Medicare Questions, Answered

Does it cost more to enroll in Medicare through an independent agent like Avelan Health?

No. Medicare plan premiums are set by the insurance company and reviewed by Medicare (for Advantage and drug plans) or your state (for Supplement plans), so the price is the same whether you enroll through Avelan Health, through the insurance company directly, or on Medicare.gov where that’s offered. Our help comparing and enrolling in plans is free to you.

You never receive a bill from us. The only thing that changes when you work with an agent is that you get a person to explain your options and help you after you enroll.

How does Avelan Health get paid if its help is free?

When you enroll in a plan through us, the insurance company pays us a commission. You don’t pay us anything, and the commission doesn’t change the price of your plan.

Commissions on Medicare Advantage and Part D plans are capped by Medicare. Our job is to help you understand your options so you can choose the plan that fits your situation.

Will an Avelan Health agent push me toward a certain plan?

No. Our goal is finding what fits your situation, not selling a specific plan. We explain how each option works, including the trade-offs, and you make the final decision.

If a plan doesn’t fit your doctors, prescriptions or budget, we’ll tell you, even if that means you don’t enroll in anything through us.

What makes Avelan Health different from other Medicare help?

Avelan Health is a family-run, independent Medicare agency founded by siblings Averee and Landen Martinez. We explain Medicare in plain English, never rush you, and stay available after you enroll, including a coverage review with you each fall.

We also create free tools, like our Medicare cheat sheet and enrollment calculators, so you can learn at your own pace before you ever talk to us.

Is Avelan Health tied to one insurance company?

No. Avelan Health is an independent agency, so we work with several Medicare insurance companies instead of just one. That lets us compare plans from different companies side by side for you.

We don’t offer every plan available in every area. See our Disclaimers for the number of companies and plans we represent.

Are Avelan Health agents licensed, and do I have to live in Nashville?

Yes. Our agents are licensed insurance agents who complete Medicare training and certifications every year. Averee Martinez is licensed in Tennessee and New Mexico, and Landen Martinez is licensed in 35 states.

We’re based in Nashville, Tennessee, but you don’t need to live nearby: we help people by phone and video in every state where our agents are licensed. See every state on our licensed states map. If you don’t see your state, reach out anyway and we’ll point you to free help where you live.

Can Avelan Health help me if I don’t live near you?

Yes. We help people with Medicare by phone and video, so where you live doesn’t matter as long as one of our agents is licensed in your state. Avelan Health agents are licensed in 35 states.

You can compare plans, ask questions and enroll from home. See every state on our licensed states map, or book a free call and we’ll check your state for you.

Do I have to meet a Medicare agent in person?

No. You don’t need an in-person meeting to get Medicare help or to enroll in a plan. We can walk through your options by phone or video call, wherever you are.

If you’d like a family member on the call, they can join from their own phone or computer too.

Can Avelan Health help me if I’m helping a parent with Medicare?

Yes. Many people we talk with are adult children helping a mom or dad. With your parent’s permission, you’re welcome to join the call and ask questions.

It helps to have your parent’s Medicare card, a list of their doctors and a list of their prescriptions handy.

What should I have ready for my call with Avelan Health?

Have your Medicare card (or your Social Security information if you’re not enrolled yet), a list of your doctors, a list of your prescriptions with the doses, and your preferred pharmacy. If you already have coverage, have that card handy too.

Don’t worry if you’re missing something. We can still walk through the basics and follow up later.

How can I avoid Medicare scams?

Medicare will not call you out of the blue asking for your Medicare number, bank information or Social Security number. If someone does, hang up. Never give your Medicare number to anyone who contacts you unexpectedly by phone, text or at your door.

If you think you’ve been targeted, report it to 1-800-MEDICARE (1-800-633-4227). Check your Medicare statements for services you didn’t receive. A licensed agent should always be happy to tell you their name, license number and the companies they represent.

What are the parts of Medicare?

Medicare has four parts. Part A covers hospital stays, Part B covers doctor visits and outpatient care, Part C is Medicare Advantage (a private plan that replaces how you get A and B), and Part D covers prescription drugs.

Parts A and B together are called Original Medicare and are run by the federal government. Parts C and D, and Medicare Supplement (Medigap) plans, are sold by private insurance companies.

What is the difference between Medicare Advantage and Medicare Supplement?

Medicare Advantage replaces how you get your Part A and B coverage, usually has a provider network and lower monthly premiums, and often includes drug coverage and extras. A Medicare Supplement works alongside Original Medicare to pay costs it leaves behind, and lets you see any doctor nationwide who accepts Medicare.

