FAQ’s

1) What company do you work for?

Medicare Insurance Advisors is a truly independent Medicare health insurance agency. We represent only the top-rated insurance carriers that offer Medicare Advantage, Medicare Supplement & Prescription Drug Plan insurance. We will first find out what is most important to you about your health insurance coverage, then impartially shop to find you the best price & benefit design for your Medicare health insurance.

2) What is Medicare?

Medicare is a federal health insurance program for people 65 years of age or older and certain people with a disability or end-stage renal disease (permanent kidney failure). It pays for much of your health care, but not all of it. There are some costs that you will have to pay yourself. These are called out-of-pocket costs. Costs that you must pay, like coinsurance, co-payments, and deductibles, are called “gaps” in original Medicare plan coverage.

3) What are Part A and Part B of Medicare? 

Part A is Hospital insurance. This helps pay for inpatient hospital care, some skilled nursing facility care, hospice care, and some home health care. Part B is Medical insurance. This helps pay for doctors’ services, outpatient hospital care, and some other medical services that Part A doesn’t cover. Part B also helps pay for such covered services and supplies when they are medically necessary. Our licensed experts can explain this in detail, and make it very easy to understand, please call us and we will help you navigate through Medicare. 

4) How do I enroll in Medicare? 

You’ll be automatically enrolled in Medicare when you turn 65 if you’re already receiving Social Security benefits, or when you apply for Social Security benefits at age 65. In either case, the Social Security Administration will notify you that you’re being enrolled. Although there’s no cost to enroll in Medicare Part A (Hospital Insurance), you’ll pay a premium to enroll in Medicare Part B (Medical Insurance). If you’ve been automatically enrolled in Part B, you’ll be notified that you have a certain amount of time after your enrollment date to decline coverage. Even if you decide not to enroll in Medicare Part B during the initial enrollment period, you can enroll later during the annual general enrollment period that runs from January 1 to March 31 each year. However, you may pay a slightly higher premium as a result. If you decide to postpone applying for Social Security past your 65th birthday, you can still enroll in Medicare when you turn 65. The Social Security Administration suggests that you call (800) 772-1213 three months before you turn 65 to discuss your options. You can apply by visiting your local Social Security office. If you are unable to visit your local office, you may be able to enroll over the phone. 

5) Do I have to be enrolled in Medicare Part A and B to get supplemental insurance? 

Yes, you must be enrolled in both Medicare Part A and B to be enrolled in either a Medicare Supplement plan or a Medicare Advantage plan. 

6) What is Medicare Advantage (Part C)? 

Medicare Advantage, also known as Medicare Part C, is a combination health insurance policy that includes all of the Part A and Part B coverage together. Medicare Advantage plans are administered by private insurance companies and can include coverage for vision care and dental care, along with doctor visits. 

Medicare enrollment for Medicare Advantage plans is not automatic. You will need to enroll through a private insurance company during the Medicare enrollment period. Each Medicare Advantage provider has different plans and options and this also functions as a privatized version of the individuals’ Medicare coverage. The Medicare Advantage provider will manage all the programs and the policyholder will have only a single card to carry. Several different types of Medicare Advantage plans are available to choose from such as HMOs (Health Maintenance Organization), PPOs (Preferred Provider Organization) and other types as well. 

7) What is Medicare Part D or the Drug Card? 

Starting January 1, 2006, new Medicare Part D drug coverage was available to all Medicare recipients. All Medicare recipients can get this coverage that can help lower drug costs and help protect against higher costs in the future. Medicare Part D drug coverage is a Medicare program run through private insurance companies. 

You choose the drug plan and pay a monthly premium. Like Medicare part B insurance, if you decide not to enroll in a drug plan when you are first eligible, you will pay a penalty if you choose to join later. 

