that determine your total Medicare cost include:
- The Parts of Medicare you have: Your costs will differ depending on whether you have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), or if you also add Medicare Part D (Prescription Drug Coverage).
- The type of coverage you choose: Your out-of-pocket expenses will look very different if you opt for Original Medicare paired with a Medicare Supplement (Medigap) plan versus an all-in-one Medicare Advantage (Part C) plan.
- Your income: Higher-income beneficiaries pay more for their Part B and Part D premiums.
- Your location: Premiums and benefits for private plans (Medigap, Medicare Advantage, Part D) vary significantly by state and even by zip code.
- The insurance providers you select: Different companies charge different premiums for similar coverage.
What are the different costs associated with Medicare?
Understanding the vocabulary of healthcare costs is essential for budgeting and comparing plans. With Medicare, you'll encounter four main types of out-of-pocket expenses:
- Premium: This is a fixed amount you pay every month to keep your insurance plan active, whether you use medical services or not. You will have a premium for Part B (projected to be $206.50 in 2026) and may have premiums for Part A, Part D, Medigap, or Medicare Advantage.
- Deductible: This is the amount you must pay for your healthcare or prescriptions out-of-pocket before your Medicare plan begins to pay its share.
- Copayment: A fixed dollar amount (for example, $25) that you pay for a specific service, like a doctor's visit or a prescription refill, after you've met your deductible.
- Coinsurance: The percentage of the cost of a covered healthcare service that you are responsible for paying after you've met your deductible. For example, under Original Medicare Part B, you typically pay 20% of the cost for most doctor services.
Is there a single premium if I have both Medicare Part A and Part B, or do I have to pay for both separately?
You pay for them separately. Medicare Part A and Part B are distinct parts of Original Medicare, and their premiums are handled independently.
- Most people do not pay a monthly premium for Part A because of their work history. But a Part A premium is between $285 or $518 (in 2025) depending on the work history you do have.
- Everyone enrolled in Part B pays a monthly premium, projected to be $206.50 in 2026. This is most often deducted directly from your Social Security benefits. If you aren't yet collecting Social Security, you will receive a quarterly bill from Medicare.
Any additional private insurance you purchase, such as a Part D or Medigap plan, will also have its own separate premium that you pay directly to the insurance company.
Are there cost savings associated with bundling Medicare Part A and Part B?
This is a common point of confusion. Because Part A and Part B are the two halves of government-administered Original Medicare, there is no "bundle discount" for having both. However, if you don't enroll in Part B when you're first eligible, you may have late enrollment penalties when you do enroll. Also, if you don't have comparable coverage from another plan, you would be responsible for 100% of the costs for doctor visits, outpatient care, and medical supplies. In that sense, having both parts "saves" you from massive out-of-pocket expenses and is essential for a complete healthcare foundation.
How are Medicare Part A premiums determined?
If you do not qualify for premium-free Part A, the premium amount is based on the number of quarters you worked. For 2025, individuals with 30-39 quarters of coverage pay a reduced premium ($285), while those with fewer than 30 quarters pay the full Part A premium ($518) per month.
How are Medicare Part B premiums determined?
The cost of Medicare Part B is determined by two main factors:
- The Standard Premium: The Centers for Medicare & Medicaid Services (CMS) sets a standard monthly premium for Part B each year. Most beneficiaries pay this amount.
- Income-Related Monthly Adjustment Amount (IRMAA): If your modified adjusted gross income (MAGI) as reported on your IRS tax return from two years ago is above a certain threshold, you will pay the standard premium plus an additional amount, known as IRMAA. There are several income brackets, and the higher your income, the higher your total monthly Part B premium will be.
Your income plays a direct role in your costs. Learn more in our article about 2025 Medicare Changes to Part B and Part D Premiums, Part A Deductibles, and IRMAA.
Will my Medicare renew automatically?
Yes, but it's important to understand the specifics for each type of plan.
- Original Medicare (Part A and Part B): Your federal coverage automatically renews annually. You do not need to take any action as long as you continue to pay your premiums.
Private Plans (Medicare Advantage and Part D): These plans also typically renew automatically. However, the plan's costs, benefits, provider network, and drug formulary can-and often do-change each year. You will receive an Annual Notice of Change (ANOC) letter from your plan provider each September. It is critical that you review this document carefully to ensure the plan will still meet your needs for the upcoming year.
What happens if I miss open enrollment? Are there penalties?
This depends on which enrollment period you miss.
- Missing your Initial Enrollment Period (IEP): Missing your 7-month window when you first become eligible can cause a lifetime late enrollment penalty for Part B.
- Missing your Medigap Open Enrollment Period: This isn't an annual event; it's a one-time, 6-month window. If you miss it, you lose your guaranteed issue rights, and insurers can use medical underwriting to deny you a policy or charge you more.
Missing the Open Enrollment Period or Annual Enrollment Period (AEP, Oct 15 - Dec 7): There is no financial "penalty" for missing this period. The consequence is that you will be locked into your current Medicare Advantage or Part D plan for another year, even if a better or more cost-effective option is available.
What if I need to change my Medicare plan? How and when can I change my Medicare if my health needs or medication changes?
Your health needs are not static, and Medicare provides opportunities to adjust your coverage. The primary time to make a change is during the Open Enrollment Period or Annual Enrollment Period (AEP) from October 15th to December 7th. During this time, you can:
- Switch from one Medicare Advantage plan to another.
