Medicare FAQ

Most people first become eligible during their Initial Enrollment Period — the seven-month window that begins three months before the month you turn 65 and ends three months after. People who qualify due to disability or certain conditions may become eligible earlier.

No. Medicare is individual coverage. Each spouse enrolls on their own once they qualify. We can help coordinate the timing of each spouse’s enrollment.

Often yes, but it depends on the employer’s size and how the plan coordinates with Medicare. We can review your situation and help you decide whether to delay Medicare Part B, enroll in Part A only, or transition fully to Medicare.

Most people end up with both. Part A (hospital) is usually premium-free if you or your spouse worked enough quarters. Part B (medical) has a monthly premium and may be delayed in some situations without penalty if you have other creditable coverage.

It depends on the type of plan you choose. With Original Medicare plus a Medicare Supplement you can generally see any provider in the U.S. who accepts Medicare. Medicare Advantage plans use networks, so we will help you confirm whether your doctors are in-network for the plans we represent.

Medicare provides limited skilled nursing facility coverage after a qualifying hospital stay, but it does not pay for long-term custodial care. Long-term care is generally covered by long-term care insurance, Medicaid (if eligible), or out-of-pocket.

If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you may have to wait for the General Enrollment Period and may owe a late enrollment penalty. We can help you understand your options.

Part C is Medicare Advantage — an alternative way to receive your Medicare benefits through a private insurance carrier approved by Medicare. Most plans bundle Parts A, B, and D plus extra benefits.

Part D is the prescription drug benefit. It is offered through standalone Part D plans (often paired with Original Medicare and a Medigap plan) or as part of most Medicare Advantage plans.

Creditable coverage is prescription drug coverage that pays, on average, at least as much as standard Medicare Part D. Maintaining creditable coverage helps you avoid the Part D late enrollment penalty if you delay enrolling in Part D.

No. Health Insurance Options LLC is a licensed independent insurance agency. We are not affiliated with or endorsed by CMS, Medicare.gov, the Social Security Administration, or HHS.