Supplement plans usually cost more each month but leave you with fewer surprise bills. Medicare Advantage plans usually cost less each month but have copays, networks and a yearly out-of-pocket maximum. Neither is automatically better. It depends on your doctors, budget and how much flexibility you want. A Medicare Supplement can’t be used with a Medicare Advantage plan, and it’s illegal for anyone to sell you one while you’re on Advantage unless you’re switching back to Original Medicare.

Does Medicare cover dental, vision and hearing?

Original Medicare (Parts A and B) generally does not cover routine dental cleanings, eye exams for glasses, or hearing aids. Many Medicare Advantage plans include some dental, vision and hearing benefits, and stand-alone dental and vision plans are also available.

Benefits vary a lot from plan to plan, so it’s worth checking the details before you choose. See our Dental, Vision & Extra Coverage questions below for more.

Do I need Medicare Part D if I don’t take any medications?

You don’t have to enroll, but if you go without Part D or other creditable drug coverage for 63 days or more in a row after your first sign-up window ends, you may pay a late enrollment penalty for as long as you have Part D. Many people pick a low-premium drug plan to avoid that.

Creditable coverage, like many employer or VA drug plans, lets you wait without a penalty. Your plan sends a yearly notice saying whether its coverage is creditable, so keep it.

Can I keep my doctors with Medicare?

With Original Medicare, and with a Medicare Supplement plan, you can see any doctor or hospital in the U.S. that accepts Medicare. Medicare Advantage plans use provider networks, so you’ll want to check that your doctors are in the plan’s network before you enroll.

HMO plans usually require you to use in-network doctors except in emergencies. PPO plans let you go out of network, often at a higher cost. Networks can change each year, which is one reason to review your plan every fall.

What is the difference between a Medicare Advantage HMO and PPO?

With an HMO, you generally have to use doctors and hospitals in the plan’s network, except for emergencies and urgent care, and you may need a referral to see a specialist. With a PPO, you can see doctors outside the network, but you usually pay more, and you often don’t need referrals.

HMOs often have lower costs, while PPOs give more flexibility, which can help if you travel or see specialists in different systems. Always check that your doctors and hospitals are in the network before you enroll.

What do Medicare star ratings mean?

Medicare rates Medicare Advantage and Part D plans from 1 to 5 stars based on things like quality of care, customer service and member complaints. New ratings come out each October. A 5-star rating is the highest.

If a 5-star plan is available where you live, you can switch into it once between December 8 and November 30 of the next year, outside the usual enrollment periods. Stars are helpful, but your doctors, drugs and costs still matter most.

What is prior authorization?

Prior authorization means your plan has to approve a service, test or drug before it will pay for it. Medicare Advantage and Part D plans use it for some care. Original Medicare uses it much less often.

Starting in 2026, Medicare Advantage plans must decide most standard requests for medical care within 7 calendar days and urgent ones within 72 hours. Drug requests are decided even faster. If a request is denied, you or your doctor can appeal. Ask us which services a plan requires approval for before you enroll.

How do I know if my prescription drugs are covered?

Every Part D and Medicare Advantage drug plan has a drug list, called a formulary, that shows which drugs it covers and what tier each one is on. Higher tiers usually cost more. Many plans also have preferred pharmacies where your costs can be lower.

Drug lists can change every year (and sometimes during the year), so check your drugs during Open Enrollment. You can compare plans with your exact drugs on Medicare’s Plan Finder, or we can do it with you for free. If your plan doesn’t cover a drug you need, your doctor can ask the plan for an exception.

What is a chronic condition special needs plan (C-SNP)?

A C-SNP is a Medicare Advantage plan built for people with certain long-term conditions, such as diabetes, chronic heart failure, heart disease or chronic lung disease. It has doctors, drug lists and extra benefits geared to that condition.

If you have a qualifying condition, you can usually join a C-SNP once at any time of year. The plan confirms your diagnosis with your doctor, and if it can’t be confirmed, you’ll be removed from the plan. Which C-SNPs you can join depends on your county.

What preventive care does Medicare cover at no cost to you?

Original Medicare covers many preventive services at no cost to you when your doctor accepts Medicare’s approved amount. These include a “Welcome to Medicare” visit in your first 12 months, a yearly wellness visit, flu, COVID-19, pneumonia and hepatitis B shots, and many cancer, heart and diabetes screenings.