If you delay taking and don’t take Medicare part D when you are initially eligible your premium cost will go up at least 1% per month for every month that you wait to join. You will have to pay this penalty as long as you have Medicare drug coverage. If you join by December 31 in any year your coverage will begin January 1 of the next year. There are two ways to get Medicare prescription drug coverage: 

1. Join a Medicare Prescription Drug Plan. These plans, often known as “Part D Plans” or “PDPs” add prescription coverage to Medicare Part A and Medicare Part B and Medicare Advantage Plans without Prescription Coverage. They are sponsored by private insurance companies who contract with and are paid by Medicare. Most plans charge an additional premium to Medicare Recipients enrolled in the plan. 

2. Join a Medicare Advantage Plan (like an HMO or PPO) or another Medicare health plan that includes prescription drug coverage. These plans replace Medicare Part A and Medicare Part B and are sponsored by private health insurance companies. They also contain prescription drug coverage. 

8) What is a Medicare Supplement plan? 

A Medicare supplement insurance plan or “Medigap” policy is a health insurance policy sold by private insurance companies. These Medicare supplement plans must follow federal and state laws. These laws protect you. The front of the Medicare supplement insurance plan material must clearly identify it as a “Medicare supplement insurance” plan. 

You might want to consider buying a Medicare Supplement plan to cover the above described gaps in Original Medicare coverage. Some Medicare supplemental plans also cover benefits that the Original Medicare Plan doesn’t cover, like emergency health care while traveling outside the United States, At Home Recovery Services, and Preventive services that might not otherwise be covered by Medicare. A Medicare Supplement insurance plan may help you save on out of pocket costs. If you buy a Medicare supplemental insurance plan, you will pay a monthly premium to the private Medicare supplement insurance company that sells you the policy. Medicare supplement plans do not have an open enrollment period. This allows you to switch another Medicare supplement plan at any point throughout the year as long as you qualify medically. 

9) Why do I Need a Medicare supplement or “Medigap” policy? 

You may need to supplement Medicare Coverage for one or more of the following reasons: 

• Medicare was never designed to pay all the health care costs of Medicare beneficiaries.
• Medicare coverage has many gaps, a Medicare supplement policy will help cover these gaps.
• Medicare deductibles may increase on an annual basis. 

10) How do I get a quote for Medicare Supplement Coverage? 

Request Information or for faster service call us toll free at 1-877-993-1990. We can help you understand how the various plans we offer work, and help you select from many different insurance companies. 

11) How do I enroll in a Medicare Supplement policy? 

All companies have an application process that each individual client needs to fill out. If you are in your guaranteed issue period then you do not need to answer the health medical questions. After you fill out the application and send it back to us for review, we will sign the application and get it to the carrier for processing. It takes 3-4 weeks to process applications and once processed we will let you know of the status. Each carrier will then send you out a copy of the policy in the mail for you to keep. 

12) When is Medicare’s Initial Enrollment Period? 

The Initial Enrollment Period begins 3 months before the month a beneficiary turns 65 and ends 3 months after the month the beneficiary turns 65. If beneficiaries wait until they are 65 or sign up during the last 3 months of the Initial Enrollment Period, their Medicare Part B start date will be delayed. 

13) What are “open enrollment” and “guaranteed issue” in Medicare? 

Open enrollment: allows the applicant to be guaranteed a Medicare supplement insurance plan regardless of their current or past health history. Otherwise, the applicant must meet medical underwriting standards to qualify if required by the insurance company. 

Guaranteed issue rights: (also called “Medigap protections”) are rights you have in certain situations when insurance companies are required by law to offer you certain Medigap policies even if you have health problems and must cover any pre-existing conditions. In these situations, an insurance company must do the following: 

• Sell you a Medigap policy
• Cover all your pre-existing health conditions
• Can’t charge you more for a Medigap policy because of past or present health problems 

14) What is the Medicare Supplement “open enrollment” period? 

The 6-month period that begins the first day of the month in which a beneficiary is both age 65 or older and enrolled in Medicare Part B. During this period, an insurance company can’t do any of the following: Refuse to sell you any Medigap policy it sells, Make you wait for coverage to start, or Charge you more for a Medigap policy because of your health problems. 

15) What if I missed my open enrollment Period? 

