Straus & Associates, Inc.
Medicare FAQs

The questions we hear most.

Straus and Associates, Inc. have been Medicare specialists since 1969. Medicare choices for Oregonians can be complicated, confusing, and overwhelming — here is where we usually begin.

01

When should I enroll in Medicare?

If you are currently drawing Social Security, you will automatically be enrolled in Medicare Parts A and B. If not, you may enroll online up to three months before your 65th birthday. Please call our office if you would like us to provide the Medicare enrollment link.

If you currently have an Employer group plan, please call us before moving forward as we will do an assessment to see if it's viable to remain on your Employer plan vs enrolling in Medicare Part B.

02

I have coverage through my Employer, should I keep it or choose Medicare instead?

Some factors to consider:

  • What does your current health plan cover?
  • Does this coverage meet your needs?
  • Are you paying for the coverage or is your employer?
  • If you are paying for all or a portion of the premium, is it more expensive than Medicare would be?
  • Do you have a spouse that is on your Employer plan that would be impacted by a change?
03

I have coverage through the Veteran's Administration, should I enroll in Medicare?

Most likely, yes. There are a few things to consider as you look at Medicare and the VA:

  • Do you have TriCare for Life?
  • Are you getting your medications through the VA?
  • Would it be more convenient to see providers outside of the VA system?
  • Are you experiencing issues with the referral process or unable to get an appointment with a VA doctor?
  • Would you like to see both civilian and VA physicians?

For instance, many Medicare Advantage plans offer “zero” premium plans provided you purchase your medications through the VA. These zero premium plans will offer you access to civilian care without jumping through the referral process required by the VA. The VA is still a fantastic option and we can very easily enhance these benefits at little or no cost to you.

04

Do I have to take my Social Security benefits when I enroll in Medicare?

No. You can enroll in Medicare and elect Social Security at a later date.

05

I do not take any medications, do I need a Part D (prescription drug plan)?

Medicare really encourages you to have a Part D drug plan. If you have coverage through your Employer or the VA, and it is considered 'credible coverage', you may not need an additional drug plan. Be aware if you choose to go without 'credible coverage', Medicare has a penalty for late enrollment if you should decide to enroll in a Part D plan at a later date.

06

What is the difference between a Medicare Supplemental policy and a Medigap policy?

Nothing, these terms are synonymous, and Medicare uses both terms interchangeably.

07

What is the difference between a Medicare Supplement and a Medicare Advantage plan?

Both are very popular options and it is an individual decision based on many factors; Are you a Snowbird? Do you have VA coverage? Which physicians and hospitals will you use?

In a nutshell, Medicare Advantage plans have medical and prescription drug benefits rolled into one plan and typically offer “extras”, such as dental, vision, gym membership, alternative care (acupuncture, chiropractic, naturopath). The premiums tend to be much lower in exchange for cost sharing / copays when you seek medical services. You must use IN network providers for the lowest cost sharing.

Medigap policies have a small deductible and typically do not have additional cost sharing for any services and you do NOT need to use a provider network. The higher premiums reflect the benefit level. These policies typically do NOT include the “extras”. Medigap policies are medical only and must be paired with a Part D, prescription drug plan.

These plans are 'apples and oranges' so we should review your specific needs to determine the best fit.

08

Can I change plans?

Medicare Advantage plans have two enrollment periods that allow you to change plans: Annual Enrollment is October 15th–December 7th each year. Open Enrollment is January 1st–March 31st each year.

Medigap guaranteed issue changes are within 30 days of your birthday. In Oregon, it is called the “Birthday Rule”. Call us for more information.

09

I've just moved, do I need to change plans?

It depends. Medicare plans vary from state to state and even county to county. Call us and we can help determine if you will need to make a change. If so, we can explain your options. You have 60 days to make a change, if needed.

10

What if I have Medicaid, do I still need to enroll in Medicare?

Yes. Medicare is primary and Medicaid will become the secondary payer if you are still eligible for Medicaid when your Medicare starts. We can explain your options as there are specific plans that enhance Medicare/Medicaid and will give you ‘added value’ benefits at no cost to you that aren’t provided by Medicare/Medicaid.

Still have a question?

Call the office and talk it through with a licensed local agent. There's no cost, and no obligation.

We do not offer every plan available in your area. Currently we represent [NUMBER] organizations which offer [NUMBER] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.