Medicare FAQ | Dalia Harris Insurance — Arizona

Question 1

What is Medicare and who qualifies?

Accepted Answer

Medicare is the federal health insurance program for people 65 and older, as well as certain younger people with disabilities or specific conditions like End-Stage Renal Disease. Most people qualify for Medicare Part A at no cost if they or their spouse paid Medicare taxes for at least 10 years. Part B requires a monthly premium. You don't have to be retired to enroll — you just need to meet the age or disability criteria.

Question 2

What do Parts A, B, C, and D actually cover?

Accepted Answer

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Part B covers outpatient services — doctor visits, preventive care, lab tests, and durable medical equipment. Together, Parts A and B are called 'Original Medicare.' Part C (Medicare Advantage) is an alternative way to get your Medicare benefits through a private insurer — it typically bundles A, B, and D together. Part D is standalone prescription drug coverage, used alongside Original Medicare or a Medigap plan.

Question 3

When should I enroll in Medicare?

Accepted Answer

Your Initial Enrollment Period (IEP) is a 7-month window: 3 months before your 65th birthday month, your birthday month, and 3 months after. Enrolling during the first 3 months means your coverage starts on the first day of your birthday month. If you miss your IEP and don't have qualifying employer coverage, you may face late enrollment penalties and gaps in coverage. If you're still working and covered by an employer plan, you may be able to delay Part B without penalty — but the rules are specific, so it's worth talking through your situation.

Question 4

What happens if I miss my enrollment window?

Accepted Answer

If you miss your Initial Enrollment Period without qualifying coverage, you'll generally have to wait for the General Enrollment Period (January 1 – March 31 each year), with coverage starting July 1. You may also face a late enrollment penalty — for Part B, that's a 10% premium increase for each 12-month period you were eligible but didn't enroll. The penalty lasts as long as you have Part B. This is one of the most common and costly Medicare mistakes I help people avoid.

Question 5

What's the difference between Medicare Advantage and Medicare Supplement (Medigap)?

Accepted Answer

This is the most important decision most Medicare beneficiaries make. Medicare Advantage (Part C) replaces Original Medicare with a private plan — it often has a $0 premium but uses networks and has copays for services. Medicare Supplement (Medigap) works alongside Original Medicare to cover the cost-sharing gaps like deductibles and coinsurance. Medigap typically has a higher monthly premium but gives you more predictable costs and the freedom to see any Medicare-accepting provider nationwide. The right choice depends on your health, your doctors, your budget, and how much you travel. I help you compare both side by side.

Question 6

Can I keep my current doctors with Medicare?

Accepted Answer

It depends on the plan type. With Original Medicare and a Medigap plan, you can see any doctor or hospital in the country that accepts Medicare — no referrals, no network restrictions. With Medicare Advantage, you're typically limited to the plan's network, and seeing out-of-network providers can cost significantly more or may not be covered at all. Before enrolling in any plan, I always verify that your specific doctors and preferred hospitals are in-network.

Question 7

How do I know if my prescriptions are covered?

Accepted Answer

Each Part D or Medicare Advantage plan has its own formulary — a list of covered drugs organized into tiers that determine your cost. The same medication can cost very differently from one plan to another. Before recommending any plan, I run a formulary check using your specific medication list to find the plan that covers your drugs at the lowest total cost. This step alone can save clients hundreds or even thousands of dollars per year.

Question 8

Are there plans that include dental, vision, and hearing?

Accepted Answer

Original Medicare covers almost none of these. However, many Medicare Advantage plans include dental, vision, and hearing benefits — though the coverage levels vary widely. Some plans offer only basic preventive dental; others include major dental work up to a significant annual maximum. I compare the actual benefit details, not just whether a plan 'includes' dental, so you know exactly what you're getting. Standalone dental and vision plans are also available and can be paired with Original Medicare or Medigap.

Question 9

Can I change my Medicare plan after I enroll?

Accepted Answer

Yes, but only during specific enrollment periods. The Annual Enrollment Period (AEP) runs October 15 – December 7 each year — this is when you can switch between Medicare Advantage plans, switch from Medicare Advantage to Original Medicare, or change your Part D plan. The Medicare Advantage Open Enrollment Period (January 1 – March 31) lets you make one switch if you're already in a Medicare Advantage plan. Outside of these windows, you generally need a Special Enrollment Period triggered by a qualifying life event. I review my clients' coverage every year during AEP to make sure their plan still fits.

Question 10

How much does it cost to work with you?

Accepted Answer

Nothing. My services are completely free to you. I'm compensated by the insurance carriers when you enroll in a plan — but that doesn't affect my recommendations. Because I'm an independent advisor, I'm not tied to any single company or quota. My job is to find the plan that's genuinely best for your situation, not the one that pays me the most. You get the same plan at the same price whether you enroll through me or directly — but with me, you get guidance, comparison, and ongoing support.

Question 11

What areas of Arizona do you serve?

Accepted Answer

I serve clients throughout Arizona. I meet in person with clients in the Phoenix metro area — including Scottsdale, Tempe, Mesa, Chandler, Gilbert, Glendale, and surrounding communities. For clients elsewhere in Arizona, I'm available by phone or video call. I'm licensed in the state of Arizona and can help you compare plans available in your specific county, since plan availability and pricing vary by location.

Question 12

What happens after I enroll — are you available for questions?

Accepted Answer

Absolutely. I stay in touch with my clients year-round. If you have a question about a bill, need help navigating a claim, want to understand a coverage decision, or just aren't sure if your plan still makes sense — call me. I also reach out proactively each fall before the Annual Enrollment Period to review your coverage and make sure nothing has changed that would affect your plan choice. You're not on your own after enrollment.

Medicare Questions, Answered in Plain English

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