Medicare open enrollment is now active for eligible adults. Navigating the enrollment process can be challenging. Here is a toolkit of resources that might make the process less stressful.
- Medicare.gov - Getting Started
- What to do if you're getting Social Security benefits before 65
- What to do if you're getting Social Security benefits after 65
- Texas Medicare resources - including the free Medicare help line
- Medicare supplement insurance guide - Texas Department of Insurance
- Download a Medicare Enrollment Cheat Sheet provided by The Senior Source
- The Senior Source - Medicare Counseling (Dallas)
Additional information about Medicare, eligibility, and enrollment from the Texas Department of Health and Human Services:
What is the Texas Health Information, Counseling and Advocacy Program?
If you are eligible for Medicare, the Texas' Health Information, Counseling and Advocacy Program can help you enroll, find information and provide counseling about your options. This partnership between the Texas Health and Human Services system, Texas Legal Services Center and the Area Agencies on Aging trains and oversees certified benefits counselors across the state.
What services does the partnership provide?
- Medicare and Medicaid information and education
- Help with original Medicare eligibility, enrollment, benefits, complaints, rights and appeals
- Explain Medicare Supplemental (Medigap)insurance policy benefits and comparisons
- Explain Medicare Advantage (Part C) and provide comparisons and help with enrollment and disenrollment
- Explain Medicare Prescription Drug (Part D) coverage, help compare plans and search for other prescription help
- Information about long-term care insurance
The partnership also helps with the following programs. Benefit Counselors are specially trained to help you understand all the fine print to find and apply to a plan that works for you. They advocate for you with these programs and help you get the services you need.
Most Common Medicare Questions
1. I’m turning 65 next month. I’ve read that I need to enroll in Medicare. Is that true?
Depends on your situation. If you have other insurance, such as group health coverage, you may not have to.
2. I’m turning 65 next month. I’m still working. Do I need enroll in Medicare now?
Do you have employer health coverage or another form of health coverage? If so, you may be able to delay Medicare enrollment.
3. What’s the difference in Traditional (Original) Medicare vs. Medicare Advantage?
The main difference is access to doctors and medical providers. Know whether your doctor/provider is in the plan’s network.
4. I’m not taking any prescriptions. Do I need prescription coverage? What if I don’t enroll in Part D?
When you become eligible for Medicare, you must have prescription coverage that is deemed “creditable” by Medicare’s standards, otherwise you may face a late enrollment penalty.
5. I need dental insurance. How can I get that with Original Medicare? Should I switch to a Medicare Advantage plan?
Original Medicare does not offer basic dental coverage. You would need to find coverage outside of Medicare. Many Medicare Advantage plans offer some form of dental benefits. Make sure you know the details about the dental coverage. It’s not wise to choose a Medicare plan based solely on the additional benefits, such as dental, vision, fitness, etc.
6. What is the best Medicare plan for me? My friend from church is on Plan _____. She says I should enroll in that plan. Is that true?
Unless you have the exact same medical needs as your friends, family, neighbors, it’s probably best to choose a plan that meets your needs, not theirs.
7. I just enrolled in Medicare, and I need to cover the 20% co-insurance that Medicare Part B does not cover. Can you help me?
You can choose to purchase a Medicare Supplement plan (aka Medigap) as a secondary to Original Medicare. The purpose is to offset the costs that Medicare does not cover, such as the 20% co-insurance for Medicare Part B.
8. Medicare is deducting $165 a month from my check. I can’t afford that. Can you help me?
There is a state benefit program that can pay for the Medicare Part B monthly premium. Eligibility is based on household income and assets.
9. I missed signing up for Medicare last January when I turned 65. Can I just wait until October during Open Enrollment to sign up
If you missed your Initial Enrollment Period for Medicare when you turned 65, and you do not qualify for a Special Enrollment Period, you may have to wait until the General Enrollment Period begins the following January 1.
10. I signed up Medicare Part A and Part B, but I am not taking SS retirement benefits yet. How will they bill me for the monthly premium?
If you are on Medicare, and not receiving SSA retirement benefits yet, Medicare will bill you for 3 months of premiums in advance of the time period. For example, If you turned 65 in October, you can expect to receive a bill from Medicare for October. November and December monthly premiums.
