Part A (Hospital Insurance) helps cover inpatient hospital care, skilled nursing facility care, hospice care, and some home health care services. Part B (Medical Insurance) helps cover outpatient care, including services from doctors and other health care providers.
If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B starts the first day of the prior month.) If you’ve been automatically enrolled in Part B, you’ll be notified that you have a certain amount of time after your enrollment date to decline coverage. In most cases, if you don’t sign up for Part B when you’re first eligible, you may have a delay in getting Medicare Part B coverage in the future, and you may have to pay a late enrollment penalty for as long as you have Part B. Even if you decide not to enroll in Medicare Part B during the initial enrollment period, you can enroll later during the annual general enrollment period that runs from January 1 to March 31 each year. However, you may pay a slightly higher premium as a result. When you sign up during this period, your coverage starts the first day of the month after you sign up.
If you’re close to 65, but NOT getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to sign up for Medicare. Visit ssa.gov/benefits/medicare to apply for Part A and Part B. You can also contact Social Security (1-800-772-1213) 3 months before you turn 65 to set up an appointment or visit your local Social Security office to apply. If you worked for a railroad, contact the RRB.
If you have questions, you can visit Medicare.gov or call 1-800-MEDICARE.
(1-800-633-4227) or get personalized assistance from one of our licensed agents. TTY users can call 1-877-486-2048.
If you’re close to 65, but NOT getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to sign up for Medicare. Visit ssa.gov/benefits/medicare to apply for Part A and Part B. You can also contact Social Security (1-800-772-1213) 3 months before you turn 65 to set up an appointment or visit your local Social Security office to apply. If you worked for a railroad, contact the RRB.
If you have questions, you can visit Medicare.gov or call 1-800-MEDICARE.
(1-800-633-4227) or get personalized assistance from one of our licensed agents. TTY users can call 1-877-486-2048.
Most people do not have to pay a premium for Part A if you or your spouse paid Medicare taxes for 10 years or 40 quarters. If you aren’t eligible for premium-free Part A, you may be able to buy it.
The standard Part B premium amount in 2023 is $164.90. Most people pay the standard Part B premium amount every month. If your modified adjusted gross income is above a certain amount (in 2023: $97,000 if you file individually or $194,000 if you’re married and file jointly), you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium. To determine if you’ll pay the IRMAA, Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. Visit https://www.medicare.gov/basics/costs/medicare-costs to learn more about IRMAA determinations. If you must pay an extra amount and you disagree (for example, your income is lower due to a life event), visit ssa.gov or call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
The standard Part B premium amount in 2023 is $164.90. Most people pay the standard Part B premium amount every month. If your modified adjusted gross income is above a certain amount (in 2023: $97,000 if you file individually or $194,000 if you’re married and file jointly), you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium. To determine if you’ll pay the IRMAA, Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. Visit https://www.medicare.gov/basics/costs/medicare-costs to learn more about IRMAA determinations. If you must pay an extra amount and you disagree (for example, your income is lower due to a life event), visit ssa.gov or call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
Yes, you must be enrolled in both Medicare Parts A and B and continue to pay your Part B premium to be enrolled in either a Medicare Supplement plan or a Medicare Advantage plan.
Medicare Advantage plans are Medicare-approved plans offered by private insurance companies that must cover all medically necessary services that Original Medicare covers and offer some extra benefits that Original Medicare doesn’t cover—like vision, hearing, and dental services. They are an alternative to Original Medicare. These plans include Part A (Hospital), Part B (Medical), and usually Part D (Prescription Drug Coverage) all in one plan. In many cases, you can only use doctors and other providers who are in the plan’s network and service area (for non-emergency care). Some plans offer non-emergency coverage out of network, but typically at a higher cost. You may need a referral to see a specialist and out-of-pocket cost sharing varies depending on the plan you select. Plans may have lower or higher out-of-pocket costs for certain services. You must continue to pay the Medicare Part B premium and the plan’s premium if applicable. Some plans may have a $0 premium and depending on your income and assets you may get help paying all or part of your Part B. Plans have a yearly limit on what you pay out of pocket for services Medicare Part A and Part B cover. Once you reach your plan’s limit, you’ll pay nothing for services Part A and Part B cover for the rest of the year.
• Annual Enrollment Period (October 15th – December 7th) - You can join, switch, or drop a Medicare Advantage Plan or a Medicare drug plan during this Open Enrollment Period each year. Your coverage starts on January 1 (if the plan gets your request by December 7).
