Frequently asked questions

A: When planning for long-term care, there are several insurance options available to help cover the potential cost of extended care services such as in-home care, assisted living, or nursing facility care. One option is a traditional long-term care insurance policy, which is designed specifically to help pay for long-term care services if you are unable to perform certain daily living activities or develop cognitive impairment. These policies typically allow you to choose benefit amounts, coverage length, and waiting periods. Another option is a hybrid or asset-based long-term care policy, which combines long-term care benefits with a life insurance policy or annuity. These plans can provide funds for long-term care if needed, while also offering a death benefit or other value if care is never required. Some individuals also choose to self-fund long-term care expenses using personal savings or retirement assets, while others may rely on Medicaid if they qualify financially. Each option has different costs, benefits, and planning considerations depending on your financial goals and healthcare needs.

A: You are eligible to enroll in Medicare during your Initial Enrollment Period, which begins three months before the month you turn 65, includes your birth month, and continues for three months after, giving you a total seven-month enrollment window. This is usually the best time to enroll to avoid delays in coverage or potential late enrollment penalties. If you plan to retire when you turn 65, it is generally recommended that you begin reviewing and enrolling in your Medicare coverage a few months before your birthday month so your coverage can start on time. In most cases, if you enroll before your birth month, your Medicare coverage will begin on the first day of the month you turn 65.

A: No, Medicare does not offer dependent coverage like many employer health insurance plans. Medicare is an individual program, which means each person must qualify and enroll based on their own age or eligibility. If your spouse is also age 65 or older, they will need to enroll in their own Medicare coverage. If your spouse is under age 65, they cannot be added to your Medicare plan and may need to remain on an employer health plan, obtain coverage through the Health Insurance Marketplace, or explore other private insurance options until they become eligible for Medicare.

A: You may not need to sign up for all parts of Medicare if you are still working and have health insurance through your employer. Many people choose to enroll in Medicare Part A when they become eligible at age 65 because it is often premium-free, even if they continue working and remain covered by an employer health plan. If you have active employer coverage through a company with 20 or more employees, you may be able to delay enrolling in Medicare Part B without a penalty while that coverage remains in place. However, if your employer has fewer than 20 employees, Medicare may become your primary coverage, which usually means you should enroll in both Part A and Part B when you first become eligible. It is important to review how your employer plan coordinates with Medicare before making a decision.

A: Yes, when you become eligible for Medicare, you can often keep your employer health coverage, but the best choice depends on the size of your employer and how the plan works with Medicare. If you work for a company with 20 or more employees, your employer plan is typically the primary coverage, and you may be able to delay enrolling in Medicare Part B without penalty while you remain covered by the employer plan. If your employer has fewer than 20 employees, Medicare generally becomes the primary payer, which usually means you should enroll in Medicare Part A and Part B when you are first eligible. Because employer plans and Medicare coordinate differently depending on the situation, it is important to review how the coverage works together before deciding whether to keep employer coverage, enroll in Medicare, or use both.

A: The monthly cost of Medicare depends on the parts of Medicare you enroll in. Medicare Part A (hospital insurance) is usually premium-free for most people if they or their spouse paid Medicare taxes for at least 10 years while working. Medicare Part B (medical insurance) has a monthly premium set each year by Medicare, and most beneficiaries pay the standard premium, although higher-income individuals may pay more due to income-related adjustments. In addition to Parts A and B, some people choose additional coverage that may have its own monthly cost. For example, Medicare Part D prescription drug plans, Medicare Advantage plans, or Medicare Supplement plans may each have their own premiums depending on the plan selected. The total monthly cost can vary based on the type of coverage you choose, your income level, and the specific insurance plan you enroll in.