If your doctor finds and treats a problem during a preventive visit, you may owe your share of the cost for that part (usually 20% coinsurance), and the Part B deductible may apply. The shingles vaccine and other recommended adult vaccines are covered at no cost under Part D. Medicare Advantage plans must cover the same preventive services at no cost when you use in-network providers.

What can I do if Medicare or my plan denies a claim?

You can appeal. With Original Medicare, follow the steps on your Medicare Summary Notice and file within 120 days of getting it. With a Medicare Advantage or Part D plan, follow the steps in the plan’s denial notice, usually within 65 days.

If waiting could seriously harm your health, ask for a fast (expedited) decision, which plans must make within 72 hours. If you think you’re being discharged from the hospital too soon, you can ask for a quick review. Call us and we’ll help you understand the letter.

Does Medicare pay for nursing homes or long-term care?

Medicare generally does not pay for long-term custodial care, like help with bathing, dressing or eating in a nursing home or at home. It does cover short-term skilled nursing care, up to 100 days per benefit period, after a hospital stay of at least 3 days in a row as an admitted inpatient (time “under observation” doesn’t count), if you need daily skilled care. Medicare Advantage plans may have different rules and costs.

For 2026, Original Medicare covers days 1 to 20 in a skilled nursing facility in full, and you pay $217 a day for days 21 to 100. Long-term care insurance, short-term care plans (which pay a daily or monthly amount for care for a set period, often up to a year) and Medicaid are the main ways people pay for ongoing custodial care. See our Medicare & Medicaid questions below.

What is the difference between Medicare Supplement Plan G and Plan N?

Plan G covers almost everything Original Medicare leaves behind except the Part B deductible ($283 in 2026). Plan N also leaves the Part B deductible, plus copays of up to $20 for some office visits and up to $50 for emergency room visits that don’t lead to an admission. Plan N usually has a lower monthly premium.

Plan N also doesn’t cover Part B excess charges, which a small number of doctors bill above Medicare’s approved amount. Plan G does. Premiums vary by company, age, ZIP code and sometimes tobacco use, so it’s worth comparing both.

Can I still get Medicare Supplement Plan F?

Only if you were eligible for Medicare before January 1, 2020. People who became eligible on or after that date can’t buy Plan F or Plan C, because those plans cover the Part B deductible. Plan G is the closest option for people new to Medicare.

If you already have Plan F, you can keep it. Plan F premiums may rise faster over time, since no one new can join the plan.

How much does a Medicare Advantage plan cost?

Many Medicare Advantage plans have a $0 monthly premium, but you still pay your Part B premium, plus copays or coinsurance when you get care. Every Advantage plan has a yearly out-of-pocket maximum for covered medical services, which caps what you pay in a year.

Medicare sets the highest maximum a plan can use, and many plans set theirs lower. When comparing plans, look at premiums, copays for the care you use most, drug costs and the out-of-pocket maximum together, not just the monthly premium.

What is a Medicare Part B giveback plan?

A Part B giveback is a feature of some Medicare Advantage plans that pays part of your Part B premium for you, so more of your Social Security check stays with you. The amount varies by plan, and these plans are only available in some areas.

You must still be enrolled in Part B and pay your premium to qualify. If your state or Medicaid already pays your Part B premium, a giveback won’t add money for you. A giveback plan may have trade-offs, like a smaller network or higher copays, so compare the whole plan.

When can I first sign up for Medicare?

Most people first sign up during their Initial Enrollment Period, a 7-month window around their 65th birthday: the 3 months before your birthday month, your birthday month, and the 3 months after.

Signing up in the months before your birthday month means your coverage can start the first day of your birthday month. (If your birthday is on the 1st, everything shifts one month earlier.) Use our free enrollment calculator to see your exact dates.

I’m still working at 65. Do I need to sign up for Medicare Part B?

If you or your spouse are still working and have health insurance through that job, you can usually delay Part B without a penalty. But if the employer has fewer than 20 employees, Medicare usually pays first, so you may need Part B to avoid big gaps. Check with the benefits office. When that job or coverage ends, you get an 8-month Special Enrollment Period to sign up.

COBRA and retiree coverage don’t count as current employer coverage for delaying Part B. Employers with fewer than 20 employees work differently, and Medicare usually pays first. Check with your employer’s benefits team before you decide.

When is the Medicare Annual Enrollment Period?

The Medicare Annual Enrollment Period runs from October 15 to December 7 every year. During it, you can switch Medicare Advantage or Part D drug plans, or move between Original Medicare and Medicare Advantage. Changes start January 1.

Plans can change their costs, networks and covered drugs every year, so it’s a good idea to review your plan each fall even if you’re happy with it.