- Switch from one Part D prescription drug plan to another.
- Drop a Medicare Advantage plan and return to Original Medicare.
If your health or medication needs change mid-year, you may qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event, such as moving to a new service area or losing other coverage.
What should I do if my Medicare plan is non-renewing or is discontinued?
First, don't panic. If your Medicare Advantage or Part D plan is discontinued or leaves your service area, you are protected. This event triggers a Special Enrollment Period that gives you the right to enroll in a new plan.
You will receive a formal non-renewal notice from your plan provider. This notice will explain your rights and timeline. Importantly, this situation also grants you guaranteed issue rights to purchase most Medigap plans, giving you a valuable opportunity to switch to Original Medicare with a Medigap policy without having to answer health questions. Your first step should be to carefully read your notice and then begin exploring your replacement coverage options.
United Medicare Advisors Questions
How is United Medicare Advisors connected to Medicare?
United Medicare Advisors is not connected with or endorsed by the U.S. Government or the federal Medicare program.
United Medicare Advisors is a licensed insurance brokerage. We work with nearly a dozen private insurance carriers to provide Medicare Supplement plans. We encourage all our customers and readers to contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.
Who owns United Medicare Advisors?
Spring Venture Group owns United Medicare Advisors. Spring Venture Group also owns SmartMatch Insurance Agency to provide credible guidance and support to customers throughout their Medicare journey.
What services does United Medicare Advisors provide?
Since 2009, UMA's agents have helped over 600,000 clients. We can help you compare Medicare Supplement plans across carriers, and our licensed agents provide up-to-the-minute information on the best rates available. And because we are not committed to any single carrier and we don't charge our customers for our services, our clients are able to choose a plan without pressure and feel more confident in their policy decisions. We also stay up to date with current Medicare policy and changes to provide educational resources through our blog, newsletters, and e-books.
Is there a cost associated with using United Medicare Advisors?
We earn commission from plans we sell, but we do not charge customers directly for our guidance or resources. The only cost of using United Medicare Advisors for beneficiaries is their time.
What qualifications and licenses do United Medicare Advisors agents have?
Each United Medicare Advisors agent is licensed and appointed to sell private Medicare Supplement plans that comply with federal and state regulations. Agents also go through an intensive internal training program and quality-assurance training to ensure customers are informed of their options and we answer all their questions. See more information about our agents in our Agents Hub page.
How do I get a Medicare quote through United Medicare Advisors?
You can call United Medicare Advisors today, or you can fill out a form here, and a licensed agent will contact you.
What information will my United Medicare Advisors agent need to provide me with a quote?
When you speak with a United Medicare Advisors agent, we will work closely with you to identify and understand your healthcare needs, becoming your personal Medicare resource and advocate. We will gather essential information, asking core questions about your health status, upcoming surgeries, and find plans that meet your health needs, lifestyle, and budget.
We use proprietary technology to collect up-to-the-minute information on prices, carriers, and products. We will shop and compare plan rates from an extensive list of trusted, national insurance carriers. During this important process, we will review plan costs, care networks, and available benefits to give you a complete picture of plans that come the closest to satisfying your wants and needs.
This thorough process is designed to help you quickly and comprehensively make an informed decision based on your coverage requirements. Our objective is to save time and money finding your plan and answering all of your questions along the way to ensure your peace of mind.
How can I track the status of my application with United Medicare Advisors?
United Medicare Advisors has a customer portal where you can login to view the status of your application and policies.
Shortly after your application was submitted, you should have received an email with your unique username and instructions to set up your account. In some cases, you may need to check your email "spam" or "junk" folder.
Note: If you find our email in your "spam" or "junk" folder, please add our email address to your contact book. This will route our emails to your inbox so you don't miss any important information about your coverage.
How can I track my Medicare plans and policies with United Medicare Advisors?
Once enrolled and approved (if underwriting is required), you can see your plan details in the United Medicare Advisors customer portal. You can also upload doctors and prescriptions into the portal which will help you keep track of what is covered when you want to review your coverage and make any changes.
What if the information on my application is incorrect? How do I fix it?
If personal information, such as your name or address, was entered incorrectly, you can call Customer Success and they will ensure it gets fixed.
Please know that in some instances, certain sections that ask health questions may be blank on your application. There is nothing to worry about. Your agent could not have submitted an application that was missing necessary information. If you still feel unsure, call our Customer Success team at (844) 539-0968.
What support does United Medicare Advisors offer after enrollment?
Once you are enrolled in a policy through UMA, we work with you to ensure all paperwork is filed with the carrier. You then have access to our Customer Success Team representatives who can answer your questions as you get started with your plan. We will also reach out to you periodically to ensure you're getting the most out of your benefits. With your consent, we will also send you a monthly Medicare Update newsletter with resources, updates, and more.
Does United Medicare Advisors offer services in languages other than English, like Spanish?
United Medicare Advisors only provide guidance in English at this time.
How is my personal information protected when working with United Medicare Advisors?
We follow strict regulatory compliance requirements when it comes to personal health information (PHI) and personal identifying information (PII). We follow TCPA consents and do not sell your personal information to third parties.
Have another question?
Contact our Customer Success team to get the help you need.
