Questions to ask when new to Medicare
If you are new to Medicare, there are several questions you should consider while approaching or within your
Initial Enrollment Period (IEP) or a Special Enrollment Period (SEP). Use this guide to consider your options
when preparing to enroll in Medicare or after you have already enrolled.
What are the basics? Medicare is a complex program and can sometimes be confusing. The best place to start
when you are new to Medicare is by familiarizing yourself with the differences between it and the health
insurance you have now. Learn what makes a person Medicare-eligible, the different parts of Medicare
insurance and what those parts cover, times to enroll in Medicare, and how putting off enrollment can result
in penalties. These initial steps will help smooth the transition from your current insurance to Medicare once
you are eligible.
What are your coverage options? Everyone has different health care needs, meaning the coverage that is right
for your friends or family may not be right for you. Will you enroll in Original Medicare or would you prefer a
Medicare Advantage Plan that may limit your provider networks or have different costs but that offers
additional coverage? If you have current employer insurance, you may decide not to enroll in Medicare until
you have retired. If you are already retired, you might find that Original Medicare plus retiree insurance works
better for you than Original Medicare plus a Medigap (or vice versa). Find out the full range of your coverage
options.
Should you enroll in Part D? While you should make sure you enroll in Part D prescription drug coverage when
you become Medicare-eligible (assuming you do not have other creditable drug coverage), there are many
Part D options for you to explore. Keep in mind, too, that sometimes retiree insurance offers prescription drug
coverage that is as good as or better than Medicare Part D. If that is the case, you might decide not to take
Part D because you are already covered. Finally, if you have difficulty affording your drug costs, you may want
to consider applying for programs that can help pay these costs.
Are you eligible for programs that help lower Medicare costs? There are several programs for people with low
incomes that help pay for Medicare-related costs, such as premiums and copays. Some of these programs are
federal while others are state-specific. Find out whether you meet the eligibility requirements and take full
advantage.
What resources exist to help you navigate Medicare? Medicare is a complex and beneficial program, and a
variety of trusted sources can help you navigate your rights and options. A few are listed here:
1-800-MEDICARE
Social Security Administration
State Health Insurance Assistance Program (SHIP)
Medicare Rights Center
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