• Open Enrollment Period (January 1st – March 31st) - If you're in a Medicare Advantage Plan, you can change to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. Any changes you make will be effective the first of the month after the plan gets your request.
• Special Enrollment Period (Qualifying life event) - In most cases, if you join a Medicare Advantage Plan, you must keep it for the calendar year starting the date your coverage begins. However, in certain situations, like if you move or lose other insurance coverage, you may be able to join, switch, or drop a Medicare Advantage Plan during a Special Enrollment Period.
• 5-Star Special Enrollment Period (December 8th – November 30th of the following year)- Medicare uses ratings from 1–5 stars to help you compare plans based on quality and performance. If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star quality rating is available in your area, you can use the 5-star Special Enrollment Period to switch from your current Medicare plan to a Medicare plan with a 5-star quality rating.
• Lock-In (December 8th – December 30th & April 1st – October 14th) – You cannot make a plan change during these times unless you qualify for a Special Election Period (SEP) or have Medical Assistance (Medicaid) coverage.
• Open Enrollment Period (January 1st – March 31st) - If you're in a Medicare Advantage Plan, you can change to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. Any changes you make will be effective the first of the month after the plan gets your request.
• Special Enrollment Period (Qualifying life event) - In most cases, if you join a Medicare Advantage Plan, you must keep it for the calendar year starting the date your coverage begins. However, in certain situations, like if you move or lose other insurance coverage, you may be able to join, switch, or drop a Medicare Advantage Plan during a Special Enrollment Period.
• 5-Star Special Enrollment Period (December 8th – November 30th of the following year)- Medicare uses ratings from 1–5 stars to help you compare plans based on quality and performance. If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star quality rating is available in your area, you can use the 5-star Special Enrollment Period to switch from your current Medicare plan to a Medicare plan with a 5-star quality rating.
• Lock-In (December 8th – December 30th & April 1st – October 14th) – You cannot make a plan change during these times unless you qualify for a Special Election Period (SEP) or have Medical Assistance (Medicaid) coverage.
A Medicare Supplement or “Medigap” plan is a health insurance policy offered by private insurance companies. Medicare Supplement plans must follow federal and state laws. Insurance companies can offer only a “standardized” plan, identified in most states as plans A – D, F, G, and K – N. All plans offer the same basic benefits, but some offer additional benefits so you can choose which one meets your needs. Medigap plans sold to people who are new to Medicare on or after January 1, 2020, aren’t allowed to cover the Part B deductible. Because of this, Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy Plan C or Plan F. People new to Medicare on or after January 1, 2020, have the right to buy Plans D and G instead of Plans C and F. See the chart below showing the 2023 plans offered and their basic benefits. If a percentage appears, the Medigap plan covers that percentage of the benefit, and you are responsible for the rest.
If you’re in a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. If you aren’t planning to drop your Medicare Advantage Plan, and someone tries to sell you a Medigap policy, report it to your State Insurance Department. If you have Medigap and join a Medicare Advantage Plan, you may want to drop Medigap. You can’t use Medigap to pay your Medicare Advantage Plan copayments, deductibles, and premiums because Medicare Advantage Plans provide other protections that Medigap doesn’t.
Request Information or for faster service call us toll free at 1-877-993-1990. We can help you understand how the various plans we offer work, and help you select from many different insurance companies.
You can first sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, in most cases, your coverage begins the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage starts the first day of the prior month. If you sign up and are paying for Part A and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period, the start date for your Part B coverage will be delayed (in 2022).
**New** If you sign up the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your coverage starts the first day of the month after you sign up.
**New** If you sign up the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your coverage starts the first day of the month after you sign up.
Open Enrollment: is a 6-month period that begins the first month you have Medicare Part B (Medical Insurance), and you’re 65 or older. (Some states have additional Open Enrollment Periods.) Also, it allows the applicant to be guaranteed a Medicare supplement/Medigap insurance plan regardless of their current or past health history. Otherwise, the applicant must meet medical underwriting standards to qualify if required by the insurance company.
Guaranteed Issue Rights: (also called “Medigap protections”) are rights you have in certain situations when insurance companies are required by law to offer you certain Medicare Supplement/Medigap policies even if you have health problems and must cover any pre-existing conditions. In these situations, an insurance company must do the following:
• Sell you a Medicare Supplement/Medigap policy.
• Cover all your pre-existing health conditions.