Can I change my Medicare Advantage plan after January 1?

Yes, once. During the Medicare Advantage Open Enrollment Period, January 1 to March 31, people already in a Medicare Advantage plan can switch to a different Advantage plan or go back to Original Medicare and add a Part D drug plan. If you’re new to Medicare and join Advantage, you also get one change during your first 3 months of having Medicare.

Some life events, like moving or losing other coverage, can also open a Special Enrollment Period at other times of year.

When is the best time to buy a Medicare Supplement (Medigap) plan?

The best time is usually your Medigap Open Enrollment Period: the 6 months starting the first month you’re 65 or older and enrolled in Part B. During this window, companies can’t turn you down or charge more because of your health.

After that window, insurance companies in most states can ask health questions and may charge more or decline coverage. A few states have extra protections, so ask us about the rules where you live.

Can I switch from Medicare Advantage to a Medicare Supplement?

Yes, but timing matters. You can leave Medicare Advantage for Original Medicare during Open Enrollment (October 15 to December 7) or from January 1 to March 31. Outside your first Medigap window, though, most states let Supplement companies ask health questions and turn you down or charge you more.

You have a guaranteed right to buy certain Supplement plans, with no health questions, in some cases: for example, if you joined Medicare Advantage when you first turned 65 and switch back within the first 12 months, if you dropped a Supplement to try Advantage for the first time and leave within 12 months, or if your plan leaves your area. A few states give extra protections. Call us before you switch so we can check whether you’d qualify for a Supplement.

I missed my Medicare sign-up window. What can I do?

If you missed your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, you can sign up for Part B during the General Enrollment Period, January 1 to March 31 each year. Coverage starts the first of the month after you sign up.

You may owe a late enrollment penalty. If you had job-based coverage the whole time, you likely qualify for a Special Enrollment Period instead. Talk to us before you sign up so you choose the right path.

Do I have to re-enroll in my Medicare plan every year?

No. Most Medicare Advantage, Part D and Medicare Supplement plans renew automatically each year. But Advantage and Part D plans can change their premiums, copays, networks and covered drugs every January, so it’s smart to review your plan each fall.

Your plan mails you an Annual Notice of Change by September 30 that lists next year’s changes. If a plan is leaving your area, you’ll get a separate notice and a chance to choose a new plan.

How much does Medicare Part B cost in 2026?

The standard Medicare Part B premium in 2026 is $202.90 a month, and the Part B deductible is $283 a year. People with higher incomes pay more. Most people pay no premium for Part A because they or a spouse worked and paid Medicare taxes for at least 10 years.

Medicare usually announces the next year’s Part B premium in the fall. We’ll update this page when the 2027 amounts are released.

What is the Medicare Part B late enrollment penalty?

If you don’t sign up for Part B when you’re first eligible and don’t have qualifying coverage, such as from a current employer, your Part B premium can go up 10% for each full 12-month period you could have had Part B but didn’t. In most cases, you pay it for as long as you have Part B.

Try our Part B penalty calculator to see an estimate.

What is the Medicare Part D late enrollment penalty?

If you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period, a penalty is added to your drug plan premium: 1% of the national base premium for every month without coverage. The national base premium is $38.99 in 2026 and $41.33 in 2027, so penalty amounts go up slightly in January. The penalty usually lasts as long as you have Part D.

Coverage from an employer or the VA can count as creditable, so keep the yearly notice your plan sends you. Try our Part D penalty calculator for an estimate.

Is there a limit on what I pay for prescription drugs with Medicare?

Yes. Medicare Part D has a yearly out-of-pocket cap on covered drugs: $2,100 in 2026, rising to $2,400 in 2027. Once you reach it, you pay nothing more for covered drugs the rest of that year. Covered insulin costs no more than $35 a month.

The cap counts what you pay for drugs your plan covers, not your monthly premium.

How much does Medicare Part A cost in 2026?

Most people pay no monthly premium for Part A because they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters). If you worked less, Part A costs $311 a month with 30 to 39 quarters or $565 a month with fewer than 30 in 2026.

When you’re admitted to the hospital, you pay a $1,736 deductible for each benefit period in 2026, then $0 for days 1 to 60. Days 61 to 90 cost $434 a day, and lifetime reserve days cost $868 a day. Medicare Supplement plans can cover most of these costs.

Can I pay my prescription drug costs monthly?

Yes. The Medicare Prescription Payment Plan, which started in 2025, lets you pay $0 at the pharmacy and spread your Part D drug costs into monthly bills from your plan over the year. There’s no cost to join and no interest.

