Frequently Asked Questions
Can I enroll in a Medicare Part D plan, Medigap plan, or Medicare Advantage plan if I am not enrolled in Medicare?
No. You must be enrolled in Medicare in order to be eligible to enroll in a Medicare Part D plan, Medigap plan, or Medicare Advantage plan. A Medicare Part D prescription drug plan only requires that you be enrolled in Medicare Part A. However, in order to enroll within a Medigap plan or a Medicare Advantage plan, you must first be enrolled in both Medicare Part A and Medicare Part B.
Do all Medicare Part D plans cover the same medications?
No, each plan may have a unique list of covered drugs. The list of covered drugs is known as a formulary. Medicare requires all Medicare Part D plans to cover at least two medications in each therapeutic category/class approved by Medicare. The drugs within the formulary are assigned to tiers. The tier determines the co-payment or out-of-pocket costs a person within the plan will pay for the drug. If you take a medication that is not covered on your Part D plan’s formulary, you will pay full retail price.
Do I have to be enrolled in Medicare Part B before I enroll in a Medicare Advantage program?
If I enroll in a Medicare Advantage plan or a Medigap plan, do I still have to pay my Medicare Part B premium?
Yes. You will have to pay your monthly Medicare Part B premium to Medicare alongside the monthly premium you pay to your Medicare Advantage plan or Medigap plan.
If I enroll in a Medigap plan, will it also cover my spouse?
No. You and your spouse must each enroll in a Medigap plan in order to obtain Medigap coverage.
Are Medicare and Medicaid the same thing?
No. Medicare is a federal health coverage program designed for the elderly as well as individuals with certain qualifying health conditions such as End Stage Renal Disease. Medicaid is a state-run health coverage program primarily targeting low-income individuals within the state.