25 Medicare Q&As You Should Know in 2023

It is common to have many Medicare-related questions running through your mind at any given time. However, finding the answer to these Medicare questions may prove to be more complex than expected. 

In this article, we have compiled a list of the top 25 most frequently asked Medicare questions that our clients are asking our Medicare experts. 

While browsing the list of questions and answers below, we hope that you find this list helpful in answering your most common Medicare questions and maybe even answer some questions you didn’t know you had.

Top 25 Medicare Questions in 2023:

The following are the top 25 most asked questions by you – our clients- to our licensed Medicare agents. These questions are listed in no particular order.

1. Who is Eligible for Medicare?
2. Will I automatically be enrolled in Medicare when I turn 65?
3. Do I need to enroll in Medicare if I work past 65?
4. Is Medicare Supplement and Medicare Advantage the same thing?
5. I delayed Medicare at 65. How do I enroll now?
6. How much does Medicare cost?
7. Can I enroll in Medicare Advantage and Medigap?
8. Do I need to renew Medicare every year?
9. What happens to my Medicare plans when I move?
10. What is the Medicare deductible?
11. Does Medicare cover prescription medications?
12. How do I change my address with Medicare?
13. What if I lose my Medicare Card?
14. Does Medicare cover dentures?
15. Will Medicare cover hearing aids?
16. Do I need Medicare if I have VA benefits?
17. Can Medicare drop you for health reasons?
18. What do I do if I cannot afford my Medicare premiums?
19. What is the difference between Medicare HMO and Medicare PPO?
20. Does Medicare have a network?
21. Am I required to enroll in Medicare?
22. Will Medicare cover all my medical bills?
23. Can I change my Medicare Part D Plan?
24. I enrolled in Medicare Advantage and want a Medigap plan. How can I switch plans?
25. Do Medicare benefits change each year?

Who is Eligible for Medicare?

To be eligible for Original Medicare, you must be a permanent legal resident (green card holder) or an American citizen who has lived in the United States for at least five years AND one of the following: 

• Age 65 or older 
• Under age 65 and receiving Social Security Disability Income for 24 months 

• Diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis 

To enroll in Original Medicare, you may be required to reach out to your local Social Security office in some circumstances.

Will I automatically be enrolled in Medicare when I turn 65?

You will automatically be enrolled in Medicare at age 65 if you are receiving Social Security benefits or railroad retirement board benefits at least four months before you enroll in Medicare. 

However, suppose you are not receiving Social Security benefits or railroad retirement board benefits. In that case, you will need to contact your local Social Security office to enroll in Medicare up to three months before your 65th birth month. 

If you must contact your local Social Security office, you can sign up for Part A and Part B at the same time. Once you complete the application and provide the required documentation, you will begin receiving benefits on the first day of your 65th birth month. 

To complete the application, you can do so online, in person, or over the phone.

Do I need to enroll in Medicare if I work past 65?

While it is not mandatory, we recommend you enroll in Medicare Part A coverage as soon as you become eligible if you qualify for premium-free Part A coverage. However, if you delay Medicare Part A, you will be able to enroll later during the General Enrollment Period or a Special Enrollment Period if you qualify. But, if you delay enrollment to the General Enrollment period, you will be required to pay late enrollment penalties. 

If your employer offers creditable health coverage, you do not need to enroll in Medicare Part B if you are working past age 65. Creditable coverage is healthcare coverage that provides at least equal benefits to Original Medicare. Suppose you do not have creditable coverage and do not enroll in Medicare Part B when you first become eligible. In that case, you may have to pay the Medicare Part B late enrollment penalty as long as you have Medicare Part B. 

Remember that even if you have creditable coverage, it is essential to compare your current plan to Original Medicare with a Medigap plan and Part D. Often, combining these Medicare plans will provide you with the most comprehensive coverage possible.

Is Medicare Supplement and Medicare Advantage the same thing?

Medicare Supplement plans and Medicare Advantage plans are not the same things. While both Medicare Supplement and Medicare Advantage plans bring additional benefits to Original Medicare, they work very differently. Medicare Supplement plans, also known as Medigap plans, work as a secondary to Original Medicare (Medicare Part A and Part B). The plan will only pay after Original Medicare has paid its portion. These plans have no networks, no restrictions, and no referrals to see specialists. 

Medicare Advantage plans, also known as Medicare Part C, on the other hand, become your primary coverage over Original Medicare. They often require you to follow a strict network of doctors and have higher out-of-pocket costs. However, they often provide additional benefits. 