It helps most if you have high drug costs early in the year. It doesn’t lower what you owe, just spreads it out. Sign up by contacting your drug plan, not at the pharmacy. If you join, you stay in the next year automatically unless you change plans.

What if I can’t afford my Medicare costs?

There are programs that help. Extra Help lowers prescription drug costs for people with limited income and resources, Medicare Savings Programs can pay your Part B premium, and Medicaid can cover many costs Medicare doesn’t. You may qualify even if you own your home.

Since 2024, people with incomes up to 150% of the federal poverty level, and resources under the limit, can qualify for full Extra Help, which lowers Part D premiums, deductibles and copays. Apply through Social Security at ssa.gov. Medicare Savings Programs and Medicaid are run by your state. We can help you figure out which ones to look into.

Does Medicare cover weight-loss drugs like Wegovy and Zepbound?

Medicare drug plans generally can’t cover drugs used only for weight loss. But a temporary program, the Medicare GLP-1 Bridge, lets eligible people get certain GLP-1 weight-loss drugs for $50 a month from July 1, 2026, through December 31, 2027.

Learn more at Medicare.gov/coverage/weight-loss-drugs or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).

What is the Medicare GLP-1 Bridge?

The Medicare GLP-1 Bridge is a temporary Medicare program that covers certain GLP-1 drugs for weight loss for a flat $50 for a one-month supply, no matter your dose or income. It runs from July 1, 2026, through December 31, 2027, and works alongside your regular Medicare drug coverage.

Medicare runs the program itself, so you don’t need to switch drug plans to use it.

Who qualifies for the Medicare GLP-1 Bridge?

You must be 18 or older, have Medicare drug coverage (a Part D plan or a Medicare Advantage plan with drug coverage), and meet one of these: a BMI of 35 or higher; a BMI of 30 or higher with certain heart failure, hard-to-control high blood pressure or stage 3a or higher kidney disease; or a BMI of 27 or higher with prediabetes, or a past heart attack, stroke or blocked arteries in the legs or arms.

You don’t qualify if your drug plan pays (or has paid) for any GLP-1 for you, if you have type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease (your plan may cover a GLP-1 for those), or if your only coverage is a private fee-for-service, cost or PACE plan. Your doctor figures your BMI from your height and weight.

Which weight-loss drugs does the GLP-1 Bridge cover?

The Bridge covers Wegovy (shot or pill), Zepbound (KwikPen only) and Foundayo (pill). Zepbound single-dose pens and vials aren’t covered.

Diabetes drugs like Ozempic and Mounjaro aren’t part of the Bridge. Compounded or “knockoff” versions of these drugs aren’t covered either.

How do I get a weight-loss drug through the GLP-1 Bridge?

Talk with your doctor about whether a covered drug is right for you. Your doctor sends a prescription to your pharmacy and submits a form for Medicare’s approval, confirming you’re also following a diet and exercise plan. Medicare mails you a letter when you’re approved, and then you pay $50 at the pharmacy for a one-month supply.

Your approval covers refills and dose changes through December 31, 2027. If you switch to a different GLP-1 drug, you’ll need a new approval. Your pharmacy may ask for your Medicare number; if you don’t have your card, they can look you up with the last 4 digits of your Social Security number.

Does the $50 GLP-1 copay count toward my drug cost limit?

No. The $50 Bridge copay doesn’t count toward your Part D deductible or your yearly out-of-pocket limit ($2,100 in 2026). Extra Help can’t lower it, and you can’t put it on the Medicare Prescription Payment Plan.

Your other prescriptions still work the same way through your regular drug plan.

Does Medicare cover Ozempic or Mounjaro for diabetes?

Yes, usually. Medicare drug plans generally cover GLP-1 drugs like Ozempic and Mounjaro when they’re used to treat type 2 diabetes. Your cost depends on your plan’s drug list and tier, and it counts toward your yearly out-of-pocket limit.

Your plan may require prior authorization to confirm you have diabetes. Check your plan’s drug list each year during Open Enrollment, since coverage and costs can change.

Can Medicare cover a GLP-1 for heart disease or sleep apnea?

It can. Some GLP-1 drugs are FDA-approved for other uses, like Wegovy to lower the risk of heart attack and stroke in people with heart disease and excess weight, and Zepbound for moderate-to-severe obstructive sleep apnea with obesity. When used for those reasons, your regular drug plan may cover them.

Coverage depends on your plan and usually requires prior authorization. If your plan covers a GLP-1 for you this way, you get it through your plan, not the Bridge.