• Can’t charge you more for a Medicare Supplement/Medigap policy because of past or present health conditions.
Guaranteed Issue Rights: (also called “Medigap protections”) are rights you have in certain situations when insurance companies are required by law to offer you certain Medicare Supplement/Medigap policies even if you have health problems and must cover any pre-existing conditions. In these situations, an insurance company must do the following:
• Sell you a Medicare Supplement/Medigap policy.
• Cover all your pre-existing health conditions.
• Can’t charge you more for a Medicare Supplement/Medigap policy because of past or present health conditions.
If you apply for Medicare Supplement/Medigap coverage after your Open Enrollment Period (6-month period that begins the first month you have Medicare Part B (Medical Insurance) and you’re 65 or older), there's no guarantee that an insurance company will sell you a Medicare Supplement/Medigap policy if you don’t meet the medical underwriting requirements, unless you're eligible due to certain situations. This same situation may arise if you drop your current Medicare Supplement/Medigap policy. There is no guarantee that you can get another policy except in very limited situations (see below). Also, if you are under age 65 and receive Medicare because you are disabled, you are not eligible for an Open Enrollment Period and must meet a company’s medical standards to purchase a Medicare Supplement/Medigap policy.
You have a guaranteed issue right (which means an insurance company can’t refuse to sell you a Medicare Supplement/Medigap policy) in the situations below:
• You’re in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan’s service area.
• You have Original Medicare and an employer group plan (including retiree or COBRA coverage) or union coverage that pays after Medicare and that plan is ending.
• You have Original Medicare and a Medicare Select policy. You move out of the Medicare Select policy’s service area.
• You joined a Medicare Advantage Plan or All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare (Trial Right).
• Your Medicare Supplement/Medigap insurance company goes bankrupt, and you lose your coverage, or your Medicare Supplement/Medigap policy coverage otherwise ends through no fault of your own.
• You leave a Medicare Advantage Plan or drop a Medicare Supplement/Medigap policy because the company hasn’t followed the rules, or it misled you.
• You’re in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan’s service area.
• You have Original Medicare and an employer group plan (including retiree or COBRA coverage) or union coverage that pays after Medicare and that plan is ending.
• You have Original Medicare and a Medicare Select policy. You move out of the Medicare Select policy’s service area.
• You joined a Medicare Advantage Plan or All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare (Trial Right).
• Your Medicare Supplement/Medigap insurance company goes bankrupt, and you lose your coverage, or your Medicare Supplement/Medigap policy coverage otherwise ends through no fault of your own.
• You leave a Medicare Advantage Plan or drop a Medicare Supplement/Medigap policy because the company hasn’t followed the rules, or it misled you.
No, but the length of time you’ve had your Medicare supplemental plan will affect how your new Medicare Supplement/Medigap policy covers you for pre-existing conditions. If you’ve had a Medicare Supplement/Medigap insurance plan for at least six months and you decide to switch, your new Medicare supplement/Medigap insurance plan must cover you for all pre-existing conditions. If you’ve had a Medicare supplement/Medigap insurance plan for less than six months, the new Medicare supplement/Medigap policy must give you credit for the time the older policy covered you. The number of months you've had your current Medicare Supplement/Medigap policy must be subtracted from the time you must wait before your new Medicare Supplement/Medigap policy covers your pre-existing condition. If the insurance company agrees to issue the new policy, they can't write pre-existing conditions, waiting periods, elimination periods, or probationary periods into the replacement policy. You have 30 days to decide if you want to keep the new Medicare Supplement/Medigap policy. This is called your "free look period." The 30-day free look period starts when you get your new Medicare Supplement/Medigap policy. You'll need to pay both premiums for one month.
Because your Medicare supplemental/Medigap insurance plan is guaranteed renewable, you will still have insurance coverage if you move. If you move to a new state, however, the Medicare supplement/Medigap insurer may quote you a different premium even for the same plan. If you have a Medicare Select/Medigap insurance plan, which contains network restrictions, you must change your Medicare insurance coverage. But you have the right to buy Medicare supplemental/Medigap insurance plans A, B, C, F, K, or L in the state you move to without having to medically qualify.
All Medicare supplement policies are guaranteed renewable, no matter how many claims you file, but a company can cancel if you do not pay premiums or give false information of a material fact on your application. If you want to switch policies, don’t cancel your first Medicare supplement policy until the second one is in place, and you have reviewed it and decided to keep it. You have 30 days to return the policy and receive a full refund.