Frequently Asked Questions

Medicare is only automatic if you are currently receiving social security benefits. You will automatically enrolled in Part A and Part B. 

If you are not receiving Social security, you will need to enroll in Medicare.  You can enroll only in Part A, or Part A and Part B.

If you are currently employed by a company that has more than 50 employees you do not need to enroll in Part B.  You will get a special election when you stop working that will allow you to enroll without a penalty.

Make sure you check with your companies policies.

Yes, anyone that is enrolled in BOTH Part A and Part B will need to enroll in a prescription drug plan.  If you don’t enroll when your Part B is effective, when you do enroll in an RX plan, you will be charged a lifetime penalty. 

Medicare Part B (Medical Insurance).

Penalty: Your monthly premium may go up 10% for each 12-month period you could have had Part B but didn’t sign up.

Example: If you waited 2 full years to enroll, your premium could be 20% higher for as long as you have Part B.

Medicare Part D (Prescription Drug Plan) Penalty: T

Penalty: 1% of the “national base beneficiary premium” ($34.70 in 2024) for each full month you were without Part D or other creditable prescription drug coverage. This penalty is added to your monthly premium for as long as you have Medicare Part D.

Example: If you were without Part D or creditable drug coverage for 20 months, your penalty would be 20% of $34.70, which adds an additional $6.94 to your monthly premium.

Enrollment In Medicare is done through social security.

NEW TO MEDICARE: If you are enrolling for the first time during your initial enrollment period, you can enroll online at ssa.gov or call social security to schedule a phone appointment.  Online, you can enroll only in Part A or both Part A and Part B.

LOSING CREDIBLE COVERAGE: If you are past your initial enrollment period, you will need to have your employer fill out CMS-L564 ER, which can be found at cms.gov . (can I link to this form or tell them where to get it?)

You will need to fill out CMS-40B, which can be found at cms.gov.

Once both forms are filling out, you can upload them online, fax them to your local social security office, or drop off at your local social security office.

It’s important TO BE working the “free” stuff shown in Medicare commercials generally refers to extra benefits provided by Medicare Advantage plans, not by Original Medicare. These plans are not designed for everyone and many have income requirements, are only offered in certain zip codes and can be misleading to the average consumer. 

Consider that the commercials are national and not apply to you.  It’s important not to be working with a trusted person that can address your specific healthcare needs.

I offer you the opportunity to speak directly to one person and not an 800 number or customer service representative from an individual carrier. 

I will gather information from you; your doctor’s and prescription medications and will ask you questions regarding your wants and needs.

Most importantly, I will educate you about how Medicare works and what all your options are so that you can narrow down your choices and make an educated decision.

How My Medicare Enrollment Services Work — At No Cost to You

I understand that navigating Medicare can feel overwhelming, but that’s where I come in. I offer my services to guide you through the Medicare process, and here’s how it works:

1. No Fee for My Service:
   • You do not pay me anything for helping you choose and enroll in a Medicare plan. My services are completely free to you. Whether it’s explaining your options, helping you compare plans, or handling the enrollment process, there is no out-of-pocket cost for working with me.
2. How I’m Compensated:
   • When you choose a Medicare Advantage, Supplement (Medigap), or Part D plan through me, I am compensated directly by the insurance company. They pay me a commission for helping you enroll.
   • This payment from the insurer has no effect on your premiums or plan costs. You pay the same price whether you sign up through me, go directly to the insurance company, or enroll online.
3. No Difference in Price:
   • The cost of your Medicare plan will not change based on how you enroll. By working with me, you get the same rates as if you had gone directly to the insurer. The difference is that I’m here to give you personalized support and make sure you’re choosing the best plan for your needs.
4. My Role Is to Guide You:
   • My goal is to help you navigate the complexities of Medicare, so you don’t have to do it alone. I take the time to understand your unique situation—your health needs, budget, and preferences—and guide you to the plan that’s the right fit.
   • I’m available to answer your questions not just during enrollment but throughout the year, ensuring you continue to get the most out of your coverage.

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary).   The formulary must cover at least 2 medications in any therapeutic category.  For example: if  there are 6 medications that fall into a category, you might see some plans not listing your specific medication on their formulary.

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