Do I need to change my Medicare plan to get the GLP-1 Bridge?

No. The Bridge works with any Part D plan or Medicare Advantage plan with drug coverage, unless your only Medicare coverage is a private fee-for-service, cost or PACE plan. You don’t need to switch plans during Open Enrollment just to get it.

Still, if you take or plan to take a GLP-1, tell us during your plan review so we can check how each plan handles your other drugs.

What happens to GLP-1 coverage after 2027?

The Bridge is scheduled to end December 31, 2027. Medicare has said a longer-term program may follow, but hasn’t confirmed what will replace the Bridge or when.

We’ll update this page as soon as Medicare shares more. Follow us on social media or join our newsletter to hear about changes.

Does Medicare cover other help with losing weight?

Yes. Part B covers obesity counseling, called intensive behavioral therapy, at no cost if your BMI is 30 or higher and it’s given in a primary care setting by a provider who accepts Medicare’s approved amount. Medicare also covers some weight-loss surgeries, like gastric bypass, for people who meet certain medical conditions, including a BMI of 35 or higher, at least one related health problem, and past medical treatment for obesity that didn’t work.

Some Medicare Advantage plans also include fitness programs like SilverSneakers. Check the plan’s benefits during your review.

What are ancillary insurance products?

Ancillary products are extra insurance plans you can add on top of your Medicare coverage to help with costs Medicare doesn’t fully cover. Common ones include dental, vision and hearing plans, hospital indemnity plans, cancer, heart attack and stroke plans, and short-term care plans. Separately, final expense life insurance helps with funeral costs.

These aren’t Medicare plans and aren’t connected with or endorsed by Medicare or the government. Whether you need any of them depends on your health, your budget and the Medicare coverage you already have.

Should I buy a separate dental plan with Medicare?

It can make sense if you have Original Medicare, a Medicare Supplement, or a Medicare Advantage plan with very limited dental. A stand-alone dental plan usually covers cleanings and exams, with partial coverage for fillings, crowns, dentures and other work.

Before you buy, check the yearly maximum the plan will pay, any waiting periods before bigger work is covered, and whether your dentist is in the network. If you’re expecting major work soon, waiting periods matter a lot.

How can I get coverage for glasses and hearing aids?

Original Medicare doesn’t cover routine eye exams, glasses (except one pair after cataract surgery) or hearing aids. Many Medicare Advantage plans include an allowance for them. With Original Medicare, you can buy a stand-alone vision plan, and many dental plans bundle in vision and hearing benefits or discounts.

Since 2022, you can also buy over-the-counter hearing aids without a prescription if you’re an adult with perceived mild to moderate hearing loss, which can cost much less. Medicare covers diagnostic hearing exams when your doctor orders them, and for some conditions you can see an audiologist once a year without an order.

What is hospital indemnity insurance?

Hospital indemnity insurance pays you a set amount of cash for a hospital stay, often per day or per admission, no matter what Medicare pays. You can use the money however you want, such as hospital copays, bills at home or a family member’s travel.

It’s most often paired with Medicare Advantage, where hospital stays come with daily copays. If you have a Medicare Supplement like Plan G, most hospital costs are already covered, so you may not need it. Some plans ask health questions.

What is cancer, heart attack and stroke insurance?

These plans, also called critical illness insurance, pay you a lump sum of cash if you’re diagnosed with a covered illness like cancer, a heart attack or a stroke. The money is yours to use for treatment costs, travel, bills or anything else.

They can help fill the gap between what Medicare pays and your real costs during a serious illness. Read the policy carefully for what counts as a covered diagnosis and any waiting period at the start.

Can I buy these extra plans any time of year?

Usually, yes. Most dental, vision, hospital indemnity, critical illness and final expense plans aren’t tied to Medicare’s enrollment periods, so you can apply whenever you want. Some ask health questions, and approval isn’t guaranteed.

It’s smart to review them at the same time as your Medicare plan, so the pieces fit together and you’re not paying for coverage twice.

What is an annuity?

An annuity is a contract with an insurance company. You pay in money, either all at once or over time, and in return the company may grow your money, pay you income, or both, depending on the type. If you choose a lifetime payout, an annuity can give you income you can’t outlive.

Annuities aren’t Medicare plans, aren’t connected with Medicare or the government, and aren’t FDIC-insured. Their guarantees depend on the strength of the insurance company that issues them.

What are the main types of annuities?

Fixed annuities pay a set interest rate for a set time, a bit like a CD. Fixed indexed annuities earn interest based partly on a stock market index, with protection from market losses. Immediate annuities turn a lump sum into monthly income that starts right away. Variable annuities are invested in the market and can lose value.