These additional benefits provided by Medicare Advantage plans often include dental, vision, hearing, and prescription drug coverage, as well as transportation assistance and gym memberships. However, not every plan or every carrier is required to offer these additional benefits.

I delayed Medicare at 65. How do I enroll now?

If you delayed Medicare coverage past age 65 with creditable coverage, you would need to contact Social Security to enroll in Original Medicare. 

Since you have creditable coverage, you will receive a Special Enrollment Period to enroll in Medicare Part A and Medicare Part B benefits. From there, you can enroll in a Medicare Part D prescription drug plan and Medicare Part C or Medicare Supplement. 

However, if you delayed Medicare coverage without creditable coverage, you would need to enroll in Original Medicare during the General Enrollment Period. This is an annual period that runs from January 1 to March 31 each year. Remember, coverage does not begin until July 1, when you enroll during the General Enrollment Period. 

How much does Medicare cost?

For most, the Medicare Part A premium is $0 per month. However, if you do not qualify for zero-premium Part A, the premium can be as high as $506. To qualify for zero premium, you must have worked at least 40 quarters or ten years paying Medicare taxes. If you did not meet this qualification, you would be required to pay the Medicare part A premium. 

The standard Medicare Part B premium in 2023 is $164.90. This can increase based on income. This difference in premium reflects your Income Related Monthly Adjustment Amount (IRMAA). 

For example, if you and your spouse make $230,000 combined, you will each pay $230.80 monthly for Medicare Part B. If you are subject to IRMAA, you will receive a determination letter with your new monthly premium.

Can I enroll in Medicare Advantage and Medigap?

It is illegal to enroll in both a Medicare Supplement plan and a Medicare Advantage plan. If you were to enroll in both plans, neither would become your primary coverage, leading to a denial of services. This could leave you paying out-of-pocket for all your healthcare services, regardless of having both coverages. 

To avoid this, it is illegal for an agent to enroll you in one plan if you are already enrolled in the other and do not have a valid way out of the plan.

Do I need to renew Medicare every year?

Original Medicare coverage is automatically renewable each year you are eligible. Thus, you do not need to renew your Medicare parts each year. 

Medicare Supplement plans work the same way, once you are accepted, the plan is automatically renewable as long as you continue to pay the monthly premium. 

Medicare Advantage plans work similarly. However, you have the option to change your plan each year if you do not like the benefits of your current plan.

What happens to my Medicare plans when I move?

If you move to a new city or state, you will need to change your address with Social Security. 

Because Original Medicare is a federal program, benefits are the same nationwide. So, your benefits will not change. 

However, if you enroll in a Medicare Supplement or Medicare Advantage plan, you may be required to choose a new plan or pay a higher (or lower) monthly premium. If you are in the process of moving, our Medicare agents will be able to help you quickly find a new top-rated plan in your area.

What is the Medicare deductible?

Medicare Part A and Medicare Part B have deductibles and costs that change annually. 

In 2023, the Medicare Part A per occurrence deductible is $1,600, and the Medicare Part B annual deductible is $226. 

You must meet these deductibles before the respective Medicare part covers its portion of the services you receive. The Medicare Part A deductible is per occurrence, meaning you could pay that cost multiple times in one year. The Medicare Part B deductible, on the other hand, is annual. Thus, you will only pay it once per calendar year. 

Medicare Part C plans often have an annual deductible that can be different for each plan. You will need to review your plan information to find your yearly deductible. Lastly, Medicare Part D plans have an annual deductible as well. In 2023, the maximum deductible is $505. However, each plan can set its deductible.

Does Medicare cover prescription medications?

Original Medicare does not cover prescription drugs. If you wish to have coverage for prescription Medications, you will need to enroll in Medicare Part D. Medicare Part D helps cover the cost of prescription medications. Additionally, some Medicare Advantage plans provide prescription drug coverage as well. 

If you do not enroll in Medicare Part D, you may be subject to the Medicare Part D late enrollment penalty. This penalty is for those who delay Part D benefits without creditable coverage. You will be required to pay the additional cost as long as you have Medicare Part D.

How do I change my address with Medicare?

To change your address with Medicare, you must contact your local Social Security office and verify your identity. From there, they can change your address on file by answering a few simple questions and providing supporting documentation. 

If you have multiple addresses, you must provide your permanent residence. This is determined by where you spend most of your time throughout the year.

What if I lose my Medicare Card?