10 Most Common Questions About Medicare

Answers to The 10 Most Common Medicare Questions

Medicare decisions are highly personal and you may have many different questions about your specific situation. But certain questions do seem to come up more often than others.

Here are some of the most common Medicare questions and answers that our local agents often hear from North Carolina residents.

How Do I Know What Medicare Coverage Is Right For Me?

The best Medicare coverage depends on your individual health needs. You should consider your own health requirements and select a Medicare plan that provides the right coverage for you. For example, suppose you’re currently taking prescription drugs. When you get Medicare, it’s essential to make sure you organize Part D prescription drug coverage. You can do this either through a stand-alone Part D plan or a Medicare Advantage plan. Chatting with a Health Plans of NC agent can be a great way to work out what level of Medicare best meets your needs.

What Do I Do About Medicare If I Work Past Age 65?

If you plan to continue working after you turn 65, you may be able to delay enrolling in Medicare. Alternatively, you may have to enroll during your Initial Enrollment Period in Parts A, B, and D to avoid late penalties. It will depend on your employer and if your employer coverage is creditable.

Some North Carolina residents who can delay Medicare still choose to enroll in just Part A when they turn 65 in addition to their employer coverage. Part A is premium-free if you or your spouse have been employed and paid Medicare taxes for at least 10 years. However, it’s essential to realize that if you do get Part A, you can no longer contribute to your HSA. Chatting to a local NC Medicare agent can help you to decide the best choice based on your circumstances.

How Does Medicare Automatic Renewal Work?

Your Medicare coverage choices will stay in place year after year unless you change your plan. This ensures that your coverage continues, but even if a plan renews, the plan benefits and costs may still change each year. Therefore, it’s good to review your Medicare choices every year during the Medicare Annual Enrollment Period each fall, from Oct. 15 to Dec. 7. Our Medicare NC agents can help with any queries when reviewing your options.

I’m Disabled. When Can I Get Medicare?

If you’re disabled, you are usually eligible for Medicare benefits after receiving Social Security disability benefits for 24 months. However, exceptions exist for individuals with certain medical conditions. You’ll be enrolled in Medicare on the 25th month and you should automatically receive your Medicare card in the mail.

I’m a North Carolina Resident. How Much Does Medicare Cost?

Medicare costs the same regardless of where you’re based in the US, but because our Medicare agents are locally based in North Carolina, we specialize in assisting NC residents. You will likely pay the Standard Part B premium to Medicare unless your modified adjusted gross income from two years prior requires an Income Related Monthly Adjustment Amount (IRMAA). Beyond that, you may pay other premiums, deductibles, co-pays, and co-insurance. The total amount you pay will depend on the type of Medicare plan(s) you choose and your healthcare services throughout the year.

How Can I Get Dental and Vision Coverage with Medicare in North Carolina?

Original Medicare (Parts A & B) doesn’t cover routine dental or vision care; however, some Medicare Advantage (Part C) plans do. Plans include all the coverage provided by Parts A and B and often additional benefits like dental, vision, hearing, and gym memberships, all in one plan. Health Plans of NC agents can assist you with any queries about Medicare dental and vision options.

Is Medicare Mandatory in NC?

No part of Medicare is mandatory. However, you could face financial penalties if you enroll in any part of Medicare after your Initial Enrollment Period. These penalties won’t apply if you qualify for a Special Enrollment Period with creditable employer coverage. All of our local NC Medicare agents understand the intricacies of Medicare. They can help talk you through everything you need to consider before making any decisions.

What’s the Difference Between Medicare and Medicaid?

Both Medicare and Medicaid are government healthcare programs, but there are some key differences. Medicare is usually for people aged 65 or older or who have a qualified disability. In 2018, there were almost two million total Medicare beneficiaries in North Carolina, with approximately 1.3 million enrolled in traditional Medicare and nearly 650,000 in Medicare Advantage private plans.

Medicaid is a state-governed program designed for people with limited income or resources. Some people are eligible for both programs, and these people are considered “dual eligible“. They often qualify for special Medicare plans.

Where Can I Get Help Paying for Medicare?

Financial assistance programs are available for anyone with limited income and assets. Some of these include Extra Help for prescription drugs, Medicare Savings Programs, and Medicaid. Qualifications for each program and the level of help available can vary depending on your circumstances. Our NC Medicare agents can provide a range of information and can help you compare your options.

Does Medicare cover COVID vaccinations in North Carolina?

Yes. Medicare covers COVID-19 vaccinations that have been approved by the FDA at no cost to you. In addition, Medicare and Medicare Advantage covers all booster shots at no cost, regardless of the manufacturer. This arrangement may be reviewed when the United States is no longer operating under a Public Health Emergency (PHE), but for now, all Medicare beneficiaries can receive their COVID vaccines for free.


RELATED: What Are Medicare Special Needs Plans?, What is the Blue to Blue Rule? (And Why It Matters), Comparing Medicare Supplement Plans, The Four Different Parts of Medicare, Different Medicare Enrollment Periods, Different Types of Medicare Supplement Plans, How to Apply for Medicare, What Additional Medicare Coverage Is Available?, Medicare Annual Enrollment 2023

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*Article updated in 2022