Frequently asked questions

You can apply for Medicare through the Social Security Administration. You’ll need to provide your Social Security number, where you were born, start and end dates for any current group health plans and start and end dates for any group health plans after age 65. If you’re signing up for Medicare Part B, you’ll need a valid email address and your existing Medicare number.

While both Medicare and Medicaid are government-funded programs, eligibility requirements are different.

Medicare is primarily for people 65 or older, or younger people with disabilities or certain illnesses, including ALS and end-stage kidney failure. Medicaid is for low-income individuals, families and children, with the specific income requirements varying by state.

If you’re 65 or older and need health insurance, or if you have a disability, ALS (Amyotrophic Lateral Sclerosis; also known as Lou Gehrig’s Disease) or end-stage renal failure, you may want to consider Medicare. The initial enrollment period for someone  just turning 65 begins at 64 & 9 months.

Medicare Part A is free if you worked and paid Medicare taxes for at least 10 years, but most people pay a monthly premium for Part B based on their income.

Parts C and D are privately run so premiums will vary depending on coverage.

While it may be tempting to go with what looks like the most affordable option, it’s important to evaluate your lifestyle, health and needs. This includes your yearly appointments, medications, preferred providers, and any anticipated treatments.

While only enrolling in Part A may seem cheaper, it could end up being a lot more expensive in the long run if you’re paying for your doctors’ appointments and prescriptions out of pocket.

It may also be worth considering the life you want to live as you continue to age. If you love to read or listen to audiobooks, you may want to ensure you have solid vision and hearing coverage with a Medicare Advantage plan.

Do you have a doctor or health network you trust? Make sure you’ll still be covered under your Medicare coverage.

Do you visit your grandchildren in another state regularly? You may want to ensure you’ll have access to doctors who participate in your Medicare Advantage plan there.

One way to maximize your Medicare benefits is by taking advantage of all the preventative care coverage it provides. This includes more than just a yearly check-up. It covers abdominal aortic aneurysm screening, bone mass measurements, mammograms, heart disease screening, cervical and vaginal cancer screening, diabetes screening, glaucoma tests, vaccinations, HIV screening, and prostate cancer screening. Catching things early will save you money — and stress — in the long run.

In the same vein, adding prescription drug coverage is worth it for many people. Just make sure to check your plan’s list of covered drugs and make sure yours are covered.

There are a lot of plan options, so don’t be afraid to ask for help. Call a Medicare representative or use the Medicare plan finder tool to talk through your options.

Technically, Medicare isn’t mandatory. But Medicare Part A begins automatically at age 65. If you opt out, you may lose your Social Security or Railroad Retirement Board benefits. Or, if you decline and sign up later, you may have to pay a penalty.

You need to enroll in Medicare Parts A & B before deciding which additional Medicare parts may be right for you.

MetroPlusHealth’s customer service representatives can walk you through the enrollment process and answer any questions you may have. To speak to a representative, call 866.496.6636.

Medicare does provide some coverage for home health services, but what it will cover depends on your plan.

Medicare doesn’t cover routine eye exams for prescription updates, but it does cover yearly glaucoma screenings and certain diagnostic tests and treatment for some people with age-related macular degeneration.

Medicare also doesn’t cover routine dental cleanings, fillings, tooth extractions, or things like dentures and implants. However, there are certain scenarios when Medicare may cover dental services, such as if it’s a dental service directly related to certain covered medical treatments.

If you’re newly eligible for Medicare, you have a seven-month period to enroll, the three months before your 65th birthday month, your birthday month, and the three months after.

You can also enroll in Medicare during the annual enrollment period from Oct. 15 – Dec. 7 each year, or you may be able to enroll during special enrollment periods depending on your circumstances.

To find out if you can enroll during a special enrollment period, or for help enrolling, you can call MetroPlusHealth at 1.800.986.0356.