Frequently Asked Questions

  • Generally, once you turn 65 or disabled for 24months. You will have had to of paid taxes equivalent to 10years to be eligible for Part A. Part B is paid for by the beneficiary each month from their social security check. If you are not drawing SSI yet, then you have to call social security to enroll and pay quarterly.

  • Visit your local social security office or apply online at www.ssa.gov.

  • An Initial Enrollment Period (IEP) for Medicare is a seven-month window when you first become eligible for Medicare, typically when you turn 65. This period begins three months before your birthday month and ends three months after, allowing you to enroll in Medicare Part A and Part B (Original Medicare). You can also use this time to enroll in Medicare Advantage plans (Part C) or Part D prescription drug plans. Failing to enroll during your IEP may result in late enrollment penalties

  • Medicare Part A premium is $0 for most people who worked and paid Medicare taxes for at least 10 years.

    The Part B premium is $185 (2025) increasing to $206.5 (2026) per month for most people, but higher-income individuals must pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of this

  • A Medicare late enrollment penalty is an added, permanent monthly cost applied to your premium if you don't sign up for Medicare Part B or Part D during your Initial Enrollment Period and don't qualify for a Special Enrollment Period. Part B penalties are typically 10% for each full 12-month period you delayed enrollment, while Part D penalties are 1% of the national base premium for each month you were eligible but didn't enroll in a plan with creditable coverage. Part A has a penalty but most people don't pay a premium for it, so they don't face it. 

    Medicare Part B Penalty 

    • How it's calculated: 10% of the standard Part B monthly premium for each full year you waited.

    • What you pay: The penalty is added to your monthly Part B premium and is paid for as long as you have Part B.

    • When it applies: If you don't sign up for Part B during your Initial Enrollment Period and don't have other creditable health coverage.

    Medicare Part D Penalty

    • How it's calculated:

      1% of the national base beneficiary premium for each month you delayed enrollment in a Part D plan without having creditable drug coverage. 

    • What you pay:

      The penalty is rounded to the nearest $0.10 and added to your monthly Part D premium. 

    • When it applies:

      If you go 63 or more days without Part D or creditable drug coverage after your Initial Enrollment Period. 

    How to Avoid Penalties

    • Sign up on time: Enroll in Parts A, B, or D during your initial enrollment period. 

    • Check for Special Enrollment Periods (SEPs): You may be eligible for an SEP if you have certain qualifying life events, such as losing your employer-sponsored health coverage. 

    • Ensure creditable coverage: If you are not enrolling in Medicare Part D, make sure your other drug coverage is "creditable," meaning it's at least as good as Medicare's. 

  • This is a Medicare term that establishes previous coverage being at least as good as Medicare’s. Typically is in play for Part “D” to avoid penalty.

  • Yes, “Extra Help with Medicare Prescription Drug Cost” is a program through social security that helps to paid for Medicare Part D drug cost for those with limited income and resources. The program helps cover costs like monthly premiums, deductibles, and co-payments, and waives the late enrollment penalty for Part D

    2025, the annual income limits are $23,475 for an individual and $31,725 for a married couple, with corresponding resource limits of $17,600 and $35,130

    Apply: https://www.ssa.gov/medicare/part-d-extra-help

  • A Medicare Advantage HMO plan usually helps pay only for care you receive from providers in the plan network. A PPO plan will generally help pay for care received outside the plan network, but it may pay less than for the same care received within the network.

  • Medicare and Medicaid are both government health care programs, but they are very different. Medicare is generally for people who are 65 or older, or who have a qualified disability. Medicaid is a state-governed program for people with limited income and resources.  Some people are eligible for both Medicare and Medicaid. These people are considered “dual eligible” and are often qualified for special Medicare plans.

  • Medicare Part D does not cover drugs used for cosmetic purposes, weight management, hair growth, or fertility, along with over-the-counter medications, barbiturates, benzodiazepines, and drugs that are already covered by Medicare Parts A or B. Specific exclusions also apply, such as drugs solely for cough and cold symptoms or prescription vitamins and minerals, with exceptions for prenatal vitamins and fluoride preparations. 

  • No, Medicare doesn’t cover vision or dental coverage. Many Medicare Advantage Part C plans have vision, dental and hearing coverage. Medicare Supplements generally do not because if medicare doesn’t cover it then the supplement can’t either due to it being secondary