Medicare FAQs

Below are our frequently asked questions. For more information, please contact us for a consultation.

 

A: Assuming you have met the work-related eligibility requirements, you may begin enrollment into Medicare 90 days in advance of the month you turn 65.
A: Medicare does not have spousal or dependent coverage. Medicare is individual. If your spouse has reached age eligibility (65), then they can enroll in Medicare of their own accord 90 days in advance of the month they turn 65.
A: Maybe. If the employer group has 20 eligible employees or more, and you’re going to continue to work, then yes it’s an option. But there are many things to consider.
A: If you have not filed to receive Social Security benefits, then you may need to proactively enroll in Part “A” and/or Part “B” benefits, if not already issued, and begin paying your premium.
A: Yes. However, you will not have prescription coverage; you will face unlimited exposure to those drug costs, as well as unlimited medical costs due to the gaps built into Original Medicare. When you get Part “D”, you will be assessed penalties for time not covered, that last for life.
A: You usually can. It’s important to be sure your doctor accepts Medicare. Some don’t.
A: No, if it is just a nursing home. Medicare doesn't cover custodial care, if it's the only care you need. Most nursing home care is custodial care, which helps you with activities of daily living (like bathing, dressing, using the bathroom, and eating) or personal needs that could be done safely and reasonably without professional skills or training. This type of care is paid for with a private long term care or recovery care policy; or Medicaid.

Yes, if it is certified skilled nursing care in a nursing facility - for up to 100 days, if: you have Part “A”, if after a qualifying three-day hospital stay, and if you have days in your benefit period. The first 20 days are no cost, and day 21 to 100 have a co-payment.
A: No. But some Advantage plans offer limited dental coverage.
A: No, a retiree plan will typically wrap around Medicare primary benefits.
A: Part “D” is the Prescription Drug plan Medicare introduced in 2006.
A: In addition to having a huge gap in coverage, you will likely face a penalty from Medicare. The Part “B” penalty can be 10% of your Part “B” premium for each 12-month period without credible medical coverage, and a gap in Part D coverage can result in a penalty of up to 1% of the national average of a Part “D” plan for each month without the Part “D” approved coverage.
A: Part “C” is another name for Medicare Advantage coverage. Also named MA, MSA, or MA-PD (when prescription coverage is included).
A: Online at SSA.gov or in person at a local Social Security office. In person is the fastest process for most people.
A: This is a term used by Medicare to describe coverage that is at least as good as Medicare requires. Typically it is used for “Part D” the drug coverage and “Part B” the medical coverage to avoid a “lack of coverage” penalty.

Example:
Veteran’s Administration coverage is not credible coverage for Medicare Part B
Veteran’s Administration coverage is credible coverage for Medicare Part D
A: Depending on the program, there are either premiums or recoveries of spent funds. Each situation is different, so consult with John Spek for “specific to you” details.

In general:
  • Medicare has a premium:
    • for Part B, the Medical coverage, that can revise annually, and is based on your income
    • some people will pay for Part A, because they have not qualified for full benefits