Medicare Frequently Asked Questions

Not necessarily. If you or your spouse are still actively working and you're covered by an employer group health plan, you may be able to delay Part B without a late-enrollment penalty.

The rules depend on the type of employer coverage you have and, in some cases, the size of the employer. That's why we recommend checking with your employer's benefits or HR department before making a decision.

Some people enroll in premium-free Part A and delay Part B while they continue working. Others enroll in both Medicare Parts A and B and coordinate Medicare with their employer coverage.

One important exception: if you contribute to a Health Savings Account (HSA), enrolling in Medicare can affect your ability to continue making HSA contributions. Check before enrolling.

For most people, yes. If you or your spouse worked and paid Medicare taxes for at least 40 quarters — generally 10 years — you usually qualify for premium-free Part A.

In 2026, people with 30–39 quarters of Medicare-covered work may purchase Part A for $311 per month. People with fewer than 30 quarters may pay $565 per month.

These amounts can change each year, so we always verify the current Medicare figures before someone enrolls.

The standard Medicare Part B premium is $202.90 per month in 2026.

Some higher-income beneficiaries pay more because of the Income-Related Monthly Adjustment Amount, commonly called IRMAA.

On the other hand, people with limited income and resources may qualify for a Medicare Savings Program through their state. Depending on eligibility, these programs can help pay the Part B premium and sometimes other Medicare costs.

This is one of the questions we hear most often, especially because of television and phone advertisements.

Original Medicare does not provide a general “food card.” Some Medicare Advantage plans may offer grocery, healthy-food or similar supplemental benefits to people who meet specific eligibility requirements.

These benefits are often associated with certain Dual Eligible Special Needs Plans for people who have both Medicare and Medicaid, or with certain plans that provide additional benefits to qualifying members with chronic health conditions.

Eligibility, benefit amounts, covered items and participating stores vary by plan and by individual circumstances.

Seeing a television advertisement does not mean everyone with Medicare qualifies for the advertised benefit. We can check the actual plan rules before you make any changes.

Unfortunately, there is no perfect way to stop every unwanted call.

You can register your number with the National Do Not Call Registry and use your phone carrier's spam-blocking tools, but illegal callers and scammers may ignore those protections.

Never give your Medicare number, Social Security number, banking information or other personal information to an unexpected caller just because they claim to represent Medicare or an insurance company.

Our advice to our customers is simple: if somebody calls with an offer that sounds too good to be true, don't feel pressured to make a decision. Hang up and call us. We'll help you check the facts.

First, don't assume you've missed your only opportunity. You may qualify for a Special Enrollment Period depending on your circumstances, particularly if you had qualifying coverage through current employment.

If you don't qualify for a Special Enrollment Period, Medicare's General Enrollment Period runs from January 1 through March 31 each year. Coverage generally begins the month after you enroll.

A late-enrollment penalty may apply if you went without qualifying coverage when you were eligible for Medicare.

Before assuming you'll owe a penalty, let us look at your circumstances. Enrollment rules depend on what coverage you had and why you delayed Medicare.

There may be opportunities to make a change.

If you're already enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs from January 1 through March 31 each year. During that period, you can generally make one change to another Medicare Advantage plan or return to Original Medicare.

People newly enrolled in Medicare Advantage also have a Medicare Advantage Open Enrollment opportunity during the first three months they have Medicare.

Medicare's annual Open Enrollment Period runs from October 15 through December 7. Changes made during that period generally begin January 1.

Certain life events may also give you a Special Enrollment Period at other times of the year.

This is an important question because Medicare Supplement — also called Medigap — enrollment rules are different from Medicare Advantage rules.

If you joined a Medicare Advantage plan when you were first eligible for Medicare at age 65 and decide within your first 12 months that you want to return to Original Medicare, you may have a Medicare “trial right” that gives you special rights to purchase certain Medigap policies.

A separate trial right may also apply if you previously had a Medigap policy, dropped it to try Medicare Advantage for the first time, and return to Original Medicare within 12 months.

Outside of a guaranteed-issue or trial-right situation, an insurance company may be allowed to use medical underwriting when you apply for Medigap, depending on applicable rules.

Don't cancel a Medicare Advantage plan until you understand whether you can obtain the Medigap coverage you want and when each coverage will begin.

Start by finding out exactly why the claim or service was denied.

In our experience, some problems turn out to be relatively simple issues — a billing or coding mistake, a claim sent to the wrong insurance company, missing information, or a prior-authorization issue. Sometimes the doctor's billing office can review and resubmit the claim.

But a true coverage denial is different. If Medicare, a Medicare Advantage plan or a Medicare drug plan refuses to cover or pay for something you believe should be covered, you have appeal rights.

Call us before assuming the bill is final. We can help you understand what happened and determine the appropriate next step.

First, check the plan's formulary — its list of covered drugs. In many cases there may be another covered medication in the same therapeutic category that your doctor believes is appropriate for you.

Medicare Part D formularies are generally required to include at least two drugs in each approved category and class, with certain exceptions and additional protections for particular drug classes.

If the medication your doctor believes you need isn't covered, your doctor or other prescriber can request a formulary exception. The prescriber will generally need to explain why the requested drug is medically necessary or why covered alternatives aren't appropriate for you.

Don't simply assume you're stuck paying full price for a non-covered medication. Call us and we'll help you understand the plan's formulary and exception process.