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Medicare Frequently Asked Questions (FAQ)

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?

Yes.

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.



Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

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