FAQ

A Medicare Supplement plan, also known as Medigap, works alongside Original Medicare to help cover out-of-pocket costs such as deductibles, copayments, and coinsurance. These plans can provide greater predictability in healthcare expenses and are standardized by plan letter, such as Plan G or Plan N.

Both options offer valuable benefits, but they work differently. Medicare Advantage plans typically have lower monthly premiums and may include additional benefits, while Medigap plans often provide greater flexibility and lower out-of-pocket costs when receiving care. The best choice depends on your healthcare needs, travel habits, doctors, and budget.

Even if you don’t currently take medications, enrolling in a Medicare Part D Prescription Drug Plan may still be worth considering. Delaying enrollment could result in a late enrollment penalty if you decide to enroll later. Having coverage in place can also provide protection if your medication needs change unexpectedly.

Yes. The Medicare Part D coverage gap, commonly known as the “donut hole,” has been eliminated. Medicare prescription drug coverage now includes enhanced protections designed to help limit out-of-pocket prescription costs and make medication expenses more predictable throughout the year.

Original Medicare generally does not cover routine dental care, vision exams, eyeglasses, hearing exams, or hearing aids. However, many Medicare Advantage plans include these benefits, which is one reason many beneficiaries explore Medicare Advantage coverage.

In many cases, yes. Original Medicare allows you to see any provider nationwide who accepts Medicare. Medicare Advantage plans often use provider networks, so it’s important to verify that your preferred doctors, specialists, and hospitals participate in the plan before enrolling.

Medicare generally does not cover long-term custodial care, such as ongoing assistance with daily living activities in a nursing home. Medicare may cover short-term skilled nursing care following a qualifying hospital stay, but long-term care planning typically requires other resources or insurance options.

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 each year. If you’re already enrolled in a Medicare Advantage Plan, you can make a one-time change to another Medicare Advantage Plan or return to Original Medicare during this period.

In most cases, Medicare plan changes must be made during an enrollment period. However, certain life events, such as moving, losing employer coverage, or qualifying for financial assistance, may make you eligible for a Special Enrollment Period that allows you to make changes outside the normal enrollment windows.

Some Medicare beneficiaries pay higher premiums based on their income. This additional amount is known as the Income-Related Monthly Adjustment Amount (IRMAA). Medicare uses income information from previous tax returns to determine whether an adjustment applies.

Not necessarily. If you have qualifying health coverage through a current employer, you may be able to delay certain parts of Medicare without penalty. Because every situation is different, it’s important to review your options before deciding whether to enroll or delay coverage.

Yes. Several programs may be available to help lower Medicare costs, including Medicare Savings Programs, Extra Help for prescription drugs, and certain Special Needs Plans. Many people qualify for assistance without realizing it, so it’s worth exploring your options.

No. Working with Long Island Medicare Help is completely free. We provide personalized Medicare guidance, plan comparisons, enrollment assistance, and ongoing support at no additional cost to you. Licensed Medicare agents are compensated by insurance carriers, and your premium remains the same whether you enroll on your own or work with an agent.