Medicare Questions Texans Ask Most
If you’re approaching 65, Medicare can feel confusing fast. Parts A, B, C, D, supplements, Advantage plans, enrollment windows — it’s a lot to sort through.
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This page answers the most common Medicare questions in plain English so you can understand how the system works and avoid costly mistakes.
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If you'd prefer to learn this step-by-step, we also offer free Medicare classes online and in-person for Texans. You can find more information on this by clicking on these here.
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FAQ Contents:
Medicare Enrollment Questions
When should I enroll in Medicare?
Most people enroll during their Initial Enrollment Period, which begins three months before the month you turn 65 and ends three months after. Signing up during this window helps you avoid penalties and coverage delays.
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If you’re still working and covered under an employer health plan, your enrollment timing may be different.
Do I automatically get Medicare at 65?
You may be automatically enrolled in Medicare Parts A and B if you are already receiving Social Security benefits before age 65.
If you are not yet receiving Social Security, you usually need to enroll yourself through the Social Security Administration.
What happens if I miss my Medicare enrollment window?
Missing your enrollment window can cause two problems:
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Late enrollment penalties
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Delayed coverage start dates
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​Some penalties can last for as long as you have Medicare, which is why planning your enrollment timing is important.
Can I delay Medicare if I’m still working?
Sometimes yes.
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If you have health insurance from active employment, you may be able to delay Part B without penalty. However, the rules depend on:
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the size of your employer
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whether the coverage is considered creditable
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whether the coverage is yours or your spouse’s
Medicare Coverage Basics
What does Medicare Part A cover?
Part A is hospital coverage. It generally helps pay for:
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hospital stays
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skilled nursing facility care
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hospice care
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limited home health services
Most people do not pay a premium for Part A if they have enough work credits.
What does Medicare Part B cover?
Part B covers outpatient medical services such as:
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doctor visits
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lab work
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preventive services
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imaging and diagnostics
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durable medical equipment
Part B has a monthly premium and typically requires cost-sharing unless you add additional coverage.
Why do people say Medicare only covers 80%?
Under Original Medicare, Part B typically pays 80% of approved outpatient costs after the deductible. The remaining 20% is your responsibility unless you have additional coverage such as:
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a Medicare Supplement (Medigap Coverage)
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a Medicare Advantage plan
Medicare Plan Options
What is the difference between Medicare Advantage and a Medicare Supplement?
Medicare Advantage plans are private insurance plans that replace Original Medicare and often include additional benefits like dental or vision. They usually use provider networks and copays.
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Medicare Supplements work with Original Medicare and help cover out-of-pocket costs like deductibles and coinsurance. Supplements generally allow broader provider access but require a monthly premium.
Which option is better: Medicare Advantage or a Supplement?
There isn’t a universal “best” option.
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Medicare Advantage may offer lower monthly premiums and additional benefits but uses provider networks and cost sharing.
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Medicare Supplements often provide more predictable costs and flexibility with providers but typically have higher monthly premiums.
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The best choice depends on your health needs, budget, and provider preferences.
Can I switch plans later?
Sometimes, but not always easily.
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Switching from a Medicare Advantage plan to a Supplement later may require medical underwriting in many situations. That means health conditions could affect eligibility or cost.
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Choosing the right plan from the start can make things easier long-term.
Prescription Drug Coverage
What is Medicare Part D?
Part D provides prescription drug coverage through private insurance companies approved by Medicare.
Plans vary based on:
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the medications they cover
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pharmacy networks
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monthly premiums
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copays
Choosing the right plan depends largely on the medications you take.
What happens if I skip Part D coverage?
If you go 63 days or longer without creditable prescription drug coverage, Medicare may charge a late enrollment penalty when you eventually enroll.
This penalty can continue for as long as you have Part D.
Working With a Medicare Advisor
Do Medicare advisors charge a fee?
In most cases, no and in Cover6 Financial's situation, never.
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Independent Medicare brokers are typically compensated by insurance companies if you enroll in a plan through them. That means many advisors can help you review options and enroll without charging you directly.
What happens at a Cover6 Medicare seminar?
At our Medicare seminars you’ll learn:
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how Medicare enrollment works
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the difference between Advantage and Supplements
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how prescription plans fit in
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common mistakes that cause penalties or high costs
The goal is to help you understand your options so you can make a confident decision.
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If you're interested in attending a seminar online or in-person, you can check out our seminars page here.