There is no open enrollment period if you are over age 65 and have been enrolled in Medicare Part B more than 6 months. You may apply for a Medicare Supplement policy, but you will be subject to medical underwriting and a pre-existing condition waiting period or exclusion. If you fail to meet the Medicare Supplement policy health standards, the company does not have to insure you. This same situation may arise if you drop your current Medicare Supplement policy. There is no guarantee that you can get another policy except in very limited situations (see below). Also if you are under age 65 and receive Medicare because you are disabled, you are not eligible for open enrollment and must meet a company’s medical standards to purchase a Medicare Supplement policy. 

16) What are the different situations that one can be in to get “guaranteed issue” for Medicare Supplement? 

Losing Medicare Advantage coverage
If you’re currently in a Medicare Advantage (Medicare Part C) plan, you can still qualify for Medigap if (1) your insurance provider decides to stop offering Medicare policies, or (2) your plan stops providing care or services in your area, or (3) you are moving out of your Medicare Advantage plan’s coverage area. However, you can only get Medigap in such situations IF you transfer to an “original” Medicare plan (Parts A and B) — not into a new Medicare Advantage program. 

Losing other supplement program
Many seniors are currently in a Medicare Parts A and B plan, but receive additional coverage from a union health plan or employer-provided group health plan. Those plans act much like Medigap and pay many of the expenses that are not covered by Medicare. If those other plans should end, you can obtain a Medigap policy even outside the mandated Medigap open enrollment period. 

Losing Medicare Select
A Medicare Select policy is a type of Medigap option that can offer lower Medigap premiums and fees — as long as you use the plan’s network of hospitals and physicians. If you move out of your Medicare Select plan’s coverage area, you can replace Medicare Select with a standard Medigap plan offered in your state. 

End of trial period
Medicare offers seniors the right to certain “trial’ periods of Medicare Advantage (Part C) plans, which are offered by private health insurance providers. For example, if a 65-year-old senior citizen opts for a Medicare Advantage plan instead of an Original Medicare Part A and B program, the first year may be considered a trial period. They can switch to an Original Medicare (Parts A and B) plan any time that first year—and obtain a Medigap plan as well. Similarly, if you drop your Medigap plan to join a Medicare Advantage program (for the very first time), you have one year to switch back to the original Medicare (Parts A and B) program—with Medigap. 

Failure of Medigap provider
If your Medigap provider goes bankrupt or hasn’t followed the rules (or misled you), you may switch to a different Medigap plan offered in your state. 

17) Do I have to wait to switch to a different Medicare supplement policy? 

No, but the length of time you’ve had your Medicare supplemental plan will affect how your new Medicare Supplement policy covers you for pre existing conditions. If you’ve had a Medicare Supplement insurance plan for at least six months and you decide to switch, your new Medicare supplemental insurance plan must cover you for all pre existing conditions. If you’ve had a Medicare supplemental insurance plan for less than six months, the new Medicare supplement policy must give you credit for the time the older policy covered you. 

18) What happens to my Medicare supplement plan if I move? 

Because your Medicare supplemental insurance plan is guaranteed renewable, you will still have insurance coverage if you move. If you move to a new state, however, the Medicare supplement insurer may quote you a different premium. If you have a Medicare Select insurance plan, which contain network restrictions, you must change your Medicare insurance coverage. But you have the right to buy Medicare supplemental insurance plans A, B, C, F, K, or L in the state you move to without having to medically qualify. 

19) Can a Medicare supplement Policy Be Canceled? 

No. All Medicare supplement policies are guaranteed renewable, no matter how many claims you file, but a company can cancel if you do not pay premiums or give false information of a material fact on your application. If you want to switch policies, don’t cancel your first Medicare supplement policy until the second one is in place and you have reviewed it and decided to keep it. You have 30 days to return the policy and receive a full refund.

Medicare Insurance Advisors is an independent insurance brokerage specializing in health insurance services. We represent many reputable health insurance providers and offer a wide variety of insurance products, including Medicare Advantage, Medicare Supplement, and Prescription Drug Plans. Our Advisor “consultations” are provided at NO COST to you.