A: You are not automatically required to enroll in both Medicare Part A and Part B. Unless you are covered under an employers plan and contribute to an HSA, most people choose to enroll in Part A when they first become eligible because it is usually premium-free for those who paid Medicare taxes while working. Part A helps cover hospital services and inpatient care. Enrollment in Part B is optional, but it is an important part of Medicare because it covers doctor visits, outpatient services, and many medically necessary treatments. If you do not enroll in Part B when you are first eligible and you do not have other creditable coverage (such as active employer coverage), you may face a late enrollment penalty and delays in coverage later. For this reason, it is important to review your situation carefully before deciding whether to enroll in Part B.

A: Yes, you can choose to have Original Medicare (Part A and Part B) as your primary health insurance when you retire. Original Medicare covers hospital care under Part A and doctor visits and outpatient services under Part B, and it allows you to see any doctor or hospital in the United States that accepts Medicare, without network restrictions or referrals. However, it is important to understand that Original Medicare does not cover all healthcare costs. In most cases, Medicare pays about 80% of approved medical services, leaving you responsible for deductibles, coinsurance, and the remaining 20% of costs. Original Medicare also does not include prescription drug coverage, so many people choose to add additional coverage such as a Medicare Supplement plan, a Medicare Advantage plan, MSA and/or a Medicare Part D prescription drug plan to help manage out-of-pocket expenses.

A: In many cases, yes—you can keep your current doctors when you move to Medicare, but it depends on the type of Medicare coverage you choose. If you enroll in Original Medicare (Part A and Part B), you can generally see any doctor or hospital in the United States that accepts Medicare, which includes the majority of healthcare providers. If you choose a Medicare Advantage plan, you may need to use doctors and hospitals within the plan’s provider network to receive the highest level of coverage. Some plans offer more flexibility than others, but it’s always important to confirm that your preferred doctors and providers participate in the plan before enrolling.

A: Medicare may cover certain services while you are in a nursing facility, but it does not typically cover long-term custodial care. Medicare Part A can help pay for a short stay in a skilled nursing facility if you meet specific requirements, such as having a qualifying inpatient hospital stay of at least three days and needing skilled nursing or rehabilitation services prescribed by a doctor. When those conditions are met, Medicare may cover up to 100 days of skilled nursing care per benefit period, although coinsurance may apply after the first 20 days. However, Medicare generally does not cover long-term care such as ongoing assistance with daily activities like bathing, dressing, or eating. These types of services are typically paid for through personal savings, long-term care insurance, Medicaid (for those who qualify), or other financial resources.

A: Original Medicare (Part A and Part B) generally does not cover routine dental care, such as cleanings, exams, fillings, dentures, or most other dental services. Medicare may only cover certain dental procedures if they are directly related to a covered medical treatment, such as a dental exam required before certain surgeries. However, individuals on Medicare often have other options for dental coverage. Many Medicare Advantage plans include dental benefits, and there are also standalone dental insurance plans specifically designed for people on Medicare. These plans can help cover routine preventive care as well as basic and major dental services.

A: No, having retiree health benefits does not usually replace Medicare. In most cases, when you become eligible for Medicare at age 65, your retiree coverage will work together with Medicare, rather than take its place. This often means Medicare becomes your primary coverage, and your retiree plan may act as secondary coverage, helping to pay some of the costs that Medicare does not cover. Because of this coordination, many retiree plans require you to enroll in Medicare Part A and Part B when you become eligible in order to maintain your retiree coverage. If you delay enrolling in Medicare when your retiree plan expects you to have it, you could experience gaps in coverage or higher out-of-pocket costs. It is important to review the details of your specific retiree plan to understand how it coordinates with Medicare before making a decision.

A: The main difference between Medicare Advantage plans and Medicare Supplement (Medigap) plans is how they provide your Medicare coverage. Medicare Advantage plans are offered by private insurance companies and manage Original Medicare by combining Part A (hospital) and Part B (medical) coverage into one plan, often including additional benefits such as prescription drugs, dental, vision, or hearing services. These plans typically operate within provider networks and may require copayments for services. Medicare Supplement plans, on the other hand, work alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, coinsurance, and copayments. They do not replace Medicare but instead help fill the “gaps” in coverage. With a Medicare Supplement plan, you can generally see any doctor or hospital in the United States that accepts Medicare, and prescription drug coverage is usually purchased separately through a Medicare Part D plan.

