Medicare FAQ

Medicare Answers · Nationwide

Frequently Asked Questions

Clear answers to the most common Medicare questions — organized by topic and backed by a licensed advocate. Pick a category, then tap any question to read the answer.

Tap a category to filter · tap any question to open its answer
Free Medicare Tools · No cost, no pressure

Medicare tools & quick guides

Interactive helpers for the questions people ask most — enrollment periods, Medicare Advantage vs. Supplement, Medigap plans, what Medicare covers, Part D drug rules, and savings programs. Tap through any tool, then talk with a licensed advocate when you’re ready.

Prefer to talk now? Call (843) 227-6725

Enrollment

Which enrollment window is mine?

Pick your situation to see the period that applies and its timing.

Initial Enrollment Period (IEP). A 7-month window — the 3 months before your birthday month, your birthday month, and the 3 months after. Signing up early helps your coverage start on time and avoids penalties.

Special Enrollment Period (SEP). When job-based coverage ends, you generally get an 8-month window to enroll in Part B with no late penalty. Part D has its own shorter window, so don’t wait to add drug coverage.

Special Enrollment Period (SEP). Moving out of your plan’s service area opens a window to pick a new Medicare Advantage or Part D plan. The exact timing depends on when you tell your plan about the move.

General Enrollment Period (GEP), Jan 1 – Mar 31. You can still enroll in Part A and Part B, and coverage starts the month after you sign up. A late-enrollment penalty may apply, so it’s worth reviewing your options.

Annual Enrollment Period (AEP), Oct 15 – Dec 7 to change Advantage or Part D for January 1. Medicare Advantage Open Enrollment, Jan 1 – Mar 31 lets current Advantage members switch once or return to Original Medicare.

Special Enrollment Period (SEP). Qualifying for Medicaid or Extra Help opens a window (often each quarter) to change plans. A Dual-Eligible plan (D-SNP) may combine both programs with added benefits.

Full enrollment guide →
Getting Started

Which Medicare path fits me?

Tell us what matters most and we’ll point you toward the likely fit.

Original Medicare + a Medigap (Supplement) plan + Part D. You can use any provider nationwide that accepts Medicare, with no networks and no referrals. Great for travelers and anyone who wants maximum freedom.

A Medicare Advantage plan often has a low or $0 monthly premium. The trade-off is a network of doctors and copays as you use care, up to a yearly out-of-pocket maximum.

A Medicare Advantage plan bundles hospital, medical, and usually drug coverage into one plan — often with extras like dental, vision, and hearing that Original Medicare doesn’t include.

Original Medicare + Medigap gives the steadiest costs: you pay a set premium and most gaps are covered, so surprise medical bills are rare. Pair it with a Part D plan for your prescriptions.

The right fit depends on your doctors, your medications, and your budget — we compare both approaches for you, free.

Advantage vs. Medigap guide →
Supplements

Medigap plans at a glance

Tap a plan to see what it covers. Lettered plans are standardized, so the same letter covers the same core benefits across carriers.

The most comprehensive plan for people new to Medicare. After you pay the annual Part B deductible, Plan G covers nearly every gap — hospital and Part B coinsurance, the Part A deductible, skilled-nursing coinsurance, Part B excess charges, and limited foreign-travel emergency care. Plan G details →

Lower premium than Plan G. Covers most gaps, but you pay small copays for some office and ER visits, and it does not cover Part B excess charges. A popular balance of savings and coverage. Plan N details →

Same broad coverage as Plan G, but you pay a set yearly deductible first. In exchange the monthly premium is much lower — a fit if you want strong coverage at the lowest premium. High-Deductible G details →

Cost-sharing plans. They cover a set percentage of the gaps (roughly 50% for K, 75% for L) with an annual out-of-pocket limit, which keeps premiums lower than full-coverage plans. Plan K → Plan L →

More basic coverage. Plan A covers the core benefits every Medigap plan must include; Plan B adds coverage of the Part A hospital deductible. Plan A → Plan B →

Fuller coverage that also pays the Part B deductible — but these are only available if you were eligible for Medicare before January 1, 2020. Plan C → Plan F →

Full Medigap A–N comparison →
Coverage

Does Medicare cover it?

Tap a category for a quick covered / not-covered answer.

✓ Covered. Part A covers inpatient hospital care, short-term skilled-nursing care, and hospice.

✓ Covered. Part B covers doctor visits, outpatient care, lab tests, preventive services, and durable medical equipment.

✓ Covered through Part D (or a Medicare Advantage plan that includes drugs). Original Medicare alone does not cover most retail prescriptions.

✕ Not covered by Original Medicare. Many Medicare Advantage plans add routine dental, vision, and hearing benefits.

⚠ Mostly not covered. Medicare pays for short-term skilled care after a qualifying stay, but not ongoing custodial or nursing-home care.

⚠ Generally not covered by Original Medicare. Some Medigap plans add limited foreign-travel emergency coverage.

