Navigating Medicare can feel overwhelming, especially with the countless plans, rules, and exceptions. That’s why we invited Ari Parker, co-founder and head of Medicare advisory at Chapter Medicare, to answer your most pressing Medicare questions. Ari is also the author of It’s Not That Complicated: The Three Medicare Decisions to Protect Your Health and Money.
In this Q&A session, we break down key Medicare topics, from understanding coverage options to lowering your Medicare bills. To make this information even more accessible, we have used AI to summarize the transcript of the video so that you can find the Q&A answers quickly below.
Understanding Medicare
Ari explains Medicare using the analogy of a three-legged stool:
- Medicare Part A – Covers hospital stays (inpatient care).
- Medicare Part B – Covers doctor visits, outpatient care, durable medical equipment, labs, X-rays, and MRIs.
- Medicare Part D – Covers prescription drugs.
Each of these “legs” is essential, and choosing the right additional coverage can help ensure you get the healthcare you need at an affordable cost.
Medicare Advantage vs. Original Medicare: What’s the Difference?
A common question is whether Medicare Advantage plans are scams. Ari reassures us that while some aggressive marketing tactics can be misleading, not all Medicare Advantage plans are bad.
Here’s how Medicare Advantage fits into the picture:
- Original Medicare (Parts A & B) covers 80% of your medical costs. You are responsible for the remaining 20%.
- Medicare Supplement (Medigap) Plans help cover that 20%, but they come with a monthly premium.
- Medicare Advantage (Part C) replaces Original Medicare and is managed by private insurance companies. These plans must provide at least the same level of coverage as Original Medicare, but they may have different networks and coverage rules.
How to Choose the Right Plan
To find the best Medicare plan, Chapter’s advisors evaluate your:
- Providers – Ensuring your doctors are covered.
- Prescriptions – Finding plans that cover your medications affordably.
- Priorities – Balancing cost, network flexibility, and additional benefits like dental and vision.
Since Medicare plans vary by zip code, having a one-on-one consultation can help you choose the right plan for your unique needs. Call 417-319-2139 or visit https://lirlinks.com/chapter to speak with a licensed Medicare advisor.
Common Medicare Questions & Answers
If I’m on Medicare due to disability, will my coverage change when I turn 65?
Yes! You will receive a second initial enrollment period to review your plan options and choose the best coverage for your situation.
How often should I review my Medicare plan?
Ari recommends reviewing your plan every year during:
- Annual Enrollment Period (Oct. 15 – Dec. 7) – Best time to switch plans.
- Medicare Advantage Open Enrollment (Jan. 1 – March 31) – A second chance to change if you’re already on a Medicare Advantage plan.
Plans change yearly, and your health needs may change too, so reviewing your plan annually ensures you’re getting the best coverage at the lowest cost.
Can I switch back to Original Medicare if I choose Medicare Advantage?
Yes! If you try Medicare Advantage and decide you prefer Original Medicare, you have a one-time trial right (typically within one year) to switch back. You may also have a chance to switch if you move to another state or experience certain qualifying life events.
How can I tell if I qualify for Medicaid along with Medicare?
Medicaid eligibility depends on income and assets, and some states have higher income limits. If you qualify for Medicaid, you automatically qualify for Part D Extra Help, which lowers your prescription drug costs.
What can I do to lower my Medicare bills?
- Make sure you’re on the right plan for your doctors, prescriptions, and budget.
- Apply for Medicare Savings Programs or Medicaid to cover premiums, deductibles, and copays.
- Check if you qualify for Part D Extra Help to lower drug costs.
Over 2 million people per year receive help with prescription costs through Extra Help.
Medicare & Additional Benefits
Does Medicare cover dental, vision, or hearing?
Original Medicare does not cover routine dental, vision, or hearing services, but many Medicare Advantage plans offer these benefits. If you have both Medicare and Medicaid, you may qualify for Dual Special Needs Plans (D-SNPs) that include these extra benefits.
What about the $900 food card?
The “Medicare Grocery Benefit” is not a standard Medicare benefit—it’s a marketing offer tied to specific Medicare Advantage plans. The benefits vary by location, and it’s crucial to ensure that the plan covers your doctors and prescriptions first before choosing based on extra perks.
What If I Lose Medicaid?
If I lose my Medicaid due to budget cuts, what happens to my Medicare?
If you lose Medicaid, you qualify for a Special Enrollment Period to find a new Medicare Advantage or Medigap plan. Chapter’s advisors can help find affordable options for those in this situation. Call 417-319-2139 or visit https://lirlinks.com/chapter for assistance.
Can I get Medicaid instead of Medicare if I’m elderly?
No, but many people qualify for both Medicare and Medicaid. If you have both, Medicaid can help cover Medicare’s costs, including the Part B premium and out-of-pocket expenses.
Key Takeaways
- Medicare has three main parts: Part A (Hospital), Part B (Doctors & Outpatient), and Part D (Prescriptions).
- There are two main types of additional coverage:
- Medicare Advantage (Part C): Replaces Original Medicare and may offer extra benefits.
- Medicare Supplement (Medigap): Helps cover the 20% gap in Original Medicare.
- If you qualify for Medicaid, it can help cover Medicare costs.
- Review your plan every year during open enrollment to ensure you’re getting the best benefits at the lowest cost.
Get Personalized Medicare Help
Choosing the right Medicare plan can save you money and ensure you get the best care. If you need help evaluating your options, call 417-319-2139 or visit https://lirlinks.com/chapter to speak with a licensed Medicare advisor.
The views and opinions expressed in the content on this website are solely those of the content creators and do not necessarily reflect the views, opinions, or positions of the Social Security Administration, Medicare, Chapter, or its affiliates. Chapter makes no representations or warranties regarding the accuracy, completeness, or reliability of the information provided. All content is intended for informational, educational, or entertainment purposes only and should not be interpreted as official positions of the Social Security Administration, Medicare, Chapter, or its affiliates. Chapter disclaims any liability for actions taken based on this content.
If you need assistance with Medicare, please reach out to Medicare, your local State Health Insurance Program (SHIP), your current Medicare insurance agent/broker/plan, or contact our Medicare partner, Chapter, at 417-319-2139 or visit their website at https://lirlinks.com/chapter. Chapter: Memoir, Inc. d/b/a Chapter is a privately owned, data- and technology-enabled advisory service helping older Americans navigate retirement. Insurance agency services are provided by Chapter Advisory, LLC, a licensed health insurance agency and wholly owned subsidiary of Memoir, Inc. In California, Chapter Advisory, LLC does business as Chapter Insurance Services (Lic. No. 6003691).Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations as well as stand-alone prescription drug plans with Medicare contracts. Enrollment depends on the renewal of those contracts. While Chapter maintains a comprehensive database of Medicare plans nationwide and assists in searching all options, Chapter has contracts with many, but not all, plans. Therefore, Chapter does not offer every plan available in your area. Chapter recommends plans even if they are not directly offered through Chapter. For complete Medicare plan options, please visit Medicare.gov, call 1-800-Medicare, or contact your local SHIP office.