CENTERS FOR MEDICARE & MEDICAID SERVICES

2019
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Welcome to Medicare!

Medicare is health insurance for people 65 or older, certain people under 65 with disabilities, and 

people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring 

dialysis or a kidney transplant). 

You’re getting this package because you’ve been enrolled automatically in Medicare Part A 

(Hospital Insurance). You don’t need to pay a monthly premium for Part A. You’ve also been 

enrolled automatically in Medicare Part B (Medical Insurance). You’ll need to pay a monthly 

premium for Part B if you choose to keep it. It’s usually deducted from your Social Security 

benefits.

This booklet explains some important decisions you need to make, including whether you want 

to keep Part B. It also includes information about the decisions you must make about your health 

care and prescription drug coverage. 

Read this booklet carefully before you make any decisions. 

The information in this booklet describes the Medicare Program at the time this booklet was printed. 

Changes may occur after printing. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get 

the most current information. TTY users can call 1-877-486-2048. 

“Welcome to Medicare” isn’t a legal document. Official Medicare Program legal guidance is contained in the 

relevant statutes, regulations, and rulings.

 
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Table of contents

Medicare basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Decisions I need to make . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Decision 1 – Should I keep Part B? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6–15

Decision 2 – How should I get my Medicare coverage? . . . . . . . . . . . . . . . . . . . 16–20

Decision 3 – Do I need Medicare prescription drug coverage (Part D)? . . . 21–25

Decision 4 – Do I need a Medicare Supplement Insurance 

(Medigap) policy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26–27

Next steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Help for people with limited income & resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

How can I get my Medicare questions answered? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
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Medicare basics

Here’s a brief look at the different parts of Medicare. Look in your “Medicare & You” handbook, or 

visit Medicare.gov for more information.

• Medicare Part A (Hospital Insurance) covers:

■ Inpatient care in hospitals 

■ Skilled nursing facility care 

■ Home health care

■ Hospice care 

• Medicare Part B (Medical Insurance) covers:

■ Services from doctors and other health care providers 

■ Outpatient care 

■ Home health care 

■ Durable medical equipment 

■ Many preventive services (like screenings, shots, and yearly “Wellness” visits)

• A Medicare Advantage Plan (also known as Part C) is another way to get your Medicare coverage. 

Medicare Advantage Plans include Part A, Part B, and usually Part D and are offered by Medicareapproved private companies that must follow rules set by Medicare. See pages 16–20. 

• Medicare Part D (Medicare prescription drug coverage)
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Decision 1: Should I keep Part B?

You were automatically enrolled in Part B. If you don’t want to keep Part B, let us know before 

the coverage start date on the front of your Medicare card, which is enclosed in this package. 

Otherwise, your Part B coverage will start on the coverage start date, and you’ll be charged a 

monthly premium. See pages 6–15.

Decision 2: How should I get my Medicare coverage? 

If you keep Part B in addition to Part A, you can choose how you get your health coverage. 

You can choose from Original Medicare (run by the federal government) or a Medicare Advantage 

Plan (run by a private insurance company). See pages 16–20.

Decision 3: Do I need Medicare prescription drug coverage (Part D)? 

If you choose Original Medicare and you want drug coverage, you’ll have to join a separate 

Medicare Prescription Drug Plan. If you choose to join a Medicare Advantage Plan (like an HMO 

or PPO), most include drug coverage. See pages 21–25.

Decision 4: Do I need a Medicare Supplement Insurance (Medigap) policy? 

If you choose Original Medicare (and don’t have other supplemental coverage), you may want to 

buy a policy that helps pay some of your out-of-pocket costs (like coinsurance and deductibles) 

for Medicare-covered services. You don’t need and can’t use a Medigap policy if you choose a 

Medicare Advantage Plan. See pages 26–27.

Decisions I need to make
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Decision 1 – Should I keep Part B?

Keeping Part B is your choice, and whether it’s best for you to keep Part B depends on your 

situation. Your decision may be based on whether you’re currently employed or already have 

other coverage. 

Important: If you don’t keep Part B when you’re first eligible and you don’t have other 

coverage based on active or current employment, there are some risks:

• You most likely will have to pay all of the costs for doctors’ services, outpatient care, medical 

supplies, and preventive services.

