Question 1

What is Medicare and what are its different parts?

Accepted Answer

Medicare is the federal health insurance program for people age 65 or older, younger people with certain disabilities, and people with End-Stage Renal Disease (permanent kidney failure). It is divided into four main parts: Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B (Medical Insurance): Covers outpatient medical services like doctor visits, preventive care, medical supplies, and outpatient procedures. Part C (Medicare Advantage): Private health plan bundles that replace Original Medicare (A & B) and usually include Part D and extra benefits. Part D (Prescription Drug Coverage): Standalone private plans that cover the costs of retail prescription drugs.

Question 2

Are dental, vision, and hearing covered by Original Medicare?

Accepted Answer

No. Original Medicare (Parts A and B) does not cover routine dental cleanings, fillings, crowns, routine eye exams, eyeglasses, contacts, or hearing aids. To secure these essential health benefits, you can either select a Medicare Advantage plan that includes routine allowances or purchase a standalone, comprehensive Dental, Vision, & Hearing (DVH) supplemental policy with no network restrictions.

Question 3

When should I first enroll in Medicare?

Accepted Answer

Most individuals should enroll during their Initial Enrollment Period (IEP). This is a 7-month window that begins 3 months before your 65th birthday month, includes your birthday month, and ends 3 months after. If you are already receiving Social Security benefits, you will be enrolled automatically. If you delay without having "creditable" employer health insurance, you could face permanent lifetime late enrollment penalties.

Question 4

Can I delay enrolling in Medicare if I am still working?

Accepted Answer

Yes, but only if your employer has 20 or more active employees and the health coverage is legally deemed "creditable" by Medicare standards. If your employer coverage qualifies, you can delay Part B and Part D without a penalty. Once you retire or your employer coverage ends, you will have an 8-month Special Enrollment Period (SEP) to enroll in Medicare with zero penalties.

Question 5

What is the difference between Medicare Advantage and Medicare Supplement (Medigap)?

Accepted Answer

They are completely separate, mutually exclusive paths: Medicare Supplement (Medigap) works alongside Original Medicare. It covers your 20% outpatient coinsurance and hospital deductibles. You pay a higher monthly premium, but you get broad doctor freedom (see any doctor in the US who accepts Medicare) without network restrictions. Medicare Advantage (Part C) replaces Original Medicare with a private managed network (HMO or PPO). You enjoy low or $0 monthly premiums and extra benefits (dental, vision, fitness), but you generally use in-network providers, may need referrals on HMO plans, and pay copays as you go up to an annual maximum out-of-pocket limit.

Question 6

How do I check if my preferred doctors are in-network?

Accepted Answer

With a Medicare Supplement (Medigap) plan, you do not need to worry about networks—if your doctor accepts Medicare, they accept your plan. For Medicare Advantage plans, you must search the private insurance company's specific provider directory. Since doctor networks change frequently, we strongly recommend calling your doctor's billing department or utilizing our complimentary provider look-up service before enrolling.

Question 7

How much does Medicare cost in 2026?

Accepted Answer

Your Medicare premium costs are split across the parts: Part A: Free for most people (who worked and paid Medicare taxes for at least 10 years / 40 quarters). Part B: The standard monthly premium in 2026 is $185.00/month for most enrollees, with higher amounts for those above certain income thresholds (IRMAA). Part C & D: Premium rates vary widely based on the specific plan you select, with many Medicare Advantage plans offering $0 additional monthly premiums. Medigap: Monthly premiums depend on your age, location, and plan letter, typically ranging from $100 to $280+.

Question 8

What is the Part D Late Enrollment Penalty, and how does it work?

Accepted Answer

If you go without "creditable" prescription drug coverage for 63 continuous days or more after your Initial Enrollment Period ends, you will face a permanent monthly penalty when you eventually enroll. The federal government calculates this penalty as 1% of the national base beneficiary premium for every full month you went without coverage. This penalty is rounded to the nearest $0.10 and added to your monthly Part D drug premium for as long as you have Medicare.

Question 9

Do Medicare Advantage plans vary by county?

Accepted Answer

Yes. Medicare Advantage plans are offered at the county level. A plan available in one county — whether in Florida, Georgia, Alabama, or North Carolina — may not be available in a neighboring county. Networks, premiums, and benefits can differ significantly even within the same metro area. SwitchBlue helps you review plans available in your specific zip code.

Question 10

Can I change my Medicare plan after I enroll?

Accepted Answer

Yes. You can change Medicare Advantage or Part D plans during the Annual Enrollment Period (October 15 – December 7 each year). Medicare Supplement (Medigap) plan changes have different rules — switching carriers after your initial enrollment window typically requires medical underwriting in FL, AL, GA, and NC. We help beneficiaries understand their options during every enrollment period.

Question 11

How much does working with SwitchBlue cost?

Accepted Answer

SwitchBlue provides no-cost Medicare guidance to consumers. Our services are funded through standard commissions paid by insurance carriers when you enroll in a plan — we do not charge consultation fees. You pay the same plan premium whether you enroll on your own or with an independent advisor.

Medicare Frequently Asked Questions

Frequently Asked Medicare Questions