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Frequently Asked Medicare Questions

Get clear, straightforward answers to the most common questions about Medicare enrollment, coverage, costs, and how TrustInsure can help.

Medicare Basics

Understanding Medicare

Start here if you are new to Medicare or want to brush up on the fundamentals.

Medicare is the federal health insurance program for Americans aged 65 and older, as well as younger people with certain disabilities or End-Stage Renal Disease (ESRD). You are automatically eligible at age 65 if you or your spouse paid Medicare taxes for at least 10 years (40 quarters). Younger individuals may qualify if they have received Social Security Disability Insurance (SSDI) benefits for 24 months, or have been diagnosed with ALS (Lou Gehrig's disease) or ESRD requiring dialysis or a transplant.

Medicare has four parts:

Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people get Part A premium-free.

Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and durable medical equipment. Has a standard monthly premium ($202.90 in 2026).

Part C (Medicare Advantage): An alternative offered by private insurers that combines Parts A and B coverage, usually includes Part D, and may offer additional benefits. Requires using a provider network.

Part D (Prescription Drugs): Covers prescription medications through private plans. Available as a standalone plan or bundled into Medicare Advantage.

Learn more on our ABCs of Medicare page.

Medicare Advantage (Part C) replaces Original Medicare with a plan from a private insurer. It bundles hospital, medical, and usually drug coverage together and may include additional benefits. You must use the plan's provider network (HMO or PPO). Premiums, copays, and benefits vary by plan and location.

Medicare Supplement (Medigap) works alongside Original Medicare to cover the out-of-pocket costs that Parts A and B do not pay, such as copays, coinsurance, and deductibles. You can see any doctor who accepts Medicare nationwide with no network restrictions. Premiums are higher but out-of-pocket costs are very predictable.

The right choice depends on your healthcare needs, preferred doctors, prescription drugs, and budget. Contact us for a no-cost comparison.

Original Medicare (Parts A and B) does not cover routine dental, vision, or hearing services such as cleanings, eye exams, eyeglasses, or hearing aids. Some Medicare Advantage plans may include additional benefits, but coverage varies by plan and location. If you have Original Medicare with a Supplement plan, you would need to explore separate coverage options. Contact us to learn what is available in your area.
The donut hole is a temporary phase in Medicare Part D prescription drug coverage where you pay more for your medications. After you and your plan have spent a combined amount on covered drugs, you enter the coverage gap. Thanks to the Inflation Reduction Act, brand-name drugs are now significantly discounted during this phase, and the gap is being phased out. After your out-of-pocket spending reaches a certain threshold, you enter catastrophic coverage where you pay very little for your drugs. Our agents can help you choose a plan that minimizes your time in the donut hole.
Enrollment & Timing

Medicare Enrollment Questions

Understand when and how to enroll in Medicare, and what happens if you miss your window.

Your Initial Enrollment Period (IEP) is a 7-month window surrounding your 65th birthday: 3 months before, your birth month, and 3 months after. This is when you first sign up for Parts A and B.

The Annual Enrollment Period (AEP) runs October 15 to December 7 each year, allowing you to switch plans or change drug coverage. The Medicare Advantage Open Enrollment Period (OEP) runs January 1 to March 31.

Special Enrollment Periods (SEPs) are available after qualifying life events like losing employer coverage, moving, or gaining Medicaid eligibility.

See our complete enrollment periods guide for all dates and details.

Missing your Initial Enrollment Period can result in permanent late enrollment penalties. The Part B penalty adds 10% to your monthly premium for each full 12-month period you delayed enrollment. The Part D penalty adds 1% of the national base premium per month of uncovered gap. These penalties are permanent and added to your premiums for as long as you have Medicare. If you think you may have missed a deadline, contact us immediately to discuss your options.
It depends on the size of your employer. If your employer has 20 or more employees, your employer coverage is primary and you can delay Medicare enrollment without penalty. You will have a Special Enrollment Period to sign up within 8 months of losing that coverage. If your employer has fewer than 20 employees, Medicare becomes primary at 65, and your employer plan becomes secondary. In this case, you should enroll in Medicare on time to avoid gaps and penalties. We recommend scheduling a no-cost consultation to review your specific situation.
Yes. During the Annual Enrollment Period (October 15 to December 7), you can switch Medicare Advantage plans, return to Original Medicare, or change your Part D drug plan. Changes take effect January 1. The Medicare Advantage Open Enrollment Period (January 1 to March 31) lets you make one additional plan change if you are in a Medicare Advantage plan. You may also qualify for a Special Enrollment Period after certain life events. TrustInsure reviews your plan every year to make sure it still fits your needs.
Costs & Coverage

Medicare Cost Questions

Understand what Medicare costs and how different parts of Medicare are structured.

Part A: Premium-free for most people (if you or your spouse paid Medicare taxes for 10+ years). The 2026 deductible is $1,736 per benefit period.

Part B: Standard premium is $202.90/month in 2026 (higher-income individuals pay more). Annual deductible is $283.

Part C (Medicare Advantage): Premiums vary by plan and location. Copays and coinsurance also vary by plan.

Part D: Premiums vary by plan. Copays depend on your medications and plan formulary.

Medigap: Premiums vary by plan type, your age, and location. Contact a licensed agent for a personalized comparison.

Medicare Part D is prescription drug coverage offered through private insurance plans. Even if you take few or no medications now, it is generally recommended to enroll when first eligible to avoid the late enrollment penalty (1% of the base premium per month you were without creditable coverage). If you have a Medicare Advantage plan that includes drug coverage, you already have Part D and do not need a separate plan. Our agents can compare Part D plans based on your specific medications to help you find the right fit. Learn more on our Part D page.
About Our Services

Questions About TrustInsure

Learn how we help and what makes our Medicare agency different.

No. Our services are at no cost to you. Insurance companies pay us a commission when you enroll in a plan, and this commission is the same regardless of which plan you choose. This means we have no financial incentive to steer you toward any specific plan. Our only goal is finding the right coverage for your individual needs and budget.
TrustInsure is licensed in North Carolina and proudly rooted in the Sandhills region, with our office in Aberdeen. While we have deep expertise in communities like Southern Pines, Pinehurst, Sanford, Laurinburg, Rockingham, and Hamlet, we serve Medicare beneficiaries across the entire state through in-person, phone, and virtual consultations.
You can schedule a no-cost consultation in several ways:
  • Phone: Call us at (910) 994-6464
  • Online: Fill out our contact form
  • In Person: Visit our office in the Sandhills area

We offer appointments Monday through Friday, with evening and weekend availability by request. Consultations can be in person, by phone, or via video call — whichever is most convenient for you.

Still Have Questions About Medicare?

Our licensed agents are here to provide no-cost, personalized answers. No question is too small.

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