Variable annuities are securities and can only be sold by agents with a securities license. Each type has trade-offs between growth, safety and access to your money, so it’s worth comparing before you choose.

Can I get my money out of an annuity?

Usually, but there may be limits. Most annuities have a surrender period, often several years, when taking out more than a certain amount, commonly 10% a year, comes with a surrender charge. After the surrender period ends, you can usually take out as much as you want.

Only put money in an annuity that you won’t need for everyday bills or emergencies during the surrender period. Many annuities waive surrender charges if you go into a nursing home or are diagnosed with a terminal illness; check the contract.

How are annuities taxed?

Money in an annuity grows tax-deferred, so you don’t pay taxes on the earnings until you take them out. When you do, the earnings are taxed as ordinary income. Withdrawals before age 59½ may also have a 10% IRS penalty.

If the annuity was bought with IRA or 401(k) money, the rules for those accounts apply, including required minimum distributions. A tax professional can help with your situation.

Can annuity income affect my Medicare or Social Security?

It can. Annuities don’t reduce your Social Security benefit, but the taxable part of annuity payments counts as income. That can make more of your Social Security taxable and, if your income is high enough, add IRMAA to your Medicare premiums two years later.

When and how you take annuity income can affect IRMAA, so a tax professional can help you plan. See our IRMAA questions above. Annuities can also affect Medicaid eligibility for long-term care, and those rules are complicated, so talk with an elder law attorney if that’s a concern.

Is my money safe in an annuity?

Fixed and fixed indexed annuities aren’t affected by stock market drops, but their guarantees depend on the financial strength of the insurance company. Surrender charges can also reduce what you get back if you leave early.

Look for insurance companies with strong financial strength ratings from agencies like A.M. Best. We’re happy to show you a company’s rating before you decide.

What if I change my mind after buying an annuity?

Every annuity comes with a “free look” period, usually at least 10 days, and longer in some cases, such as when you replace an annuity you already own. During that time you can cancel and get your money back (for some annuities, the current value).

Read your contract as soon as it arrives so you have time to ask questions while the free look period is still open.

How do I know if an annuity is right for me?

Annuities can be a good fit if you want guaranteed income or protection from market losses, and you have other savings for emergencies. They’re usually not a good fit for money you may need soon. Agents must act in your best interest when they recommend an annuity.

Be careful of anyone who pressures you to decide quickly, tells you to put all your savings in one annuity, or wants you to swap an annuity you already own for a new one with new surrender charges. A good agent will explain the costs and limits in writing.

Can Avelan Health help me with annuities?

Yes. Our agents can help you compare annuities and explain how they work, with no pressure. We won’t bring up annuities at your Medicare appointment. Medicare’s rules don’t allow agents to discuss annuities during a Medicare plan appointment, so just ask us and we’ll set up a separate conversation.

We’re not financial advisors or tax professionals. For big decisions about your savings, you may also want to talk with one. Call us at (505) 408-5984 to set up an annuity conversation.

Do I need life insurance after 65?

Many people still do. Life insurance can replace income your spouse would lose, since a surviving spouse keeps only the larger of your two Social Security checks. It can also pay off a mortgage or other debts, cover funeral costs, or leave money to your children, grandchildren or a charity.

If no one depends on your income and your savings will cover your final bills, you may need little or none. Life insurance isn’t a Medicare plan and isn’t connected with Medicare or the government.

What is the difference between term and whole life insurance?

Term life covers you for a set number of years, like 10 or 20, and usually costs the least, but it ends if you outlive the term. Whole life covers you for your whole life, with premiums that stay the same, and builds cash value you can borrow against. Universal life is permanent coverage with more flexible premiums.

Guaranteed universal life is a popular middle ground for older buyers: lifelong coverage with less cash value, usually for less than whole life. Final expense insurance is a small whole life policy; see the next question.

What is final expense insurance?

Final expense insurance is a small whole life insurance policy, often between a few thousand and $25,000, meant to cover funeral costs and final bills so your family doesn’t have to. Premiums usually stay the same for life, and many policies ask only a few health questions.

Some policies, called graded or guaranteed issue, don’t pay the full amount if death from illness happens in the first two years. Final expense insurance isn’t health insurance, so we only discuss it if you ask, separate from any Medicare plan conversation.

Can I get life insurance in my 70s or 80s?

