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FAQS
01
Start With the Basics
What is Medicare?
Medicare is a federal health insurance program primarily for individuals age 65 and older. Certain individuals under 65 may qualify due to a disability or specific medical condition.
What are the four parts of Medicare?
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Part A helps cover inpatient hospital care and certain other services.
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Part B helps cover doctor visits, outpatient care, and medically necessary services.
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Part C, also known as Medicare Advantage, is an alternative way to receive Medicare Part A and Part B benefits through Medicare-approved private plans.
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Part D helps cover prescription medications​.
Do I automatically qualify for Medicare when I turn 65?
Most people become eligible at age 65, but enrollment is not always automatic. Whether you need to enroll depends on factors such as whether you're already receiving Social Security benefits.
Can I have Medicare if I'm still working?
Yes. If you have employer-sponsored health coverage, your Medicare enrollment decisions may depend on your employer's size, your existing coverage, and other factors. Delaying enrollment can sometimes result in penalties or gaps in coverage.
02
Medicare Coverage Options
What is the difference between Original Medicare and Medicare Advantage?
Original Medicare is provided through the federal government and includes Part A and Part B. You may also enroll in a separate prescription drug plan and purchase Medicare Supplement insurance if eligible.
Medicare Advantage plans are offered by Medicare-approved private insurance companies. Plans may include prescription drug coverage and additional benefits. Provider networks, costs, and benefits vary.
What is Medicare Supplement insurance?
Medicare Supplement insurance, also called Medigap, helps pay certain costs not covered by Original Medicare, such as deductibles, coinsurance, and copayments. Coverage depends on the standardized plan selected.
Can I keep my doctor?
It depends on your coverage. Original Medicare generally allows you to see providers who accept Medicare. Medicare Advantage plans may use provider networks and have different rules for accessing care.
Does Medicare cover dental, vision, and hearing?
Original Medicare generally does not cover routine dental care, routine vision exams for eyeglasses, or hearing aids. Some Medicare Advantage plans may offer additional benefits. Availability and limitations vary by plan.
03
Enrollment and Costs
When can I enroll in Medicare?
Your Initial Enrollment Period generally lasts seven months: the three months before your 65th birthday month, your birthday month, and the three months after. Different rules may apply depending on how you qualify for Medicare.
When can I change my Medicare plan?
The Medicare Annual Enrollment Period generally runs from October 15 through December 7 each year. Eligible Medicare Advantage members may also make certain changes from January 1 through March 31. Special Enrollment Periods may apply in other circumstances.
Is Medicare free?
No. Medicare may include premiums, deductibles, copayments, and coinsurance. Some individuals qualify for premium-free Part A, but Part B generally has a monthly premium. Actual costs depend on your coverage and circumstances.
Can I get help paying for Medicare?
You may qualify for financial assistance through Medicare Savings Programs, Extra Help, or Medi-Cal. Eligibility requirements apply.
04
Medicare in California
What is California's Medicare Supplement Birthday Rule?
California provides eligible Medicare Supplement policyholders a 60-day period beginning on their birthday each year to switch to certain Medigap policies with equal or lesser benefits without medical underwriting, subject to applicable rules.