Medicare FAQ

Medicare Advantage and Part D benefits change each year. This means your premiums can increase and your benefits may change. Some common reasons you may want to change your coverage are: your monthly premium is increasing, the Medicare Advantage plan no longer has your doctor in the network of your plan, or the drug formulary drops your medication off the list of covered drugs. You'll receive an Annual Notice of Change (ANoC) in September from your carrier. The ANoC will explain any changes happening to your current policy that will take effect the following year. If you're unhappy with the changes shown in your ANoC, you can change your coverage during the Annual Enrollment Period. Our team of AAA Licensed Insurance Agents can help you review your options.

Medicare Advantage and Part D benefits change each year. This means your premiums can increase and your benefits may change. Some common reasons you may want to change your coverage are: your monthly premium is increasing, the Medicare Advantage plan no longer has your doctor in the network of your plan, or the drug formulary drops your medication off the list of covered drugs.

You'll receive an Annual Notice of Change (ANoC) in September from your carrier. The ANoC will explain any changes happening to your current policy that will take effect the following year.

If you're unhappy with the changes shown in your ANoC, you can change your coverage during the Annual Enrollment Period. Our team of AAA Licensed Insurance Agents can help you review your options.

No, Original Medicare doesn't cover routine dental, vision, and hearing services, but many Medicare Advantage plans do. You can also buy dental, vision, and hearing coverage separately. Consider your needs and the available coverage as part of your overall evaluation of Medicare Advantage plans. See the Medicare 101 page on our website for more information on deciding how you want to receive your Medicare Coverage.

You're Medicare-eligible when you reach age 65 or receive Social Security benefits for 24 months. You can also enroll if you've been diagnosed with ALS (automatic enrollment) or ESRD (self-enroll). If don't plan to retire at 65, check out the Working Past 65 section of our website.

If you're already collecting Social Security or Railroad Retirement benefits before your 65th birthday, you don't need to do a thing. You'll be enrolled automatically and will receive your Medicare card by mail. If not, you can easily sign up online or by phone

When you enroll depends on your personal situation and whether you'll be working past age 65. For more information on when to enroll, visit the Medicare 101 page on our website. To discuss your personal Medicare timeline with one of our AAA Licensed Insurance Agents, please call us at (877) 477-7120. (By calling, you agree that a AAA Licensed Insurance Agent may contact you.)

More and more Americans are choosing to work past the typical "retirement age" of 65. Medicare eligibility begins at age 65 and signing up on time helps you avoid lifetime penalties. If you're working past 65, you may have bit more leeway, but it depends on your company's size and health care plan. If you have questions, our AAA Licensed Insurance Agents can help. Just call us at (877) 477-7120. (By calling, you agree that a AAA Licensed Insurance Agent may contact you.)

Medicare Advantage plans and Medicare Supplement Insurance (also known as Medigap) are offered by private, Medicare-approved health insurance companies, and you must pay your Medicare Part B premium in addition to any monthly premium for the plan. See the Coverage Options section of our website for more details and a comparison of the benefits these popular plans offer.

The Medicare Giveback Benefit is a Part B premium reduction offered by some Medicare Part C (Medicare Advantage) plans. If you enroll in a Medicare Advantage plan with this benefit, the plan carrier will pay some or all of your Part B monthly premium. Amounts can range from $0.10 in some counties up to the full standard premium for the year. To be eligible, you must be enrolled in Medicare Parts A and B and pay your own Part B premium. If you receive Medicaid or any government assistance that helps pay your Part B premium, you are NOT eligible. Our AAA Licensed Insurance Agents can help you determine which plans in your area offer this benefit.

In general, if you have Medicare and retiree insurance, Medicare will pay your health care bills first. In this case, your group coverage is your secondary insurance, similar to a Medicare Supplement policy. To get full benefits from your retiree insurance, you'll want to enroll in Medicare Part A and Part B when you become eligible.

You'll also want to make sure that your retiree insurance includes creditable coverage for prescription drugs. If you like your employer drug coverage and it counts as creditable coverage, you can keep it and won't need to enroll in a Part D prescription drug plan. However, if you don't have creditable drug coverage, it's best to enroll in Part D as soon as you're eligible to avoid penalties. Each employer plan is different, so contact your human resources representative for more details. For more information, see the What To Do About Part D Coverage section of our website.

If you're considering dropping your retiree insurance for Medicare, you can. Remember, though, ineligible spouses and dependents can't enroll with you. They'll lose their coverage through your employer's plan if you disenroll.

