Medicare Rules & Enrollment
This is the period from January 1 to March 31 when people who missed their initial Medicare enrollment can sign up.
What is the General Enrollment Period?
Medicare Part A primarily covers care received in this type of facility
What is a hospital?
Medicare Part B helps cover these types of visits to a physician.
What are outpatient doctor visits?
Medicare Part D does not cover these types of medications, including weight-loss drugs and over-the-counter medications.
What are excluded drugs?
Medicare Advantage plans are also known by this name.
What is Medicare Part C?
Before delaying Medicare enrollment, individuals who work past age 65 should check if their employer has this many employees, which determines if Medicare is primary or secondary.
What is 20 employees?
Beyond 90 days in a hospital, Medicare provides these extra days before the patient becomes responsible for all costs
What are 60 lifetime reserve days?
Higher-income beneficiaries must pay this additional charge on their Medicare Part B premium.
What is the Income-Related Monthly Adjustment Amount (IRMAA)?
During the Medicare Part D coverage gap (donut hole), beneficiaries must pay this percentage of their prescription costs.
What is 25%?
When a Medicare Advantage plan stops offering coverage in a beneficiary’s area, they qualify for this type of special enrollment period.
What is a Special Enrollment Period (SEP)?
For each full year a person delays enrolling in Medicare Part B without creditable coverage, their premium increases by this percentage
What is 10%?
Despite occurring in a hospital, this type of procedure is not covered by Medicare Part A
What is outpatient surgery?
Within the first 12 months of enrolling in Part B, Medicare covers this one-time preventive visit.
Welcome to Medicare" visit
As of 2024, this is the maximum deductible a Medicare Part D plan can charge before drug coverage begins.
What is $545?
This Medigap plan, which covered the Part B deductible, is no longer available to new Medicare beneficiaries.
What is Plan F?
Individuals under age 65 can qualify for Medicare if they have one of these two conditions.
What are End-Stage Renal Disease (ESRD) or ALS?
This minimum number of years of Medicare tax contributions is required for premium-free Part A coverage.
What is 10 years (40 quarters)?
This percentage of the cost for durable medical equipment (DME) is covered by Medicare Part B after the deductible is met.
What is 80%?
This federally administered program provides temporary immediate Part D coverage for low-income Medicare beneficiaries who qualify for Extra Help but are not yet enrolled in a Part D plan—and it retroactively covers prescriptions filled within the past 30 days.
What is the Limited Income Newly Eligible Transition (LiNet) program?
A Medicare Advantage enrollee has a "trial right" to switch back to Original Medicare within this timeframe if it’s their first time joining an MA plan.
What is within the first 12 months?
Despite offering temporary health coverage, this type of insurance does not count as creditable coverage for delaying Medicare, leading to potential late penalties.
What is COBRA?
A patient must have this type of hospital stay before Medicare will cover skilled nursing facility
What is an inpatient stay of at least 3 days?
This is the key difference between a doctor who accepts Medicare assignment and one who is contracted with Medicare but does not accept assignment.
What is the amount they can charge the patient?
Once a Medicare Part D enrollee reaches this out-of-pocket spending threshold in 2025, they no longer pay for covered drugs.
What is $2,000?
This 1997 action film follows a group of dangerous convicts who hijack a prison transport plane, only to be thwarted by an ex-Army Ranger trying to get home to his family.
What is Con Air