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Medicare
Questions
& Answers
Q: What is Medicare Part D?
- Thomas Pasadena, CA
A: Medicare Part D is a stand-alone prescription drug plan. If you have original Medicare or a Medicare Supplement/Medigap plan, you must purchase a Part D plan with a private insurer when eligible to avoid penalties. Many Medicare Advantage (Part C) plans include prescription plans.
- Mark Altadena, CA
Q: How Long Do I Have to Sign-Up for Medicare?
A: In California, you have a seven month period to sign-up for Medicare. Three months before your 65th birthday month, your birthday month, and three months after. You can call Social Security at 1-800-772-1213 or submit an application online. There are other exceptions, so contact your insurance agent for more information.
If you're under 65 and disabled, you can apply for Medicare after a 24-month qualifying period.
Q: What is a Medigap plan?
- Vance Sierra Madre , CA
A: A Medigap plan, also known as a Medicare Supplement is a form of insurance that fills in the financial and medical liabilities that original Medicare doesn't cover. Examples are the hospital deductibles and the first three pints of blood.
Medigap plans vary by coverage and are denoted by letters A-N with Plan G being preferred by most Medicare recipients. Click here to view all the Medigap plans available.
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In order to qualify for a Medigap plan, you must have original Medicare Parts A & B and sign-up for a standalone Part D prescription drug plan. Medigaps have an extra premium and often do not have extra perks included such as vision and dental- those benefits are usually purchased separately.
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The best time to sign-up for a Medigap plan is when you're first signing up for Medicare because underwriting is not required and you'll qualify for cheaper premiums. Medigap policies are more difficult and expensive to purchase after your initial Medicare enrollment period.
Q: A question about the California "birthday rule". If I don't want to keep the Medigap policy for some reason, would I be able to switch to a Medicare Advantage plan, instead of another Gap plan in January? Or does the birthday rule only allow switching to another Gap plan specifically?
- Tony Cerritos , CA
A: The "Birthday Rule" only applies to people with an existing Medigap/supplement policy. In California, it allows people to switch their Medigap insurer to another insurer (Medigap only) 60 days after their birthday. If at any point you want to get a Medicare Advantage plan (Plan C), you can do so during Annual Enrollment from October 15th-Decemeber 7th with an effective date of January 1st. If you're new to Medicare, you also have a 12 month trial period where you can switch from a Medigap to a Medicare Advantage plan or visa-versa.
Q: Do I need Medicare Part C with my A and B?
- Ann Monrovia, CA
A: Part C has nothing to do with original Medicare which is Part A (hospital) and Part B (doctors visits). Part C (also called Medicare Advantage plans) allows private insurers such as UnitedHealthCare or Humana manage your Medicare needs.
Private insurers must follow Medicare guidelines plus they can also offer extra benefits such as vision, dental, and hearing. Some Medicare Advantage plans also include prescription drugs and extra perks such as gym memberships, over-the-counter allowances, and even Part B premium buy-backs/refunds. Talk to your licensed insurance agent to figure-out if a Part C plan is the best fit for your health and financial needs.
- Gloria Rosemead, CA
Q: How Do I Stop Unwanted Medicare Sales Calls, Emails, and Mail?
A: To cut-down on unwanted mail, please visit the FTC guidance page here.
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To stop marketing calls, visit the Do Not Call List here to add your number.
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To stop unwanted emails, navigate to the bottom of the unwanted email and click "unsubscribe".
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Remember, if you filled out a card requesting information regarding Medicare, a licensed agent or insurance company has permission to contact you unless you state otherwise.
Q: What is a Medicare Special Needs Plan?
-Sarah Los Angeles, CA
A: A Medicare Special Needs plan is actually a type of Medicare Advantage plan.
They consist of three types: Dual Special Needs Plan (D-SNP), Chronic Special Needs Plans (C-SNP), and Institutionalized Special Needs Plans (I-SNP).
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D-SNP plans are for individuals that qualify for Medi-cal (CA state Medicaid) and Medicare. The plan coordinates with both programs and also offers extra perks that original Medicare doesn't offer. In some cases, the state may help pay for all or some of your Part B premiums and Part D costs.
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C-SNP plans are for individuals that qualify for Medicare but also have a chronic condition such as diabetes or heart disease. These plans are tailored to your condition and in addition to extra perks, they often come with a case manager that helps you navigate your healthcare needs.
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I-SNP plans are for individuals in a nursing home or convalescent setting. They also offer extra perks that original Medicare doesn't offer.
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