Medicare is always primary if it's your only form of coverage. When you introduce another form of coverage into the picture, there's a predetermined coordination of benefits. The coordination of benefits will determine what form of coverage is primary and what form of coverage is secondary. The primary coverage will pay first, and the secondary coverage pays second. Below, we'll go over scenarios when Medicare is primary and when it's secondary.

For the most part, when you have more than one form of coverage, Medicare is primary. Some examples include having group coverage through a smaller employer, COBRA, being on inactive duty with TRICARE, or Medicaid. Usually, secondary insurance will only pay if the primary insurance paid its portion first. Still have questions? Our AAA Licensed Insurance Agents can help you decide what's best in your individual situation.
 

• Group coverage through a small employer
   
• COBRA — There are scenarios when you'll have Medicare & COBRA at the same time. The majority of the time, Medicare will be primary, and COBRA will be secondary. The exception to this is if your group coverage had special rules that determined who the primary payer is.
  
  It's not common for COBRA to be the better option for an individual who's eligible for Medicare. This is because COBRA costs more money than Medicare. Once you enroll in Medicare, you can drop your COBRA coverage.
  
  Another key fact to know is that COBRA is not considered creditable coverage. If you're eligible for Medicare and do not enroll, you'll incur late enrollment penalties since COBRA is not considered as good as Medicare. You'll need to enroll in Medicare within the first 8 months you have COBRA even if your COBRA coverage is active longer than 8 months.
   
• Retiree Coverage — When your group employer insurance continues to provide your health insurance after you retiree, this is called retiree coverage. In this scenario, Medicare is primary and your retiree coverage is secondary. Often retiree coverage will include prescription drug coverage. If this is the case for you, you probably won't need to enroll in a Part D prescription drug plan, as long as you have creditable coverage. 
   
• TRICARE for Life — When military retirees and their spouses are eligible for Medicare, they become eligible for TRICARE for Life (TFL). For any care you receive at a non-military facility, Medicare will pay first, so you need to enroll in Part A and Part B when you become eligible.
  
  TFL includes creditable coverage for prescription drugs, so you don't need to enroll in Part D. Some TFL beneficiaries choose to enroll in a Medicare Advantage plan due to the extra benefits they may offer, including dental, hearing and vision benefits. In addition, TFL will help cover some of the out-of-pocket costs that come with Medicare Advantage plans.
   
• Medicaid — Medicaid is a state-run federal assistance program created to assist those who are considered low income. When you become eligible for Medicare and are also eligible for Medicaid, you're considered dual-eligible. When you're dual eligible for both Medicare and Medicaid, Medicare is your primary payer. Medicaid will not pay until Medicare has paid first.
  
  If you need assistance covering the costs of Part B and Part D and are dual-eligible, you could qualify for a Medicare Savings Program to assist you with these costs. Always make sure your provider accepts both Medicare and Medicaid before seeking care.

Once you sign up for Medicare, you're no longer eligible to contribute to a health savings account (HSA), so in some cases, it pays to hold off on enrolling.

Health savings accounts offer a great opportunity to sock away funds on a tax-free basis to pay for healthcare costs during your working years and retirement. Often confused with flexible spending accounts, HSAs do not require you to use up your plan balance year after year. In fact, the value of the HSA lies in your ability to invest your contributions and grow them into a larger sum over time. That way, when retirement rolls around, you'll have savings specifically earmarked for medical expenses.

However, if you're enrolled in Medicare, you'll no longer be eligible to contribute to an HSA. Enrolling in Medicare, however, does not bar you from taking withdrawals from an existing HSA. That money is there to cover qualified healthcare expenses, and you can use those funds to pay for your premiums, deductibles, coinsurance payments, or prescription copays. In some cases, you can even use the money in your HSA to purchase long-term care insurance. 

In some cases, you may want to stop contributing six months prior to when you plan to enroll in Medicare. Once you sign up for Part A, you're entitled to up to six months of retroactive coverage (going back only to your eligibility date), so if you don't halt your HSA contributions half a year prior to enrolling, you may be subject to tax penalties on the funds you put into your HSA during that time.

If you have an HSA and are unsure about when to enroll in Medicare, our AAA Licensed Insurance Agents are here to guide you. Just call us at (877) 477-7120. (By calling, you agree that a AAA Licensed Insurance Agent may contact you.)