Top 7 Most Common Medicare Questions

1. What Is Medicare and How Does It Work?

Medicare is a federal health insurance program primarily for individuals 65 and older, though some people under 65 may qualify due to certain disabilities.

Medicare consists of two main parts:

• Part A (Hospital Insurance): Covers hospital stays, skilled nursing facilities, hospice, and some home healthcare services.
• Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and medical supplies.

Additionally, there are two optional parts:

• Part C (Medicare Advantage): A private insurance alternative to Original Medicare that often includes additional benefits like prescription drug coverage, dental, and vision.
• Part D (Prescription Drug Coverage): Helps cover the cost of prescription medications.

2. What Does Medicare Cost?

• Part A is free if you’ve worked at least 10 years and paid Medicare taxes.
• Part B has a standard premium, which in 2025 is $185.00 per month. Your premium may be higher if your income exceeds a certain threshold.
• Part C and Part D costs vary depending on the plan you choose.
• Additional costs include deductibles, co-pays, and co-insurance.

3. When and How Do I Sign Up for Medicare?

You have a seven-month window to enroll in Medicare, known as the Initial Enrollment Period (IEP):

• 3 months before your 65th birthday
• Month of your 65th birthday
• 3 months after your 65th birthday

If you are still working and have employer coverage, you may delay Part B without penalty. However, if you don’t have employer coverage, missing your IEP could result in late enrollment penalties.

4. What’s the Difference Between Medicare Supplement and Medicare Advantage?

Medicare Supplement (Medigap)

• Works alongside Original Medicare and covers costs like deductibles, co-pays, and co-insurance.
• No network restrictions – see any doctor nationwide that accepts Medicare.
• Higher monthly premiums (typically $100+ per month).
• Requires separate Part D plan for prescription coverage.

Medicare Advantage (Part C)

• Replaces Original Medicare and acts as your primary insurance.
• Includes network restrictions (HMO/PPO plans).
• Often $0 premium, but includes co-pays and out-of-pocket maximums.
• Many plans include prescription drug, dental, and vision coverage.

5. Do I Need a Medicare Supplement or Medigap Policy?

Original Medicare covers about 80% of medical costs, leaving you responsible for the remaining 20%, with no cap on out-of-pocket expenses.

A Medicare Supplement policy helps cover that 20% and provides peace of mind by limiting unexpected costs. If you choose Medicare Advantage instead, you cannot have a Medicare Supplement policy.

6. Does Medicare Cover Dental and Prescription Drugs?

• Prescription Drugs (Part D): Not included in Original Medicare. You must enroll in a separate Part D plan or choose a Medicare Advantage plan with drug coverage.
• Dental & Vision: Original Medicare does not cover routine dental and vision care. However, many Medicare Advantage plans include dental, vision, and hearing benefits.

7. Can I Delay Medicare If I’m Still Working?

Yes, if you have employer-sponsored health insurance and your employer has more than 20 employees, you can delay Medicare Part B without a penalty. When you retire, you’ll have a Special Enrollment Period (SEP) to sign up for Medicare without facing late enrollment penalties.

Get Expert Help with Medicare!

Understanding Medicare can be overwhelming, but you don’t have to do it alone. At Bluewave Insurance, we offer free consultations to help you choose the best Medicare plan for your needs.

Call us at 800-208-4974 for a free Medicare review! Let’s find the right coverage for you.