Questions and
Answers Updated
2026
PPO,BHMO,BMSA,BCostBPlan,BPFFSB-BAnswerBTypesBofBMedicareBAdvantageBPlans
ServeBbothBMedicareBandBMedicaidBindividuals.BIncludeBPartBDBcoverage.BIndividualsB
sometimesBreferredBtoBasBdualBeligiblesB-BAnswerBMedicare-MedicaidBplans
TypeBofBMedicareBhealthBplan.BHaveBPartBBBtoBenroll.BCanBjoinBanytimeBplanBisBacce
ptingBnewBmembers.BABnonBnetworkBproviderBwillBcanBchargeBhigherBcoinsurancesBa
ndBdeuctibles.BDifferentBenrollment/disenrollmentBperiodsBapply.BCanBgetBPartBDBRxBc
overageBifBavailable,BorBapplyBforBaBseparateBPDP.B-BAnswerBMedicareBCostBPlan
IndividualsBwithBESRDBmayBsignBupBatBanytime.BDateBonBwhichBcoverageBbeginsBisBt
heBfourthBmonthBafterBdialysisBbegins.B-BAnswerBMedicareBEntitlement/EnrollmentB-
BPartBAB&BPartBB
IndividualsBwhoBdoBnotBenrollBinBPartBBBwhenBfirstBeligibleBcanBenrollBduringBaBGen
eralBEnrollmentBPeriod,BJanB1stBtoBMarB31stBeachByear.BCoverageBbeginsBJulyB1stBof
BthatByear.B-BAnswerBMedicareBEnrollmentBPeriod
IndividualsBwhoBhaveBgroupBhealthBcoveageBthroughBemployerBmayBenrollBinBPartBAB
and/orBPartBBBanytimeBwhileBonBgroupBcoverageBduringBaBSpecialBEnrollmentBPeriod.
BOccursBduringBtheB8BmonthBperiodBfollowingBlastBmonthBofBgroupBcoverage.B-
BAnswerBMedicareBEnrollmentBPeriodB-BGroupBHealthBCoverage
, FreeBifBworkedB40BquartersBofByourBlifeBandBpaidBMedicareBtaxes.BPremiumBisB$240.
00BforBindividualsBorBspousesBwhoBpaidBMedicareBtaxesBforB30B-
B39Bquarters.BPremiumBisB$437.00BforBlessBthanB30Bquarters.B-
BAnswerBMedicareBPartBABPremium
Don'tBenrollBinBPartBABwhenBfistBeligible,BwillBpayBaBlateBpenaltyBofBupBtoB10%Bunle
ssBenrollBduringBaBSpecialBEnrollmentBPeriod.B-BAnswerBMedicareBPartBABPenalty
InB2019,BtheBstandardBmonthlyBpremiumBisB$135.50BorBhigherBdependingBonBincome.
BDeductedBfromBS.S.BcheckBorBRailroadBRetirementBcheck.BDoBnotBenrollBwhenBfirstB
eligible,BpremiumBisBincreasedB10%BforBeachB12BmonthBperiodBnotBenrolled.BDeducti
bleBforB2019BisB$185.00B-BAnswerBMedicareBPartBBBPremium
EntiledBtoBbenefitsBunderBPartBABANDBenrolledBinBPartBB.B-
BAnswerBPartBCBMedicareBAdvantageBplans
EntitledBtoBbenefitsBunderBPartBABbutBnotBenrolledBinBPartBB.BMustBbeBentitledBtoB
PartBABAND/ORBenrolledBinBPartBB.B-BAnswerBPartBDBPrescriptionBDrugBbenefits
DoBnotBqualifyBforBPartBDBLowBIncomeBSubsidy,BbutBareBofBlimitedBmeans,BmayBqual
ifyBforBhelpBinBPartBDBcostsBthroughBStateBPharmaceuticalBAssistanceBProgram.B-
BAnswerBPartBDBLowBIncomeBSubsidy
$1364.00BdeductibleBforBeachBbenefitBperiod.BDaysB1B-
B60:B$0Bcoinsurance.BDaysB61B-
B90:B$341.00BcoinsuranceBperBday.BdaysB91BandBbeyond:B$682.00BcoinsuranceBperBe
achB"lifetimeBreserveBday"BafterBdayB90BforBeachBbenefitBperiodB(upBtoB60BdaysBove
rBaBbeneficiarysBlifetime.BBeyondBlifetimeBreserveBdays,BallBcosts.B-
BAnswerBPartBABBenefits
Blood,Bhospice,BhomeBhealthBcare,BskilledBnursingBandBrehabilitativeBcareBonlyBafterB
aB3BdayBhospitalBstayBupBtoB100BdaysBinBaBbenefitBperiod.BInB2019,BwillBpayB$170.5
0BcoinsuranceBforBdaysB21B-