A: Medicare Part D is the portion of Medicare that provides prescription drug coverage. These plans are offered by private insurance companies approved by Medicare and help cover the cost of many commonly prescribed medications. Individuals enrolled in Original Medicare can choose a standalone Part D prescription drug plan, while many Medicare Advantage plans include prescription drug coverage as part of the plan. Each Part D plan has its own list of covered medications (formulary), as well as specific premiums, deductibles, and copayments. Having Part D coverage can help protect against the high cost of prescription drugs and make medication expenses more predictable.

A: A Medicare Part C plan, also known as a Medicare Advantage plan, is an alternative way to receive your Medicare benefits through a private insurance company approved by Medicare. These plans combine the coverage of Medicare Part A (hospital insurance) and Part B (medical insurance) into one plan, and many also include prescription drug coverage (Part D) along with additional benefits such as dental, vision, hearing, and wellness programs. Medicare Advantage plans typically operate through provider networks, such as HMO or PPO plans, and may require members to use certain doctors and hospitals to receive the highest level of coverage. They often include predictable copayments and an annual out-of-pocket maximum, which can help protect beneficiaries from very high healthcare costs during the year.

A: If you miss your designated Medicare enrollment window, you may have to wait until the General Enrollment Period to sign up. This period runs from January 1 through March 31 each year, and your coverage would typically begin on 1st day of the month following your application date. Missing your initial enrollment period can result in a gap in coverage until your Medicare benefits take effect. In addition, you may be subject to late enrollment penalties, particularly for Medicare Part B and Part D, if you did not have other qualifying (creditable) coverage during the time you delayed enrolling. These penalties can increase your monthly premiums and may last for as long as you have Medicare coverage, which is why it is important to enroll during the appropriate enrollment period whenever possible.

A: You can sign up for Medicare through the Social Security Administration. The easiest way is to enroll online by visiting the Social Security website at www.ssa.gov,(http://www.ssa.gov) where you can complete the Medicare application electronically. You can also apply by calling Social Security at 1-800-772-1213 or by scheduling an appointment at your local Social Security office. Many people are automatically enrolled in Medicare Part A and Part B if they are already receiving Social Security benefits before turning 65. If you are not yet receiving Social Security, you will need to apply for Medicare during your Initial Enrollment Period, which begins three months before the month you turn 65.

A: Creditable coverage is health insurance that is considered at least as good as Medicare coverage, particularly when it comes to prescription drug benefits. If you have creditable coverage—such as through an employer, union plan, or certain retiree health plans—it means the coverage is expected to pay, on average, as much as or more than Medicare’s standard prescription drug coverage (Part D). Having creditable coverage is important because it allows you to delay enrolling in Medicare Part D without facing a late enrollment penalty. If you lose that coverage later, you are typically given a special enrollment period to sign up for a Medicare drug plan without penalty. Your plan provider usually sends an annual notice stating whether your coverage is considered creditable.

A: No, you cannot have both a Medicare Advantage plan and a Medicare Supplement (Medigap) plan at the same time. Medicare Advantage plans are designed to replace Original Medicare (Part A and Part B) by providing your Medicare benefits through a private insurance company, while Medicare Supplement plans are designed to work alongside Original Medicare to help cover out-of-pocket costs such as deductibles and coinsurance. Medicare rules do not allow a Medicare Supplement plan to be used with a Medicare Advantage plan. A Supplement plan is designed to work only with Original Medicare (Part A and Part B) to help cover deductibles, coinsurance, and other out-of-pocket costs. If you enroll in a Medicare Advantage plan, you would not be able to use a Medicare Supplement policy at the same time.