Frequently Asked Questions
About Medicare Insurance
What is Medicare?
Medicare is a federal health insurance program primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS). Medicare helps cover various healthcare services, but it doesn’t cover all medical expenses or the cost of most long-term care.
What are the different parts of Medicare?
Medicare consists of four parts:
Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B (Medical Insurance): Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Part C (Medicare Advantage): An alternative to Original Medicare offered by private companies approved by Medicare, combining Part A and Part B coverage and often including Part D.
Part D (Prescription Drug Coverage): Adds prescription drug coverage to Original Medicare and some Medicare Cost Plans, Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.
When can I enroll in Medicare?
You can enroll in Medicare during specific periods:
Initial Enrollment Period (IEP): A 7-month period that begins three months before the month you turn 65, includes your birth month, and ends three months after.
General Enrollment Period (GEP): January 1 to March 31 each year, if you didn’t sign up during your IEP.
Special Enrollment Period (SEP): If you’re covered under a group health plan, you can enroll without penalty during the 8-month period that begins the month after your employment or the group health plan coverage ends, whichever comes first.
How do I enroll in Medicare?
At USA Benefits Group, we will guide you in signing up for Medicare, and choosing the right plan for your unique health requirements, considering your both situation now, and for the future as well.
What is the cost of Medicare?
Costs vary depending on the coverage:
Part A: Most people don’t pay a premium if they paid Medicare taxes while working. In 2025, the deductible for hospital stays is $1,632 per benefit period.
Part B: The standard monthly premium is $185 in 2025, with a deductible of $257. After meeting the deductible, you typically pay 20% of the Medicare-approved amount for services.
Part C and Part D: Costs vary by plan and provider. That’s where USA Benefits Group will be able to assist you in selecting the right plan. We understand Medicare and we are licensed and appointed with every Medicare plan choice accessible, ensuring that you understand all of your options and receive unbiased suggestions for your specific circumstances.
What is the difference between Original Medicare and Medicare Advantage?
Original Medicare: Includes Part A and Part B. You can see any doctor or hospital that accepts Medicare. Prescription drug coverage requires enrolling in a separate Part D plan.
Medicare Advantage (Part C): Offered by private companies, these plans include Part A and Part B coverage and often Part D. They may offer additional benefits like vision, dental, and hearing services. However, they may have network restrictions.
Do I need a Medicare Supplement (Medigap) plan?
Medigap policies are sold by private companies to cover costs not covered by Original Medicare, like copayments, coinsurance, and deductibles. If you have Original Medicare and want help with out-of-pocket costs, a Medigap policy might be beneficial. Note that you can’t have both a Medigap policy and a Medicare Advantage Plan.
What does Medicare not cover?
Medicare doesn’t cover:
Long-term care (also called custodial care)
Most dental care
Eye exams related to prescribing glasses
Dentures
Cosmetic surgery
Acupuncture
Hearing aids and exams for fitting them
Routine foot care
How can I get help choosing a Medicare plan?
Call USA Benefits today for a free personal consultation! (386) 401-5644