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faq
faq
Frequently Asked Questions
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FAQ
General Questions
When can I enroll in Medicare?
You’re eligible to enroll during a
7-month window
that begins
3 months before the month you turn 65
and ends
3 months after
. This is called your
Initial Enrollment Period
. If you miss it, you may have to wait and pay a late enrollment penalty.
What’s the difference between Medicare Parts A, B, C, and D?
Part A
: Hospital coverage (inpatient care, nursing facilities, hospice)
Part B
: Medical coverage (doctor visits, outpatient care, preventive services)
Part C
: Medicare Advantage (private plans that bundle A, B, and often D)
Part D
: Prescription drug coverage
Do I need a Medicare Supplement plan (Medigap)?
If you have
Original Medicare (Parts A & B)
, a
Medigap plan
can help pay out-of-pocket costs like deductibles, copays, and coinsurance. It can provide peace of mind by limiting what you have to pay out of pocket.
What if my medications aren’t covered by my Medicare plan?
PharmaShield can help you review your coverage, compare other plans, and—if needed—work with your doctor to find
cost-effective alternatives
that are covered. You’re not stuck with high prices.
Can I keep my doctor with Medicare?
Yes—
but it depends on your plan
. With Original Medicare, most doctors accept it. With Medicare Advantage plans, you’ll need to check if your doctor is in-network. We help you choose plans that keep your preferred providers.
How do I avoid Medicare late penalties?
Enroll in
Part B and/or Part D on time
—even if you’re healthy. Delaying enrollment without having other credible coverage can result in
lifetime penalties
added to your premium. Let us help you enroll at the right time to avoid this.
What’s the difference between Original Medicare and Medicare Advantage?
Original Medicare
is the traditional program run by the government (Parts A & B).
Medicare Advantage (Part C)
is offered by private insurance companies and often includes additional benefits like
vision, dental, hearing, and prescription drugs
. We help you compare both to see what works best for your needs.
How much does Medicare cost?
Part A
is usually
free
if you’ve worked and paid Medicare taxes for 10+ years.
Part B
has a
monthly premium
(most people pay a standard amount).
Part D and Medicare Advantage
costs vary by plan.
We’ll help you estimate your total costs and find the most affordable plan.
Can I change my Medicare plan later?
Yes! You can make changes during
Open Enrollment
(October 15 – December 7 each year) or during
Medicare Advantage Open Enrollment
(January 1 – March 31). Life events may also allow for special enrollment. We monitor these periods and help you make changes when needed.
What if I’m still working at 65—do I need to enroll?
If you have
credible employer coverage
, you may be able to
delay Part B and Part D
without penalty. We’ll help you evaluate your current insurance and determine the best time to enroll in Medicare.
Will Medicare cover all of my medical expenses?
No. Medicare
does not cover everything
, such as long-term care, routine dental/vision, and custodial care. That’s why many people choose
supplemental coverage or Medicare Advantage
. We’ll help you build a plan that fills the gaps.
How can PharmaShield help me with Medicare?
We offer
free personalized reviews
to help you:Understand your Medicare optionsCompare plans based on your doctors, prescriptions, and budgetAvoid costly mistakesSave money on medications
With
pharmacy-based expertise and no-pressure guidance
, we make Medicare simple.
What is a Medicare Supplement (Medigap) plan, and how does it work?
A
Medicare Supplement
, or
Medigap
, is extra insurance that helps cover
out-of-pocket costs
not paid by Original Medicare—like deductibles, coinsurance, and copayments. These plans give you
predictable costs
and more
freedom to see any doctor
that accepts Medicare. We help you compare the options and find the right fit.
Do I have to use the same Medicare plan as my spouse?
No.
Medicare is individual coverage
, so your spouse may need a different plan based on their health needs, doctors, or medications. We can help each of you choose the best plan—
even if they’re different
—to make sure both of you are fully covered.
Still have questions? Our team is here to help!
Contact us