Frequently Asked Questions

Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance). Part A helps cover things like hospital stays (does not include all provider services/charges OR services/charges in a hospital setting), skilled nursing facilities, and certain types of medical care provided in your home. Part B helps cover things like outpatient surgery, doctor office visits, physician services, and lab tests.

Original Medicare won’t cover all your health care expenses or protect you with an out-of-pocket limit, so it’s important to have additional coverage.

In most cases, you won't pay a monthly premium for Part A if you or your spouse paid Medicare taxes for a certain amount of time while working. You must pay the Part B premium each month, and the amount can change each year.

If you do not sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B (10% increase to your monthly premium for each full 12 months you delay enrollment). If you are allowed to sign up for Part B during a Special Enrollment Period, you usually do not pay a late enrollment penalty. Refer to the Medicare & You Handbook for full information.

Most people become eligible for Medicare when they turn 65. You may be eligible for Medicare before 65 if you have certain disabilities, certain types of kidney disease, or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.

If you are already receiving Social Security benefits before the age of 65, you’ll automatically get Part A and Part B starting the first day of the month you turn 65. If you are not already receiving Social Security benefits, you’ll need to sign up for Medicare. You can call the Social Security Administration at 800-772-1213, visit your local Social Security Administration office, or visit www.ssa.gov to sign up.

Original Medicare does not include Part D prescription drug coverage. You will need to have additional coverage like a Medicare Advantage plan or a Part D Prescription Drug Plan.

Original Medicare does not include dental, vision, or hearing coverage, so it’s important to have additional coverage.

Medicare Advantage plans are managed by private insurance companies and must be approved by Medicare. These plans must have the same coverage as Original Medicare (Part and Part B), but they have an annual limit (out-of-pocket maximum) on how much members pay. Some plans, including all Viva Medicare plans, cover extra benefits such as dental, fitness benefits, and worldwide emergency coverage. You must have both Medicare Part A and Part B to be eligible for a Medicare Advantage plan, also known as Medicare Part C. Most Medicare Advantage plans include Part D prescription drug coverage.

Medicare Advantage plans can have a monthly premium as low as $0 a month. Unlike Original Medicare, members are protected by an annual out-of-pocket maximum.

You can enroll in a Medicare Advantage plan when you first become eligible for Medicare. This is called the Initial Coverage Election Period (ICEP). Your ICEP begins 3 months before the date you have both Medicare Part A and Part B for the first time and ends either on the last day of the month after the month in which you first have both Part A and Part B; or the last day of your Part B Initial Enrollment Period, whichever is later. Your coverage will begin the month you are eligible for Medicare or the 1st of the month following the month you elect your Medicare Advantage coverage during your ICEP, whichever is later.

You can also enroll in a Medicare Advantage plan during the Annual Enrollment Period (AEP). This is between October 15 and December 7 every year. Anyone with Medicare Part A and Part B can join, switch, or drop a Medicare Advantage plan during AEP. Your coverage begins on January 1 as long as you enroll between October 15 and midnight on December 7.

If you are already enrolled in a Medicare Advantage plan as of January 1, then you can make a one-time election to go to another Medicare Advantage plan or Original Medicare and make a coordinating change to add or drop Part D prescription drug coverage. This is called the Medicare Advantage Open Enrollment Period (MA OEP). It is between January 1 and March 31 each year.

Finally, you may also enroll in a Medicare Advantage plan at other times during the year if you qualify for a Special Enrollment Period (SEP). Your coverage start date depends on the election period you are eligible for. The most common SEPs happen when you lose group health insurance coverage, you move into an area with different plan options, you qualify for Extra Help with prescription drug costs, or you have a change in your Medicaid status.

Most Medicare Advantage plans, like Viva Medicare, have plans that include Part D drug coverage, giving you all-in-one coverage.

Most Medicare Advantage plans, like all Viva Medicare plans, include dental, vision, and hearing coverage for no additional cost.

Original Medicare only includes Part A (Hospital Insurance) and Part B (Medical Insurance) and does not have an out-of-pocket limit. Medicare Advantage plans cover all Part A and Part B health care benefits and must have an out-of-pocket limit. Many Medicare Advantage plans, like all Viva Medicare plans, come with extra benefits like dental, vision, and hearing coverage. Most plans also include Part D prescription drug coverage and may cost as little as $0 a month.

Medicare is a federal health insurance program for people 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a federal and state program that helps people with limited income and resources pay their health care costs.

Depending on your income and resources, you may qualify for Medicaid. A Viva Medicare representative can help you determine if you qualify and help you apply for Medicaid.

You can have both Medicare and Medicaid. Dual-eligible special needs plans (D-SNP) are a type of Medicare Advantage plan made just for people who have both Medicare and Medicaid.

Depending on your income and resources, you may qualify for Extra Help with prescription drug costs and/or government programs that help pay your Medicare Part B premium and health care costs. A Viva Medicare representative can help you apply for these programs.

It’s important to ask your employer if you need to sign up for Medicare when you turn 65.

If you continue to work after 65, you may be able to have both Medicare and an employer health plan. You also may be able to delay signing up for Medicare if you or your spouse are still working.

When you stop working or lose your employer-sponsored health insurance, you will have a Special Enrollment Period (SEP) when you can sign up for Medicare.