✓ Covered. An annual wellness visit plus many screenings and vaccines are covered, often at no cost to you.

✕ Not covered by Original Medicare. Some Medicare Advantage plans include a hearing-aid benefit.

What Medicare covers →
Costs & Help

Could I lower my Medicare costs?

Pick what best describes you to see which help may apply.

Medicaid + Medicare (dual eligible). You may qualify for both programs. A Dual-Eligible plan (D-SNP) can combine them and add extra benefits at little or no cost.

Medicare Savings Programs (QMB, SLMB, QI). Based on income and resources, these can pay some or all of your Part B premium and other Medicare costs.

Extra Help (Low-Income Subsidy). This lowers Part D premiums, deductibles, and drug copays — sometimes all the way to $0.

Many people qualify without realizing it. A quick look at your income and resources shows which savings programs you may be eligible for — we can walk through it with you.

Costs of Medicare & savings →
Costs & Rules

How do Medicare penalties work?

Late penalties are avoidable. Here’s how each one works.

Part B late penalty. If you delay Part B without other creditable coverage, your premium can rise by 10% for each full 12-month period you could have had it — and it generally lasts the whole time you have Part B.

Part D late penalty. Go 63 days or more without creditable drug coverage and a permanent amount is added to your Part D premium, based on how many months you went uncovered.

Stay on time or stay covered. Enroll during your Initial Enrollment Period, or keep creditable coverage (like a large-employer plan) and enroll during a Special Enrollment Period when it ends. Keep proof of prior coverage.

How to avoid penalties →
Compare

Medicare Advantage vs. Supplement

Two ways to fill the gaps in Original Medicare. Here’s how they stack up.

Feature
Advantage
Supplement
Monthly premium
Often low or $0
Higher, set premium
Doctor networks
Usually network-based
Any provider that takes Medicare
Referrals
Sometimes required (HMO)
Not required
Extra benefits
Often dental, vision, hearing
Not included — add separately
Out-of-pocket
Copays up to a yearly cap
Most gaps pre-paid, few surprises
Travel in the U.S.
Best in your plan’s area
Works nationwide

What matters most to you?

Medicare Advantage usually wins on monthly premium — often $0 — with costs shared as you use care.

Original Medicare + Supplement lets you see any Medicare provider nationwide, with no networks.

Medicare Advantage commonly adds dental, vision, and hearing in one plan.

Original Medicare + Supplement gives the most predictable costs after your premium.

You can’t use both at once — a Supplement works only with Original Medicare. We’ll help you choose.

Full Advantage vs. Supplement guide →
Basics

The four parts of Medicare

A quick reference to what each part does.

Quick Calculators

Estimate it in seconds

Fixed-by-law penalty math runs right here. For live dollar figures, each result links to the full calculator.

Calculator

Part B late-penalty calculator

The penalty is set by law: +10% for each full year you could have had Part B but didn’t. Pick how long you delayed.

0%

No penalty. Under a full 12 months, nothing is added.

See the dollar impact →
+10%

added to your Part B premium — for as long as you have Part B.

See the dollar impact →
+20%

added to your Part B premium — for as long as you have Part B.

See the dollar impact →
+30%

added to your Part B premium — for as long as you have Part B.

See the dollar impact →
+40%

added to your Part B premium — for as long as you have Part B.

See the dollar impact →
+50% or more

added to your Part B premium — and it keeps growing the longer you wait.

See the dollar impact →
Calculator

Part D late-penalty calculator

The penalty is about 1% of the national base drug premium for each month you went without creditable drug coverage. Pick roughly how long.

0%

No penalty — you kept creditable drug coverage.

Get today’s dollar amount →
≈ 6%

of the national base drug premium, added to your Part D premium each month.

Get today’s dollar amount →
≈ 12%

of the national base drug premium, added to your Part D premium each month.

Get today’s dollar amount →
≈ 24%

of the national base drug premium, added each month — for as long as you have Part D.

Get today’s dollar amount →
≈ 36% or more

of the national base drug premium, added each month — for as long as you have Part D.

Get today’s dollar amount →
Calculator

IRMAA: does a surcharge apply to me?

Higher incomes pay an extra amount (IRMAA) on top of Part B and Part D, set by income tier from your tax return two years back.

No IRMAA

Most people pay the standard Part B and Part D premiums with no surcharge.

Check your exact surcharge →
Surcharge likely

IRMAA is added to both your Part B and Part D premiums. The amount steps up by income tier.

Check your exact surcharge →
Depends on your income

IRMAA looks at your income from two years ago. If you’re a higher earner it may apply — the calculator shows your exact tier.

Check your exact surcharge →
Full Tool

Cost & savings calculator

For a full estimate — monthly costs, Medigap vs. Advantage, and savings-program eligibility — open the complete calculator, updated for the current year.

Still have a question? Let’s answer it together.

Every situation is a little different. Talk with a licensed May River Medicare advocate and get straight, unbiased answers — free, with no pressure.