Before you read any further, have you spoken with one of our Fair Square Medicare experts yet
If you're not sure where to start with that first phone call with your Medicare advisor for life, let's play 20 questions.
That depends on whether or not you (or your spouse Creditable coverage
The best time to sign up for Medicare is during your Initial Enrollment Period (IEP)
If you already missed your Initial Enrollment Period, then you might have to wait for the General Enrollment Period. This lasts from January 1 to March 31 each year, and your coverage starts the month after you sign up. Be wary, for each month that you are without coverage after you become eligible for Medicare, you might have to pay a Late Enrollment Penalty. If you have a Special Enrollment Period due to your circumstances, you can enroll without facing the LEP. Here’s a list of Special Enrollment Period qualifying events.
Odds are you are already enrolled in Social Security, which means you are automatically enrolled in Medicare Part A and Part B, aka Original Medicare. If you want to avoid a Late Enrollment Penalty for your prescription drug coverage, you need to sign up for Part D as well. You might have heard of Part C, but that’s just another name for Medicare Advantage, which can act as a bundle for Parts A, B, and D.
Part A is also known as Hospital Insurance, you will likely not have to pay any premium for Part A, so you only have to pay the Part A deductible of $1,676 per benefit period if you are admitted into the hospital.
Part B is also known as Medical Insurance, you will have different ways to pay:
A yearly deductible of $257
Monthly premium of $185 (depending on your income)
Coinsurance of 20% of medical costs (which can add up)
Part D Prescription Drug has premiums, deductibles and copayments depending on your choice of plan. Check out our blog post for estimating prescription drug costs
For most people, it’s not enough. We like to use the analogy that only having Original Medicare is like trying to make it through winter with only a hat and scarf
One easy way to illustrate this difference is that one is fee-based, and the other is value-based
Medicare Advantage (MA) plans are value-based. The government gives MA carriers a fixed amount of money per person they insure. This is called a capitation fee, after the word "capita," referring to "per head." The plans can spend this money however they want as long as their members have quality health outcomes. One way MA plans do this is by taking more control of what services you can use and when. For example, unlike Medigap plans or Original Medicare, MA plans require you to see in-network doctors rather than any doctor you like. Many also require your primary physician to refer you to a specialist. You can't go straight to one. This control allows some of their plans to be $0 premium.
prescription drug prices
work on Medicare?Your price for prescription drugs will depend on which tier your prescription drug plan (PDP) has designated for that specific drug. Generally, plans have up to 5 tiers, with prices increasing with each successive tier. Your price will also depend on which coverage phase you are in. The coverage phases, initial coverage and catastrophic coverage, go into effect after you pay your deductible.
Short answer: chat with one of our Medicare agents
Longer answer: there are many considerations, but first, you should ask if your current doctors and prescriptions are covered. Once you’ve narrowed down to plans that work with your medical providers, you should consider your healthcare needs and how they square with your budget. This is where the decision between Medicare Supplement and Medicare Advantage comes into focus.
We often recommend Medicare Supplement plans to our clients because they offer the most comprehensive coverage. Your healthcare costs generally increase as you age, and it’s much more difficult to switch from a Medicare Advantage plan to a Medigap plan than vice versa.
Medicare Advantage plans are often called the “Pay-As-You-Go” option. That’s why it might be risky to opt for short-term savings on your monthly premium against long-term spending on your healthcare. With that being said, Medicare Advantage plans are not inherently bad
Yes, the Part B premium of $185 is paid in addition to the Plan premium of your Medicare Advantage or Medicare Supplement plan.
You have to pay your monthly premiums. Otherwise, you are at risk of losing coverage. Before your coverage kicks in, you need to pay your deductibles. Then once you hit your deductibles, then your costs will be your copays and/or coinsurances, depending on your plan. Before you know it, the costs of Medicare can pile up.
This is another answer that might seem complicated but is quite simple. Plan G is the most popular option. In some states, Plan N might also be popular. If you were Medicare eligible before 2020, you might be eligible for Plan F. Our blog post here
They do not. These extra benefits are only included in some Medicare Advantage plans. If you choose a Medigap plan, you might need separate plans for dental, vision, and/or hearing benefits.
If you are asking this question, you are likely referring to Flex Cards
Yes, you can! Your monthly premiums can be deducted from your taxes in addition to costs associated with certain procedures. Check out our handy guide here
What if my doctor doesn’t accept Medicare?
Over 90% of doctors nationwide accept Medicare, so this isn’t too common of an issue. However, if your doctor is one of the select few who has chosen not to accept Medicare, here are some strategies:
Ask for a referral
Use the Medicare physician directory
Find a new doctor in your plan's network
Ask for a discount from your doctor
As we discussed earlier, some Medicare Advantage plans have limitations on which doctors you can visit based on your network. If your physician or procedure is not approved by your Medicare Advantage plan’s network, consider switching to Medicare Supplement.
Do I need to renew my Medicare plan?
No, you don’t need to renew your plan as long as you’re up to date with paying your premiums. However, a best practice is to review your plan details every year, as these might change depending on your plan.
Call us Annual Enrollment Period (AEP)
We have a section of our blog
You can also consult the AI-powered Virgil
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For any questions here that were left unanswered, our Medicare experts are ready to help. Call us today at 888-376-2028 and take your next step on your Medicare journey.
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Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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