Medicare FAQs

It is federal health coverage once you turn sixty five, and earlier for some people who qualify through a lasting disability or a named health condition. What you earn does not decide whether you get in, though it can move the premium I quote you.

Some people find themselves signed up without lifting a finger, normally because retirement benefits are already paying out. Others have to go and do it themselves. I tell you which of the two you are by looking at what you were already receiving before the birthday landed.

Bring me an up to date list of your medicines, the names of the doctors and clinics you see, and any letter about coverage from a current or former employer. With those three in front of me I can answer most of what comes up early on.

No. Original Medicare is paid by the federal program itself and travels to any provider willing to accept it. An Advantage plan is sold by a private carrier that takes those benefits over and wraps its own network and rules around them, usually with drug coverage folded inside.

It stands behind Original Medicare and picks up what is still owed after Medicare pays its part, things like coinsurance or a hospital deductible. It replaces nothing, and I cannot pair it with an Advantage plan.

Original Medicare travels easily across the country because no local network is holding it down. Private plans differ a great deal, and some keep routine care inside one service area, so tell me how much you are away before I recommend anything.

Left alone, most plans roll into the following year by themselves. The trap is that the plan rolling over may not be the plan you joined, because drug lists, networks and cost shares can all be rewritten first.

The premium is just the price of the ticket. The deductible, the copay at every visit, the tier your medicine falls into and the yearly cap on spending all shift the true figure, now and then by more than the premium ever will.

Every drug plan carries its own list of covered medicines, and each medicine sits in a tier that decides your share. One prescription can be cheap under one plan and painful under the next, so I check your list name by name.

There are programs that cut premiums, deductibles or prescription costs for people who qualify on income and savings. Let me check one against your numbers before you write a plan off as too expensive.

From the middle of October to the first week of December, anyone already on Medicare can weigh the plans again and move for the year ahead. Whatever you change in that stretch starts working when January arrives.

A late charge can fasten onto your premium and stay put, and your coverage may not start until months later. Certain turns in life, such as a job plan ending, open their own window and let me move you outside the usual dates.

Rarely, unless something in your life qualifies you. A move to a new area, employer coverage running out or a plan walking away from its contract can each reopen the door, and each one gives you only a short stretch to use it.