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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.

HealthPlans of NC

Health Plans of NC, Kelly Quinn

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 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 through a stand-alone Part D or Medicare Advantage plan. Chatting with a Health Plans of NC agent can be a great way to determine 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 ten years. However, realizing that if you get Part A, you can no longer contribute to your HSA is essential. Chatting with 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 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 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 Medicare dental and vision options queries.

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 you through everything you need to consider before making any decisions.

What’s the Difference Between Medicare and Medicaid?

Medicare and Medicaid are government healthcare programs, but some key differences exist. Medicare is usually for people aged 65 or older with 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. 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 help you compare your options.

Does Medicare cover COVID-19 vaccinations in North Carolina?

Yes. Medicare covers COVID-19 vaccinations approved by the FDA at no cost to you. In addition, Medicare and Medicare Advantage cover 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). Still, for now, all Medicare beneficiaries can receive their COVID-19 vaccines for free.

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Am I Eligible For Medicare?

If you’re a U.S. citizen or a permanent legal resident of the United States, then you may be eligible for Medicare if you meet one of the following criteria: You are 65 years old or older. You’re younger than 65, but you have a qualifying disability. You are of any age and have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s Disease). To qualify as a legal resident, you need to have lived in the United States for at least five consecutive years before applying for Medicare.
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Medicare Costs

If you’re approaching Medicare eligibility, it’s essential to understand the costs for each of the different parts of Medicare, so you can work out how much to budget. Unfortunately, many people don’t realize the costs associated with certain aspects of Medicare, which can make it difficult to manage your monthly bills.
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Medicare Advantage For Veterans

You may not have considered Medicare Advantage coverage if you’re a veteran with Veterans Affairs (VA) or TRICARE health coverage. However, combining Medicare Advantage with your existing health coverage can offer many benefits. With the help of an independent health insurance agent, you can get the right coverage for your health care and budget.  Our experienced local agents help North Carolina residents daily and specialize in assisting veterans with their health insurance needs.
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Signing Up For Medicare: Initial Enrollment Period

There are many different types of Medicare Enrollment Periods.  One is your Initial Enrollment Period (IEP).  If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance.)  The same is true for people who receive benefits from the Railroad Retirement Board and people who have received disability benefits for 24 months.  If you are not getting these benefits, you must actively sign up for Medicare through or by visiting your local social security office.  You do not have to start your regular monthly social security benefits in order to get your entitled Medicare benefits.
Initial Enrollment Period
Your initial enrollment period is a 7-month period that:
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