• If you change your mind and want to get Part B later, you’ll have to wait until the General 

Enrollment Period (January 1–March 31 each year) to sign up, and your coverage won’t start 

until July 1 of that year. This may cause a gap in your health coverage.

• In most cases, if you decide you want Part B later, you’ll also have to pay a late enrollment 

penalty for as long as you have Part B coverage. (The penalty amount is added to your 

monthly Part B premium and it increases the longer you go without Part B coverage. See page 

15 for more information about the penalty.)

Read the information on the next few pages to help you decide.
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Should I keep Part B?

Find your situation below to help you decide if you should keep Part B. 

I’m still working and have coverage through my employer. Or, my spouse (or a family member, 

if I’m disabled) is still working and I’m covered through his or her employer. See page 9.

I’m retired and have coverage through a former employer, or I have COBRA or VA coverage.

See page 10.

I have coverage through the Health Insurance Marketplace as an individual or through an 

employer. See page 11.

I have TRICARE coverage (insurance for active-duty military, military retirees, and their 

families). You must have Part B to keep TRICARE coverage. However, if you’re an active-duty 

service member or the spouse or dependent child of an active-duty service member, you don’t 

have to get Part B right away. 

I have CHAMPVA coverage. You must have Part B to keep your CHAMPVA coverage.
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Should I keep Part B? (continued)

Find your situation below to help you decide if you should keep Part B. (continued) 

I have coverage through a private insurance plan (not through the Health Insurance 

Marketplace or an employer). See page 12.

I have Medicaid. You should sign up for Part B. Medicare will pay first, and Medicaid will pay 

second. Your state may also help pay for your Medicare premiums. See page 29.

I don’t have other medical insurance. If you don’t have any medical insurance, you should keep 

Part B so you have coverage for things like doctors’ services or preventive services. 

If you don’t keep Part B, be aware of the risks described on page 6.
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I’m still working and have coverage through my employer 

Contact your benefits administrator to find out how your coverage works with Medicare. If your 

employer has less than 20 employees, ask your benefits administrator if you’ll need to sign up for 

Part B right away. If your employer has 20 or more employees, you can sign up for Part B later 

during a Special Enrollment Period without a late enrollment penalty if one of these statements 

applies to you: 

• You’re 65 or older, you or your spouse is currently working, and you’re covered by an employer or 

union group health plan based on that current employment. 

• You’re under 65 and disabled, you, a spouse, or a family member is currently working, and you’re 

covered by an employer or union group health plan based on that current employment. (If the 

group health plan coverage is based on the current employment of a family member, the employer 

must have 100 or more employees for you to get a Special Enrollment Period.) 

If you’re eligible for a Special Enrollment Period, you can sign up for Part B during one of these 

times:

• Anytime while you’re covered by the employer or union group health plan based on current 

employment.

• For up to 8 months after the group health plan coverage or the employment ends, whichever 

happens first. 

Note: If you have COBRA coverage, VA coverage, or a retiree health plan, you don’t have 

coverage based on current employment. See the next page for more information.
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I’m retired and have coverage through a former employer, or I have 

COBRA or VA coverage

If you’re retired and have retiree health insurance from a former employer or union, or you have 

COBRA coverage, Medicare generally will become your primary health insurance. Medicare will 

pay its part of the costs for any covered health care services you get, and then any amount not 

covered by Medicare can be submitted to your non-Medicare plan. If you have Medicare and 

U.S. Department of Veterans Affairs (VA) coverage, you can get treatment under either program. 

Medicare can’t pay for the same service that was covered by VA benefits, and your VA benefits can’t 

pay for the same service that was covered by Medicare.

If you don’t keep Part B, your current coverage might not pay your medical costs during any 

period you were eligible for Medicare but didn’t sign up for it. You may need to have both Part A 

and Part B to get full benefits from this coverage. You’re also not eligible for a Special Enrollment 

Period when this coverage ends. This means:

• You’ll have to wait until the General Enrollment Period (January 1–March 31 each year) to sign 

up, and your coverage would start July 1 of that year. 

• In most cases, you’ll also have to pay a late enrollment penalty each time you pay your premium 

for as long as you have Part B coverage. The penalty increases the longer you go without Part B 

coverage. See page 15.

