A. You can apply for Medicare Part A & B online at www.SSA.gov, in person at your local Social Security Office or by making an appointment with one of our Agents. We can help you apply online and advise you on the next steps of choosing the right plan for you. Call us at 951-769-0005 for a NO COST appointment.

A; If you miss your Initial Enrollment Period, you will likely incur a penalty. There is an annual 10% penalty for each year you do not enroll in part B. Likewise, if you do not enroll in a Part D (Drug Plan such as a Stand-Alone Prescription Drug Plan or a Medicare Advantage Plan with Prescription Drug Coverage) you will incur a Penalty of 1% each month you do not enroll. If you have Credible Coverage, such as group coverage through an employer, you can avoid paying a penalty for delaying enrollment.

A. You can continue your coverage through your employer and delay enrollment in Medicare Part B as long as it is “Credible Coverage” deemed by the Government. Creditable coverage must provide you with benefits that are as good as or better than Medicare’s coverage. Not all employer coverage is considered creditable.

Common types of credible coverage include:

- Large employer Group Coverage (more than 20 employees)

- Union-sponsored health plans

- Federal Employee Health Benefits (FEHB)

Remember, delaying Medicare Part B without creditable coverage can be detrimental to your wallet in the future. If you do not enroll in Medicare Part B as soon as you become eligible for Medicare, you may be subject to a penalty. This penalty increases incrementally for every year you lack creditable coverage. When you eventually enroll in Medicare Part B, you will pay the penalty plus your Part B Premium each month.

A. Original Medicare is coverage managed by the federal government. Generally, there's a cost for each service. In most cases you can go to any doctor, health care provider, hospital, or facility that is enrolled in Medicare and are accepting new Medicare patients. With few exceptions, most prescriptions are not covered in Original Medicare. You can add drug coverage by joining a Medicare Drug Plan (see more on this under Part D Prescription plans). You generally pay a set amount for your health care (deductible) before Medicare pays its share. There is no yearly limit for what you pay out-of-pocket. A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare.

MAPD plans provide Part A and Part B Medicare benefits and in California they include Part D prescription coverage as well. These plans can include HMO’s (Health Maintenance Organizations), PPO’s (Preferred Provider Organizations), PFFS (Private Fee-for-Service Plans), SNP’s (Special Needs Plans), CSNP’s (Chronic Special Needs Plans). If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and are not paid for under Original Medicare. There is a cap for out of the pocket expenses, which varies from plan to plan. They also include benefits that Original Medicare does not (such as vision, hearing, dental, chiropractic, over the counter allowance, gym membership, etc.)

A. The amount you pay for your Part B Medicare is based on your specific financial situation and determined by Social Security. With most Medicare Advantage Plan there is no additional cost for the plan itself.

A. Under the Part D benefit, you get prescription drug coverage through the MAPD plan. Typically, the copay is zero dollars for tier 1 and 2 prescription drugs. There can be some cost to the individual for prescription drugs that fall under Tier 3, 4 and 5.

 A. Part A is usually no cost, as long as you have worked 10 years (40 quarters) throughout your life.

Part B does have a premium. It fluctuates year to year. For 2025 the premium in most cases is $185 per month depending on your income.

A. IEP (Initial Enrollment Period) When you turn 65, you have a 7-month window to apply for your Medicare Part A & B (3 months before your birth month, the month of your birthday and 3 months after your birth month). You may choose to delay enrollment if you have credible coverage such as group insurance through your employer.

A. Yes. If you do not enroll in Part B when eligible, there is a 10% penalty for every year you do not enroll, this penalty will follow you throughout your life. If you do not enroll in a D Plan (either a standalone Prescription Drug Plan or a Medicare Advantage Plan with Prescription Drug Coverage) you will incur a 1% penalty each month you do not enroll, this penalty will also follow you through out your life.

A: Yes! If you need assistance applying to your Medicare, we would be happy to help you. Call our office at 951-769-0005 and we will schedule a NO COST appointment to get you enrolled.

Common types of credible coverage include:

- Large employer Group Coverage (more than 20 employees)

- Union-sponsored health plans

- Federal Employee Health Benefits (FEHB)

Remember, delaying Medicare Part B without creditable coverage can be detrimental to your wallet in the future. If you do not enroll in Medicare Part B as soon as you become eligible for Medicare, you may be subject to a penalty. This penalty increases incrementally for every year you lack creditable coverage. When you eventually enroll in Medicare Part B, you will pay the penalty plus your Part B Premium each month.

A. Medicare Advantage Plans provide services that fall under Part A, Part B and Part D benefits to those enrolled. Additionally, there is typically some coverage for transportation, vision, dental, hearing and other Medicare support needs that may arise.

MAPD plans provide Part A and Part B Medicare benefits and in California they include Part D prescription coverage as well. These plans can include HMO’s (Health Maintenance Organizations), PPO’s (Preferred Provider Organizations), PFFS (Private Fee-for-Service Plans), SNP’s (Special Needs Plans), CSNP’s (Chronic Special Needs Plans). If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and are not paid for under Original Medicare. There is a cap for out of the pocket expenses, which varies from plan to plan. They also include benefits that Original Medicare does not (such as vision, hearing, dental, chiropractic, over the counter allowance, gym membership, etc.)

A. Yes. Sometimes there is a copay with a provided service, however, many of the services have a zero-dollar copay. Copays differ from plan to plan, so it is important to discuss with your agent your Medicare history; this way he/she can recommend to you the plan that will best meet your specific needs.

A. The Centers for Medicare & Medicaid Services (CMS) is the agency within the U.S. Department of Health and Human Services (HHS) that administers the nation’s major healthcare programs. The CMS oversees programs including Medicare, Medicaid, CHIP (Children’s Health Insurance Program), and the state and federal health insurance marketplaces. CMS releases updated Medicare premium and deductible information each year. CMS pays a fixed amount for your care each month to the companies that offer the MAPD plans. These companies much follow the rules set by Medicare.