Medicare FAQ's

This depends on several factors and with a quick call to our office we can better advise you.

However, in a nutshell, if your employer has under 20 employees you will absolutely need Parts A and B of Medicare as it will be “primary” coverage. Meaning Medicare pays before your employer plan pays on a claim. If you do not have Medicare in place, then your employer plan will not pay anything toward your expenses.

Also, Medicare and HSA’s (health savings accounts) do not play well together so if you have an HSA we should discuss this in more detail.

This depends on several factors:

• What does your current health plan cover?
• Does this coverage meet your needs?
• Are you paying for the coverage or is your employer?
• If you are paying for the coverage, is it more expensive than Medicare would be?
• Do you have a spouse that is on your employer’s policy that would be impacted by a change?

Probably. There are a few things to consider as you look at Medicare and the VA:

• Do you have TriCare for Life coverage?
• Are you getting your medications through the VA?
• Would it be more convenient to work outside of the VA system?
• Are you experiencing issues with the referral process or unable to get in to see your VA physician in a timely manner?
• Would you like to see both civilian and VA physicians?

For instance, many Medicare Advantage plans offer “zero premium” policies (that’s right, it will not cost you a penny!) if you access your medications through the VA. These zero premium plans will offer you access to civilian care without jumping through the referral process required by the VA. The VA is a fantastic option, and we can very easily enhance these benefits at little or no cost to you.

No. You can enroll onto Medicare and elect Social Security at a later date.

Medicare really encourages you to have a drug plan. If you have coverage through your employer or the VA, you may not need any additional coverage. Be aware, if you choose to go without prescription coverage, Medicare has a penalty for late enrollment.

However, there are some very affordable prescription plans that will satisfy this requirement without breaking the bank. We are happy to provide you with the available options.

Nothing, these terms are synonymous, and Medicare uses both terms interchangeably.

Both are very popular options, but it is an individual decision based on many factors (Are you a snowbird? Do you have VA coverage? Which physicians and clinics will you use?).

In a nutshell, Medicare Advantage plans have medical and prescription benefits rolled into one policy and typically have “extras” such as vision, dental, gym memberships and alternative care (acupuncture, chiropractic and naturopath). These premiums tend to be lower in exchange for copays as you seek medical services. These plans are often HMO’s so we need to make sure your physician is contracted accordingly.

Medigap policies have a small deductible and typically do not have copays for any services however the higher premiums reflect the benefit level. These policies do not include the “extras”. Medigap policies are medical only and would have to be paired with a prescription plan.

These plans are “apples and oranges” so we should review your specific needs to determine the best fit.

Yes. Every October 15^th through December 7^th we will assist you in reviewing your current plan. If warranted we can change your plan for the following year.

Maybe. Medicare plans vary state to state and even county to county. A simple change in your zip code will determine the plans available to you.