Important: If you have questions, about your current insurance, contact your benefits 

administrator, insurer, or plan provider.
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I have Health Insurance Marketplace coverage

If you have a Marketplace plan for individuals or families, you should consider the following factors 

when deciding whether to keep Part B and stop your Marketplace plan when your Medicare starts.

• You won’t be eligible for premium tax credits or cost-sharing reductions for a Marketplace plan once your 

Part A coverage starts. If you get tax credits to help pay your Marketplace plan premium after your 

Medicare coverage starts, you might have to pay back the credits you got after your Medicare coverage 

starts when you file your taxes.

• If you don’t keep Part B and choose to enroll in it later, you generally won’t be eligible for a Special 

Enrollment Period, so you’ll have to wait to sign up. Also, you may have to pay a late enrollment penalty 

for as long as you have Part B coverage. The penalty increases the longer you go without Part B coverage. 

See page 6 for more information about when you can sign up and page 15 for more details about the cost 

of the penalty.

• Under certain circumstances, plans can’t renew your Marketplace coverage at the end of the year when 

you become eligible for Medicare. This means you (and potentially your family) could have a gap in your 

coverage starting on January 1. If you chose on your Marketplace application to have the Marketplace act 

to end your coverage on your behalf when you got Medicare and you don’t keep your Part B coverage, you 

may not be eligible for a Special Enrollment Period, so you’ll have to wait to sign up. And you may have to 

pay a late enrollment penalty as long as you have Part B coverage.

If you have employer coverage through the Marketplace (sometimes called Small Business Health 

Options Program or “SHOP” coverage), you can wait until you stop working to enroll in Part B.

See page 9. Visit HealthCare.gov and Medicare.gov to learn more.
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I have coverage through a private insurance plan (not through the Health 

Insurance Marketplace or an employer)

Medicare may be your primary health coverage. Medicare will pay its part of the costs for any 

covered health care services you get. 

If you don’t keep Part B, you won’t be eligible for a Special Enrollment Period if this 

coverage ends. This means:

• You’ll have to wait until the General Enrollment Period (January 1–March 31 each year) to sign 

up, and your coverage will start July 1 of that year. 

• In most cases, you’ll also have to pay a late enrollment penalty for as long as you have Part B 

coverage. The penalty increases the longer you go without Part B coverage. See page 15 for 

more about the cost of the penalty. 

Important: Contact your current plan for more information about how your coverage will work 

with Medicare.
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 I want to keep Medicare Part B

To keep Part B, you don’t need to do anything other than pay the premiums. Just cut out your 

Medicare card and keep it safe.

Make sure you show your Medicare card to your health care providers, so they can submit your 

claims to Medicare for payment. If you have other coverage (like a Medigap, employer, or retiree 

plan), make sure you also show that plan’s card to your health care providers.

The monthly Part B premium will be deducted automatically from your Social Security benefit 

payment when your coverage starts. If your Social Security benefits aren’t enough to cover the 

whole Part B premium or you stop getting Social Security benefits, you’ll get a bill for your Part B 

premium every 3 months. The monthly Part B standard premium is $135.50 in 2019. 

Your monthly premium will be higher if your modified adjusted gross income as reported on 

your IRS tax return from 2 years ago is more than $85,000 (if you’re single and file an individual 

tax return) or more than $170,000 (if you’re married and file a joint tax return). These amounts 

can change each year. If your income goes down because of a life-changing event, like retirement, 

you can apply to Social Security for an adjustment.

If you have limited income and resources, you may be able to get help from your state to pay 

your Part B premium if you meet certain conditions. See page 29.
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I don’t want to keep Medicare Part B 

If you don’t want to keep Part B, here’s what you need to do: 

1. Check the box after “I don’t want Medical Insurance” on the back of the enclosed Medicare 

card. 

2. Sign the back of the card. 

3. Send back the entire form (including the card) in the enclosed envelope before the effective 

date on the front of the Medicare card. 

Medicare will send you a new Medicare card in a few weeks that shows you have Part A only. 

In the meantime, write down your Medicare Number (found on the front of the card). Keep it in 

case you need to go to the hospital before your new card arrives. 
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How much is the Part B late enrollment penalty? 

If you sign up for Part B after you’re first eligible and you aren’t eligible for a Special Enrollment 

Period, you’ll pay 10% more for each full 12-month period you could’ve had Part B but didn’t 

take it. In most cases, you’ll have to pay this late enrollment penalty each time you pay your 

premiums, for as long as you have Part B. 

