Frequently Asked Questions About Medicare

If you’re not currently collecting Social Security benefits, then yes, you do need to contact Social Security three months before turning 65.

Be ready when the time comes. Give us a call at 877-905-9216, TTY: 711 or visit us at HealthTeamAdvantage.com/contact and tell us when you expect to retire. We’ll get in touch with the information you need to choose the right Medicare plan for your needs when you’re ready.

No. You can wait until you’re ready to move off your (or your spouse’s) employer plan. When you do, you’ll qualify for a Special Enrollment Period and have an 8-month window to sign up for Part B. It begins when your employer or union coverage ends, or when employment ends, whichever is first. Be sure to elect Part B at that time to avoid the late enrollment penalty.

No. Each person must sign up for Medicare individually.

Absolutely not. You can choose any type of plan you want, from any insurance company you want—possibly for the first time in your life. It’s best to look at available plans, speak with your employer group benefits administrator, compare your options, and choose the best value.

Call or visit your local Social Security office or enroll online at ssa.gov.

No. Part D enrollment is different. If you want Medicare prescription drug benefits (Part D), you must enroll in a private insurance plan that contracts with Medicare. You can join either a Medicare Advantage plan that offers combined health and drug coverage in one plan or join a stand-alone plan that covers prescriptions only.

If you fail to sign up for Medicare coverage during your Initial Enrollment Period, you may be subject to the following penalties:

Medicare Part A: 10% late enrollment penalty applied to your monthly premium for twice the number of years you did not have Part A despite being eligible. If you or your spouse paid Medicare taxes while employed, there is typically no Part A monthly premium. Otherwise the monthly premium is $428.

Medicare Part B: 10% late enrollment penalty applied to your monthly premium for each full 12-month period that you did not have Part B despite being eligible. In most cases, this penalty will be added to your monthly premium for the remainder of your enrollment in Medicare. The Part B monthly premium is generally $109–$140 depending on your income. There is a late enrollment fee as well.

Medicare Part D: The late enrollment penalty amount typically is 1% of the national base beneficiary premium for each full, uncovered month you didn’t have Part D or creditable coverage. The national base beneficiary premium for 2020 is $32.74. The monthly penalty is rounded to the nearest $0.10 and added to the monthly Part D premium. The base beneficiary premium changes each year. Medicare uses the current coverage year’s amount to calculate your new penalty amount. In general, once Medicare determines your penalty amount, you’ll continue to owe a penalty for as long as you are enrolled in a Medicare drug plan. This means that even if you join another Medicare drug plan, you’ll still have to pay the penalty once enrolled in a new plan. This also means that if you join a plan that has a $0 monthly premium, you’ll still owe a penalty.

Visit medicare.gov/your-medicare-costs/part-b-costs.html for more information.

It’s best to call Medicare directly at (800) 633-4227 (800-MEDICARE) 24 hours a day, 7 days a week. TTY/TDD users should call (877) 486-2048. Talk with a representative, explain your circumstances, and ask if you can still enroll or need to wait until the next enrollment period.

No. You must be 65 to be eligible for Medicare benefits. The exception is if you are under age 65 and have a qualified disability.

You must contact Social Security to enroll and start your benefits. You could pay a higher premium for late enrollment. If you’re covered under a group health plan based on current employment, you will be eligible for a Special Enrollment Period to sign up for Part A and/or Part B any time as long as you or your spouse is working. You also have eight months starting the month after the employment ends to sign up for Part B without a penalty.

No. Most people will not pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working (10-year minimum). If you don’t meet the requirements and purchase Part A, you will receive a monthly bill from Medicare.

If you are 65 and have credible coverage through an employer, you do not have to sign up for Part B. If you do not have credible employer coverage, you must sign up for Part B or may incur a late enrollment penalty.

Most people pay approximately $145 per month, but if your income is above a certain amount, you could pay more. Medicare revises this amount periodically. Visit medicare.gov/your-medicare-cost/part-b- cost.html for more information.

Yes. You will continue to pay your Part B premium and the monthly premium from your health plan.

Yes. You will pay deductibles, copays, coinsurance and Part B premiums.

No. All people age 65 and older are eligible to receive or purchase Medicare benefits.

Yes. In fact, it’s smart to review your medical needs every year and decide whether your current Medicare plan is working for you. You have the option with Medicare Advantage plans to change once a year during the annual enrollment period (AEP), unless you qualify for a special enrollment period.

Resources

Medicare

Social Security is responsible for determining eligibility and handling enrollment for Medicare. If you are already getting Social Security checks, enrollment into Medicare is automatic. ssa.gov

Call Social Security Administration
800-633-4227
TTY and TDD 877-486-2048
Monday-Friday, 7 a.m.-7 p.m

  • The official Medicare handbook for Medicare programs is updated each year.
  • You can download a copy at the Medicare website, Medicare.gov, or call the Medicare Helpline to request a copy.
  • For online tools to find and compare Drug plans, Medicare Advantage Plans and Medigap Policies go to medicare.gov.

Medicare.gov

Social Security is responsible for determining eligibility and handling enrollment for Medicare. If you are already getting Social Security checks, enrollment into Medicare is automatic. ssa.gov

Call Social Security Administration
800-633-4227
TTY and TDD 877-486-2048
Monday-Friday, 7 a.m.-7 p.m

Seniors’ Health Insurance Information Program (SHIIP)

Get information about Medicare through your local SHIIP program. The organization offers counseling and assistance to people with Medicare and their families.

Call the NC Seniors’ Health Insurance Information Program
855-408-1212
Monday-Friday, 8 a.m.-5 p.m.

Visit the North Carolina Department of Insurance online NCDOI.gov/medicare-an-shiip

Elder Care Locator

This public service of the U.S. Administration on Aging, offers help in finding local, state, and community-based organizations that serve older adults and their caregivers in your area.

Call Elder Care Locator
800-677-1116
Monday-Friday, 7 a.m.-7 p.m

Visit Elder Care Locator online
eldercare.acl.gov

Your Current Health Plan

Your health plan’s customer service center can answer any questions you may have about your current coverage; call the number on your identification card.