Frequently Asked
Questions
Understanding Medicare often comes with a lot of questions, especially if you’re nearing 65, planning retirement, or comparing coverage for the first time. This section answers common Medicare questions, explains Medicare coverage questions, and supports people who need help choosing a Medicare plan without guesswork or unnecessary complexity.
Medigap – also called Medicare Supplement insurance – helps pay some of the out-of-pocket costs that Original Medicare (Parts A and B) does not fully cover. Depending on the plan you choose, Medigap may help with:
Medigap works with Original Medicare (it does not replace it). Most Medigap plans sold today do not include outpatient prescription drug coverage, so many people pair Medigap with a standalone Medicare Part D prescription drug plan.
- Part A hospital coinsurance and hospital costs
- Part A deductible
- Skilled nursing facility coinsurance
- Part B coinsurance (often the 20% you’d otherwise pay)
- Foreign travel emergency coverage (on certain plans)
Medigap (Medicare Supplement) works alongside Original Medicare and helps cover your share of Medicare-approved costs. In most cases, you can see any provider nationwide who accepts Medicare, with no network restrictions.
Medicare Advantage (Part C) is an alternative way to receive your Medicare benefits through a private insurance company.
These plans typically:
- Use provider networks (HMO, PPO, HMO-POS, etc.)
- Have copays/coinsurance and plan rules (and may require referrals depending on plan type)
- Often includes Part D drug coverage and may include extra benefits like dental/vision/hearing
You cannot have Medigap and Medicare Advantage at the same time.
Medigap can be worth it for people who want more predictable medical costs and protection from large, unexpected bills. Because Original Medicare has no annual out-of-pocket maximum, Medigap can reduce the financial uncertainty that comes with frequent care, specialist visits, outpatient procedures, or hospital stays.
Whether it’s the right fit depends on your situation – your health, how often you expect to use care, your budget, and your comfort level with networks and copays. A MedigapRx advisor can compare Medigap and Medicare Advantage side-by-side so you understand both the monthly premium and the “when you use it” costs.
This is one of the most common Medicare supplement FAQ topics. A Medicare Supplement plan is optional, but without it, you are generally responsible for deductibles and ongoing coinsurance under Original Medicare.
If you prefer stable costs and broad provider access, Medigap may be a good fit. If you are comfortable with networks and variable costs, Medicare Advantage may be another option.
You’re typically enrolled automatically in Medicare if you’re already receiving Social Security or Railroad Retirement Board benefits when you turn 65. In that case, your Medicare card often arrives about three months before your 65th birthday.
Some people under 65 may also be enrolled automatically due to disability benefits or certain qualifying conditions. If you’re not receiving Social Security yet when you turn 65, you generally need to enroll during your Initial Enrollment Period.
Enrolling on time helps avoid coverage gaps and potential late penalties. If you (or your spouse) are still working and have employer coverage, you may be able to delay certain parts of Medicare without penalties – depending on the plan and employer size. MedigapRx can review your coverage and help confirm the right timing.
Most people enroll during their Initial Enrollment Period (IEP) – a 7-month window:
- Starts 3 months before the month you turn 65
- Includes your birthday month
- Ends 3 months after
Because penalties can be long-lasting, it’s smart to confirm whether your current coverage is considered creditable before delaying enrollment.
If you delay Medicare without qualifying coverage, you may face penalties – especially for Part B and Part D.
- Part B penalty: Usually an added percentage of the Part B premium for each full 12-month period you were eligible but not enrolled. You typically pay it as long as you have Part B.
- Part D penalty: Often applies if you go 63 days or more without “creditable” prescription drug coverage after you’re first eligible. The penalty is generally added to your monthly Part D premium.
Most people enroll through the Social Security Administration – online, by phone, or at a local office. If you’re not enrolled automatically, you’ll typically apply for Parts A and B during your Initial Enrollment Period (or a Special Enrollment Period, if you qualify).
MedigapRx can help you understand which parts to enroll in and how to coordinate start dates with employer or retiree coverage. Once your Medicare is active, we can help you compare Medigap, Medicare Advantage, and Part D options available in Fort Lauderdale, Broward County, and beyond (based on licensing and plan availability).
Many people delay Part B because they are still working and have qualifying employer coverage (or coverage through a spouse). In some cases, enrolling in Part B right away could mean paying an additional premium for coverage you don’t need yet.
Delaying Part B without qualifying coverage can lead to penalties and temporary gaps. A MedigapRx advisor can help you review your employer plan and confirm whether delaying Part B makes sense.
It depends on your employer coverage, costs, and employer size. Some people enroll in premium-free Part A at 65 and delay Part B until retirement; others enroll in both and coordinate benefits.
MedigapRx can help you compare your employer plan against Medicare options so you avoid penalties and unnecessary duplicate coverage.
Most people are eligible at age 65 if they are U.S. citizens or permanent legal residents who meet residency requirements. Some people qualify earlier due to disability benefits or certain health conditions.
If you or your spouse worked and paid Medicare taxes long enough, you may qualify for premium-free Part A. Part B generally has a monthly premium. We can help you confirm eligibility and estimate costs before you enroll.
Then compare standardized plans (for example, Plan G vs Plan N) and shop prices across carriers in your area. MedigapRx provides side-by-side comparisons so you can see coverage differences, pricing, and value – not just premiums.
Start with two questions:
- How much protection do you want from out-of-pocket costs (deductibles/coinsurance)?
- What monthly premium fits your budget?
In many cases, yes – but switching can involve medical underwriting depending on timing, state rules, and your situation. Outside protected periods, insurers may review health history and can sometimes charge more or decline the application.
If you’re in your Medigap open enrollment window (generally when you’re 65+ and enrolled in Part B) or you have a guaranteed-issue right, you may be able to switch without underwriting. We can help you understand your options and timing.
No. Medigap only works with Original Medicare, and you can’t use it with a Medicare Advantage plan.
If you want to move from Medicare Advantage back to Original Medicare and add Medigap, you typically must do so during certain enrollment periods – and you may face underwriting for Medigap depending on timing. MedigapRx can help you plan the switch to avoid gaps.
No. Medigap policies sold after 2005 generally do not cover outpatient prescription drugs. For drug coverage, many people enroll in a standalone Medicare Part D plan.
MedigapRx can compare Part D plans based on your medications, preferred pharmacies, and total annual costs – not just the monthly premium.
We help you compare both options using your doctors, prescriptions, and expected usage – so you can choose confidently.
Neither is universally “better.” The right choice depends on how you prefer to receive care and pay for it.
- Medigap often appeals to people who want predictable costs and broad nationwide access to Medicare-accepting providers.
- Medicare Advantage often appeals to people who prefer lower premiums and are comfortable using networks and paying copays/coinsurance.
In most cases, yes. With Original Medicare + Medigap, you can generally see any provider in the U.S. who accepts Medicare, without network restrictions. That can be valuable for frequent travelers, snowbirds, or anyone who wants flexibility with specialists.
If you apply outside your protected enrollment windows, insurers may use medical underwriting, meaning they can consider your health history and may charge more or decline coverage.
During your Medigap Open Enrollment Period (typically when you’re 65+ and enrolled in Part B), insurers generally cannot deny you or charge more due to health conditions. Timing matters, and we can help you apply when you have the strongest protections.
Most Medigap policies are guaranteed renewable as long as you pay premiums on time and do not materially misstate information on your application. Policies can be terminated for reasons such as non-payment or other limited circumstances under applicable rules.
If you’re concerned about losing coverage, MedigapRx can help you understand your rights and evaluate next steps.