Example

If you waited 2 full years (24 months) to sign up for Part B and didn’t qualify for a Special 

Enrollment Period, you’ll have to pay a 20% late enrollment penalty (10% for each full 12-month 

period that you could have been enrolled), plus the standard Part B monthly premium ($135.50 

in 2019). 

 $135.50 (2019 Part B standard premium) 

+ $27.10 (20% [of $135.50] late enrollment penalty) 

$162.60 will be your Part B monthly premium for 2019. This amount is rounded to the nearest 

$.10 and includes the late enrollment penalty.

Note: The example above applies if you delayed enrolling in Part B for 24 months. You don’t pay 

a late enrollment penalty if you enroll before the first full 12-month period has passed or if you 

qualify for a Special Enrollment Period. See page 9. The amount could also be different if your 

income is above a certain amount. See page 13.
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Tip: To find out how to choose and join a Medicare Advantage Plan, see page 23.

Decision 2 – How should I get my Medicare coverage?

You have 2 main choices for getting your Medicare health coverage. In most cases, you’ll 

automatically be in Original Medicare unless you join a Medicare Advantage Plan. The 

information below through page 20 gives you a quick look at the differences between Original 

Medicare and Medicare Advantage. You can also visit Medicare.gov/medicarecoverageoptions to 

get this information in a more personalized way. 

Doctor and hospital choice

Original Medicare Medicare Advantage

You can go to any doctor that accepts 

Medicare.

In most cases, you’ll need to use doctors who are in 

the plan’s network (for non-emergency or non-urgent 

care). Ask your doctors if they participate in any 

Medicare Advantage Plans.

In most cases you don’t need a referral to 

see a specialist.

You may need to get a referral to see a specialist.
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Cost

Original Medicare Medicare Advantage

For Part B-covered services, you usually pay 

20% of the Medicare-approved amount after 

you meet your deductible.

Out-of-pocket costs vary—some plans may have low 

or no out-of-pocket costs. 

You pay a premium (monthly premium) 

for Part B (The 2019 Part B deductible is 

$135.50) If you choose to buy prescription 

drug coverage, you’ll pay that premium 

separately.

You may pay a premium for the plan (most include 

prescription drug coverage) and a premium for 

Part B. Some plans have a $0 premium or will help pay 

all or part of your Part B premium.

There’s no yearly limit on what you pay out-ofpocket. Plans have a yearly limit on what you pay out-of-pocket 

for Medicare Part A and B covered services. Once you 

reach your plan’s limit, you’ll pay nothing for Part Aand Part B-covered services for the rest of the year. 

Note: Medicare won’t pay for your Part A and Part B claims if you’re not lawfully present in the U. S. You also 

can’t enroll in a Medicare Advantage Plan or a Medicare Prescription Drug Plan if you’re not lawfully present 

in the U.S.
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Decision 2 – How should I get my Medicare coverage? (continued)

Cost (continued)

Original Medicare Medicare Advantage

You can buy supplemental coverage to help pay 

your out-of-pocket costs (like your deductible 

and 20% coinsurance).

You can’t buy or use separate supplemental 

coverage - but some plans have lower out-of-pocket 

costs than Original Medicare.
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Coverage

Original Medicare Medicare Advantage

Original Medicare covers medical services and 

supplies in hospitals, doctors’ offices, and other 

health care settings.

Plans must cover all of the services that Original Medicare 

covers. Some plans offer extra benefits that Original 

Medicare doesn’t cover—like vision, hearing, dental , and 

more.

You can join a separate Medicare Prescription 

Drug Plan to get drug coverage.

Prescription drug coverage is included in most plans.

In most cases, you don’t have to get a 

service or supply approved ahead of time 

for it to be covered.

In some cases, you have to get a service or supply 

approved ahead of time for it to be covered by the plan.
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Decision 2 – How should I get my Medicare coverage? (continued)

Travel

Original Medicare Medicare Advantage

Original Medicare generally doesn’t cover 

care outside the U.S. You may be able to buy 

supplemental coverage that covers care outside the 

U.S.

Plans usually don’t cover care outside the U.S. Also, 

plans usually don’t cover non-emergency care you get 

outside of your plan’s network.
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Decision 3 – Do I need Medicare prescription drug coverage?

