Medicare Questions Answered, in Plain English

Not necessarily. If you have employer coverage through a job (yours or a spouse's) at a company with 20 or more employees, you can usually delay Part B without a penalty until that coverage ends. Companies with fewer than 20 employees usually require you to enroll in Medicare at 65 regardless. We can help you check which rule applies to your situation.

People of any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant) can qualify for Medicare, typically starting the fourth month of dialysis or the month a transplant is performed.

Yes. Most people who have received Social Security Disability Insurance (SSDI) for 24 months are automatically enrolled in Medicare, regardless of age.

You'll need to wait for the General Enrollment Period (January 1 – March 31) to sign up for Part B, with coverage starting the month after you enroll, and you may owe a permanent late enrollment penalty. See how that penalty is calculated →

Only if you're already receiving Social Security or Railroad Retirement benefits before turning 65 — in that case, Part A and Part B start automatically. Otherwise, you need to actively enroll, either online at ssa.gov, at your local Social Security office, or with our help.

You should enroll in Medicare during your Initial Enrollment Period and plan to drop your marketplace plan — once you're eligible for Medicare, marketplace subsidies generally end, and staying on a marketplace plan instead of Medicare can mean a lifetime late enrollment penalty.

Often yes. VA benefits and Medicare can work together, but most people with VA benefits still enroll in Medicare Part B to keep their options open, since VA facilities and Medicare-network providers aren't the same. TRICARE for Life generally requires you to have both Medicare Part A and Part B. We can walk through how your specific benefit interacts with Medicare.

Original Medicare (Parts A and B) moves with you anywhere in the U.S. Medicare Advantage and Part D plans are tied to a specific service area, so a move outside your plan's area triggers a Special Enrollment Period to pick a new plan in your new location.

No. COBRA is not considered creditable coverage for delaying Medicare enrollment without a penalty. If you're 65 or older, you generally need to enroll in Medicare during your Initial Enrollment Period regardless of COBRA.

Yes — there's no requirement to stop working. Many people enroll in Medicare at 65 and keep both their job and employer coverage, using Medicare as either primary or secondary coverage depending on the size of the employer.

Yes — in addition to Nebraska, Landon is licensed in multiple other states. If you split time between states or have family elsewhere who need Medicare help, give us a call to confirm we're licensed where they live.

IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to your Part B and Part D premiums if your income is above a certain threshold, based on your tax return from two years prior. It's recalculated annually and can be appealed after certain life events like retirement. See 2026 Part B costs →

Extra Help (also called the Low-Income Subsidy) helps people with limited income and resources pay for Part D premiums, deductibles, and copays. Qualifying can also trigger a Special Enrollment Period to change plans outside the normal windows.

Yes — this is called being "dual-eligible." If you qualify for both, Medicaid often covers costs Medicare doesn't, like long-term care, and may also cover your Medicare premiums.

In many cases, yes — Medicare premiums can count as medical expenses if you itemize deductions and your total medical expenses exceed a certain percentage of your income. Check with a tax professional for your specific situation.

You can use existing HSA funds tax-free for medical expenses, but you can no longer contribute new money to an HSA once you're enrolled in any part of Medicare. This is worth planning around if you're still working and have an HSA-eligible plan near 65.

HMO plans generally require you to use in-network providers and get referrals to see specialists, usually at a lower premium. PPO plans cost more but let you see out-of-network providers, usually without a referral. More on choosing a Medicare Advantage plan →

No — it's illegal for someone to sell you a Medigap policy if you're in a Medicare Advantage plan, since they serve the same purpose in different ways. You choose one path or the other.

Original Medicare does not cover routine dental, vision, or hearing care. Many Medicare Advantage plans include some of these benefits, which is one reason people choose Advantage over Original Medicare. Compare your options →

A Special Needs Plan is a type of Medicare Advantage plan designed for people with specific conditions, dual Medicare/Medicaid eligibility, or who live in an institution. They tailor provider networks and drug coverage to those specific needs.

CMS rates Medicare Advantage and Part D plans from 1 to 5 stars each year based on quality measures like member satisfaction, customer service, and how well the plan manages chronic conditions. Higher-rated plans may also offer better benefits or have a longer enrollment window through a Special Enrollment Period.

Creditable coverage means a health or drug plan that's expected to pay at least as much as Medicare's standard coverage — usually a current employer plan. If your coverage is creditable, you can delay Medicare without a late penalty. Your plan administrator or HR department can confirm this in writing.

Every September, your Medicare Advantage or Part D plan sends an Annual Notice of Change describing what's different about your plan for the next year — premiums, copays, covered drugs, and network changes. It's worth reading closely every year, since a plan that fit you well can quietly change before the next Annual Election Period.

Yes, but mainly during the Annual Election Period (Oct 15 – Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31). Outside those windows, you generally need to qualify for a Special Enrollment Period. See every enrollment window →

You'll get a notice and a Special Enrollment Period to pick a new Medicare Advantage plan or switch to Original Medicare, typically without being subject to medical underwriting for a companion Medigap policy if you act within the allowed window.

Not necessarily, but it's still worth a quick annual review. Plans change their costs, networks, and drug formularies every year, and what was the best fit last year may not be this year. We do free annual reviews →