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What are the parts of Original Medicare?
Part A & B
Where should someone go to enroll in Medicare?
Social Security Administration online or their local office. Railroad workers and their families enroll through the Railroad Retirement Board.
Can an individual on Medicare due to disability enroll in a Medicare Supplement plan?
Yes, but it depends on age and state law: a person on Medicare due to disability can enroll in a Medicare Supplement (Medigap) plan in some states, but federal law generally does not require insurers to sell Medigap to people under 65, so many people must wait until they turn 65, when they get a federal 6-month Medigap open enrollment period.
This program is jointly funded by the federal government and states and helps cover health care for many low-income adults, children, pregnant people, older adults, and people with disabilities. What is it called?
Medicaid.
Medicaid is a joint federal-state program, which means it is funded by both the federal government and the states.
Yes.
What makes someone eligible for Medicare?
Their age of 65 or over or those with certain disabilities and ESRD. Individuals must have worked long enough (usually 10 years or 40 quarters) to pay Medicare taxes while working
How many quarters does an individual have to work to qualify for premium free Part A?
An individual generally must have 40 quarters of Medicare-covered work (about 10 years) to qualify for premium-free Medicare Part A.
What is Part D and who sells it?
Medicare Part D is optional prescription drug coverage, and it is sold by Medicare-approved private insurance companies and other private companies, either as a standalone drug plan or through a Medicare Advantage plan with drug coverage.
True or False: Medicaid is administered by states under federal rules, which is why eligibility rules and covered benefits can vary from one state to another.
True.
Who is the primary payer for long-term care services, Medicare or Medicaid?
Medicaid.
When should someone enroll in Medicare?
During your 7-month Initial Enrollment Period (IEP), which includes the three months before, the month of, and the three months after 65th birthday.
Is there a deductible for Part A? Part B?
Yes. In 2026, Medicare Part A has a $1,736 inpatient hospital deductible per benefit period, and Medicare Part B has a $283 annual deductible.
Can Part D be deducted from an individuals Social Security?
Yes， an individual can usually have their Medicare Part D plan premium deducted from their Social Security benefit, although they must arrange this through their drug plan and it may take up to 3 months to start
Can a person qualify for both Medicare and Medicaid? Which one pays first for services covered by both?
Yes. Medicare.
What legislation led to the Medicaid Expansion program ?
Affordable Care Act.
Do Medicare Part A & B have a premium? If so what is it?
In 2026, most Medicare beneficiaries pay no Part A premium, but those without enough work history pay $311 or $565 per month, while the standard Part B premium is $202.90 per month and is higher for high-income enrollees.
Where can I locate providers that accept Medicare?
Providers can be located using the look up tool on the Medicare.gov website.
Who sets the premiums for Part D/PDP plans?
Private insurance companies set the premiums for Medicare Part D prescription drug plans (PDPs), but the plans must follow Medicare’s rules and approval requirements.
What is CHIP?
CHIP is the Children’s Health Insurance Program, which covers eligible children in families with incomes too high for Medicaid but too low to afford private coverage.
Explain how Medicaid Spend-down program works.
In some states, Medicaid has a “medically needy” option for people whose income is too high to otherwise qualify. If they incur enough uninsured medical or remedial care expenses to reduce their excess income to the state’s medically needy income level.
Are there penalties if someone does not enroll in Medicare when initially eligible? If so what is the penalty amount and how long does it last?
Yes. If someone delays Medicare enrollment without qualifying coverage, Part A (if they must buy it) costs 10% more for twice the delay period, Part B adds 10% for each full 12-month delay for as long as they have Part B, and Part D adds 1% of the national base premium for each uncovered month for as long as they have Part D.
Did the Affordable Care Act try to reform Medicare from a volume-based "fee-for-service" model to a value-based system?
Yes. The Affordable Care Act pushed Medicare toward value-based payment by creating programs such as Hospital Value-Based Purchasing, the Medicare Shared Savings Program (ACOs), and the CMS Innovation Center, all intended to link payment more closely to quality, coordination, and efficiency rather than just volume.
What are common types of Medicare Advantage Plans?
The most common types of Medicare Advantage plans are Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Private Fee-for-Service (PFFS) plans.
Yes or No: Medicaid may help pay Medicare premiums and other costs for some beneficiaries.
Yes.
What is the term for a person who has both Medicare and full Medicaid coverage?