Medicare offers prescription drug coverage (also called “Part D”) to everyone with Medicare. 

However, it isn’t automatic for most people – you have to sign up for it. You get Medicare 

prescription drug coverage either by joining a Medicare Prescription Drug Plan or through a 

Medicare Advantage Plan that includes drug coverage. Both types of Medicare drug coverage are 

called “Medicare drug plans” in this booklet. 

Medicare drug plans cover a variety of brand-name and generic prescription drugs. Most plans 

have premiums, deductibles, and copayments that you pay in addition to your Part B premium. 

Costs and coverage are different in every plan. 

You can join a Medicare drug plan when you’re first eligible for Medicare. If you don’t join 

a Medicare drug plan when you’re first eligible for Medicare, and you don’t have other 

creditable prescription drug coverage, you may have to pay a monthly Part D late enrollment 

penalty if you join a plan later. In most cases, you’ll have to pay the penalty as long as you have 

Medicare prescription drug coverage and it will increase the longer you go without Part D or 

creditable drug coverage. Creditable prescription drug coverage is coverage that’s expected to pay, 

on average, at least as much as Medicare’s standard prescription drug coverage. Your plan must tell 

you each year if your drug coverage is creditable coverage. See page 25.

Read the information on the next few pages to help you decide.
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Should I get Medicare prescription drug coverage?

Here are some questions to help you decide if you need Medicare prescription drug coverage:

Do I already have drug coverage? If you already have other “creditable prescription drug 

coverage,” you can wait and sign up for Medicare drug coverage later without a penalty as 

long as you don’t go 63 days or more in a row without creditable drug coverage. Creditable 

prescription drug coverage could be drug coverage from an employer or union, TRICARE, 

the Department of Veterans Affairs (VA), the Federal Employees Health Benefits (FEHB) 

Program, COBRA, Indian Health Service (IHS), or a state program. If you have questions, 

talk to your benefits administrator, insurer, or plan provider before you make any changes 

to your current coverage. In some cases, joining a Medicare drug plan might cause you (and 

your family) to lose employer or union coverage.

Do I need drug coverage? Even if you don’t take a lot of drugs now, you still may want to 

join a Medicare drug plan to avoid being without coverage.

Am I planning to join a Medicare Advantage Plan that includes drug coverage? If you’re 

joining a plan that includes drug coverage, you don’t need to join a separate Medicare drug 

plan. If you join a Medicare Advantage Plan that doesn’t have drug coverage, in most cases 

you won’t be able to add a separate Medicare Prescription Drug Plan.

 
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How to choose & join a Medicare Advantage Plan or a Medicare 

Prescription Drug Plan 

Find out which plans are available in your area. Here’s how:

• Visit Medicare.gov/find-a-plan. 

• Look at your “Medicare & You” handbook. Plans available in your area are listed in the back.

• Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Once you’ve considered your options, you can join a Medicare Advantage Plan or Medicare 

Prescription Drug Plan by visiting Medicare.gov/find-a-plan or contacting the plan directly. 

If you need help deciding, look on the back cover of your “Medicare & You” handbook to get 

the contact information for your State Health Insurance Assistance Program (SHIP). SHIPs are 

programs that offer free, local health insurance counseling to people with Medicare. 

Tip: You may want to make a list of all the drugs and health care services you use regularly, and 

calculate how much you would spend under each plan you’re considering.

You have a 7-month period to first join a plan. If you sign up during one of the 3 months before 

your effective date, your coverage will start on the same day as your effective date. If you sign up 

during the month of your effective date, your coverage will start the first day of the next month. If 

you sign up during the 3 months after your effective date, your coverage will start the first day of 

the month after you ask to join the plan. After your 7-month period is over, you can only sign up 

during one of the times listed on the next page. 
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Can I make changes to my coverage later?

You’ll have at least one chance each year to make changes to your Medicare coverage.

October 15–December 7

You can join, switch, or leave a Medicare Advantage Plan or a Medicare drug plan during this 

period each year. Your new coverage will begin on January 1 of the following year. 

January 1–March 31

If you’re in a Medicare Advantage Plan, you can make one change to a different Medicare Advantage 

Plan plan or switch back to Original Medicare (and join a stand-alone Medicare Prescription Drug 

Plan) once during this time. Any changes you make will be effective the first of the month after the plan 

gets your request. 

Special Enrollment Periods

In certain situations, you may be able to join, switch, or drop Medicare drug plans at other times. 

Some examples are if you:

• Have Medicaid or qualify for Extra Help (see page 29)

• Move out of your plan’s service area

• Lose other creditable prescription drug coverage

• Live in an institution, like a nursing home
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How much is the penalty if I join a Medicare drug plan later?

The cost of the Part D late enrollment penalty depends on how long you didn’t have creditable 

prescription drug coverage. The late enrollment penalty is calculated by multiplying 1% (.01) of 

the “national base beneficiary premium” ($33.19 in 2019) times the number of full, uncovered 

months that you were eligible, but didn’t join a Medicare drug plan and went without other 

creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and 

permanently added to your monthly premium. 

Example

If you go without other creditable drug coverage for 20 months before you join a Medicare drug 

plan, you’ll pay a monthly penalty of $6.60 in 2019 ($33.19 x .01 = $.3319 x 20 = $6.60) in addition 

to your plan’s monthly premium. 

Tip: If you have limited income and resources and qualify for Extra Help paying for Medicare 

prescription drug costs, you don’t have to pay the late enrollment penalty. See page 29 to learn 

more about Extra Help and other programs for people with limited income and resources.
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Decision 4 – Do I need a Medicare Supplement Insurance (Medigap) policy? 

Medicare Supplement Insurance (Medigap) policies are a type of private insurance designed to help 

pay some of your out-of-pocket costs for covered services (like coinsurance, copayments, and 

deductibles) in Original Medicare. In most cases, Medigap policies sold today don’t cover long-term 

care, private-duty nursing, or prescription drug coverage. Generally, Medigap policies also don’t have 

to help pay for services that Original Medicare doesn’t cover (like long-term care, vision or dental care, 

hearing aids, eyeglasses, etc.). 

You need both Part A and Part B to buy a Medigap policy. 

Insurance companies can only sell standardized policies, identified in most states by plans with letter 

designations (for example Plan F or Plan G). Each standardized policy with the same letter available 

today must offer the same benefits, no matter which insurance company sells it. This means that you 

can easily compare the cost of Plan F sold by one insurance company with the cost of a Plan F sold 

by another. Cost is usually the only difference between Medigap policies with the same letter sold by 

different insurance companies. All policies may not be available in every state or from every company. 

How much does a Medigap policy cost? 

Even though Medigap policy benefits are standardized, costs can vary depending on the company 

you buy from and where you live. You’ll pay a monthly premium directly to the private company you 

bought the policy from, in addition to your Part B premium.

Tip: Each Medigap policy covers only one person. If you and your spouse both want Medigap 

coverage, you must each buy your own Medigap policy.
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Do I need a Medicare Supplement Insurance (Medigap) policy? (continued)

Here are some questions to help you decide whether you need a Medigap policy:

Am I joining a Medicare Advantage Plan? People in Medicare Advantage Plans don’t need 

and can’t use Medigap policies. (If you join a Medicare Advantage Plan for the first time, and 

you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap 

policy if you return to Original Medicare within 12 months of joining.) 

Do I need extra coverage? If you stay in Original Medicare and don’t have other 

supplemental coverage, a Medigap policy may help lower your out-of-pocket costs. 

Tip: The best time to buy a Medigap policy is during the 6-month period that starts with the first 

month you’re 65 or older and enrolled in Part B. This is called your Medigap Open Enrollment 

Period. During this period, you can buy any Medigap policy being sold in your state, even if you 

have health problems. During your Medigap Open Enrollment Period, you can’t be refused a 

policy and you can’t be charged more than people with good health. After this period, you may 

have to pay more, or you may not be able to get the Medigap policy you want. If you’re under 65, 

you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 

65. If you’re able to buy one when you’re under 65, it may cost more.

You can compare Medigap policies in your area by visiting Medicare.gov. You can also call 

1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. 
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Next steps

• Learn more about Extra Help for people with limited income and resources. See page 29.

• Watch the mail for your copy of the “Medicare & You” handbook. It provides more information 

about Medicare. You can find the handbook online at Medicare.gov/medicare-and-you. 

• Get answers to your Medicare questions. See page 30 for more information.

• Find out if your doctor is enrolled in Medicare. Visit Medicare.gov/physiciancompare, or call 

1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. 

• Ask your doctor about the one-time “Welcome to Medicare” preventive visit and other 

preventive services you might need. These include yearly “Wellness” visits, flu and 

pneumococcal shots, cancer screenings, and more. Read your “Medicare & You” handbook or 

visit Medicare.gov for for a list of covered preventive services.

• Create an account on MyMedicare.gov to view your personal Medicare information. You can 

sign up to get electronic versions of your “Medicare & You” handbooks and Medicare Summary 

Notices (eMSNs) for Original Medicare. You can also track your Medicare claims and preventive 

services, view your eligibility information, and much more. 

• Fill out an authorization form in case you ever need Medicare to share your personal health 

information with someone else, like a family member or caregiver. Complete the form online at 

Medicare.gov/medicareonlineforms, or call 1-800-MEDICARE. 
29

Help for people with limited income and resources

Help is available to pay for some of your health care and prescription drug costs: 

Medicaid: Medicaid is a joint federal and state program that helps pay medical costs for some 

people with limited income and resources. Medicaid programs vary from state to state. They may 

also have different names, like “Medical Assistance” or “Medi-Cal.” For more information, call 

your Medicaid office. You can get the phone number by visiting Medicare.gov/contacts, or by 

calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Medicare Savings Programs: States have programs that pay Medicare premiums for people with 

limited income and resources and, in some cases, may pay Medicare deductibles and coinsurance. 

For more information, call your Medicaid office. You can get the phone number by visiting 

Medicare.gov/contacts, or by calling 1-800-MEDICARE. 

Extra Help with Medicare prescription drug costs: If you have limited income and resources, 

you may qualify to get help paying for your drug plan’s monthly premium, yearly deductible, and 

copayments. To apply, visit socialsecurity.gov/extrahelp, or call Social Security at 1-800-772-1213. 

TTY users can call 1-800-325-0778. 

Supplemental Security Income (SSI): SSI makes monthly payments to people with limited 

income and resources who are disabled, blind, or 65 or older. For more information, visit 

socialsecurity.gov, or call Social Security.

Note: If you live in a U.S. territory and have limited income and resources, there are different 

programs to help you pay your Medicare costs. Call your local Medicaid office to learn more.
30

How can I get my Medicare questions answered?

Contact ... For information about ...

Social Security - socialsecurity.gov

1-800-772-1213

TTY: 1-800-325-0778

■ Enrolling in Medicare or correcting your Medicare card

■ Supplemental Security Income (SSI)

■ Help paying for Medicare prescription drug coverage

■ Changing your address

Medicare - Medicare.gov

1-800-MEDICARE (1-800-633-4227) 

TTY: 1-877-486-2048

■ General or claims-specific Medicare information

■ Medicare health and prescription drug plan choices in your 

area

State Health Insurance Assistance Program (SHIP) - shiptacenter.org

For your local SHIP phone number, visit shiptacenter.org, or call 

1-800-MEDICARE. You can also find the number on the back of 

your “Medicare & You” handbook.

■ Free personalized health insurance counseling, help with 

Medicare claims and appeals, and help making health 

coverage decisions and plan choices

Department of Health and Human Services, Office for Civil Rights hhs.gov/ocr, 1-800-368-1019, TTY: 1-800-537-7697

■ Your rights if you believe you’ve been discriminated against 

because of your race, color, religion, national origin, 

disability, age, or sex

■ 1-800-MEDICARE

■ Federal Trade Commission (for identity theft)

ID Theft Hotline: 1-877-438-4338, TTY: 1-866-653-4261

■ Senior Medicare Patrol (SMP) Program - smpresource.org 

1-877-808-2468

■ Protecting yourself from Medicare fraud

■ Protecting yourself from identity theft
31
Official Business 

Penalty for Private Use, $300 

CMS Product No. 11095

Revised December 2018

You have the right to get Medicare information in an accessible format, like large print, Braille, or audio. 

You also have the right to file a complaint if you feel you’ve been discriminated against. Visit 

Medicare.gov/about-us/nondiscrimination/accessibility-nondiscrimination.html, or call 

1-800-MEDICARE (1-800-633-4227) for more information. TTY users can call 1-877-486-2048.

Paid for by the U.S. Department of Health and Human Services.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, Maryland 21244-1850