Yes. You’ll have fewer choices and pay more than a younger buyer, but many companies sell coverage into your 80s. Fully underwritten policies look closely at your health and give the best prices to healthy people. Simplified issue policies ask a few health questions, and guaranteed issue policies ask none.

Guaranteed issue policies are usually small and often pay only premiums back plus interest if death from illness happens in the first two or three years. The healthier you are when you apply, the more options you’ll have, so it’s worth looking sooner rather than later.

Do I need a medical exam to get life insurance?

Not always. Many policies for older adults need only a phone interview or a short health questionnaire, plus a check of your prescription history and medical records. Larger policies, or ones with the lowest prices, may require an exam with blood work that’s usually done at your home for free.

Always answer health questions honestly. Leaving something out can let the company deny a claim later.

How much life insurance do I need?

It depends on what you want it to do. Add up any debts you’d want paid off, funeral costs, income your spouse would need to replace, and any money you’d like to leave behind. Then subtract savings and other coverage you already have.

The median funeral with viewing and burial cost about $8,300 in 2023, not counting the cemetery plot, headstone and other extras, which can add thousands more. A funeral with cremation had a median of about $6,300. We can walk through the numbers with you for free.

What happens to my life insurance from work when I retire?

Group life insurance from an employer often ends or shrinks when you retire. Many group policies let you convert to an individual policy or keep the coverage, without a health exam, if you apply within a short window, often 31 days after leaving.

Ask your HR department what happens to your coverage before your last day so you don’t miss the deadline. Converted policies can be expensive, so compare them with other options.

What are living benefits on a life insurance policy?

Living benefits, also called accelerated death benefit riders, let you use part of your death benefit while you’re still alive if you become terminally, chronically or critically ill. The money can help pay for care, treatment or bills.

Some policies include these riders at no extra cost and others charge for them. Whatever you use is subtracted from what your beneficiaries receive. Some life insurance policies also have long-term care riders that work in a similar way.

Is a life insurance payout taxed?

In most cases, the money your beneficiaries receive from a life insurance death benefit isn’t subject to federal income tax. Large estates can face estate taxes, and any interest paid on a delayed payout may be taxable.

Keep your beneficiaries up to date, especially after a marriage, divorce or death in the family. Naming a person instead of your estate usually lets the money skip probate and reach your family faster.

Can Avelan Health help me with life insurance?

Yes. Our agents can compare life insurance policies from several companies and explain them in plain English, with no pressure. We won’t bring up life insurance at your Medicare appointment. Medicare’s rules don’t allow agents to discuss life insurance during a Medicare plan appointment, so just ask us and we’ll set up a separate conversation.

Call us at (505) 408-5984 and tell us you’d like to talk about life insurance.

What is the difference between Medicare and Medicaid?

Medicare is federal health insurance for people 65 and older and some younger people with disabilities, no matter their income. Medicaid is health coverage for people with limited income and resources, run by each state with federal help. In Tennessee, Medicaid is called TennCare. In New Mexico, it’s called Turquoise Care.

Because each state runs its own Medicaid program, the rules, income limits and benefits are different from state to state.

Can I have Medicare and Medicaid at the same time?

Yes. People who qualify for both are called “dual eligible.” Medicare pays first, and Medicaid can help pay your premiums, deductibles and copays, plus some things Medicare doesn’t cover, like long-term care. If you have both, you automatically qualify for Extra Help with your drug costs.

Some people get full Medicaid benefits, and others qualify only for help with Medicare costs through a Medicare Savings Program. Both count as dual eligible.

What is a Medicare Savings Program?

Medicare Savings Programs are state programs that help pay Medicare costs for people with limited income and resources. All three pay your Part B premium. The main ones are QMB, which also covers Medicare deductibles and copays, SLMB and QI. If you qualify for any of them, you automatically get Extra Help too.

Income limits are set by the federal poverty level and are higher than many people expect, especially for QI. If you have QMB, doctors and hospitals that take Medicare aren’t allowed to bill you for Medicare-covered care. Even if you think you earn too much, it’s worth checking.

What is a dual special needs plan (D-SNP)?

A D-SNP is a Medicare Advantage plan built only for people who have both Medicare and Medicaid. It often includes extra benefits like dental, vision, hearing, an over-the-counter allowance and rides to appointments, and it works with your Medicaid coverage so you have fewer bills.

Benefits and plans depend on your county and the level of Medicaid you have. We can check which D-SNPs you qualify for at your ZIP code.

If I have Medicaid, can I change my Medicare plan during the year?

Yes, more often than most people. If you have Medicaid or Extra Help, you can switch to Original Medicare with a stand-alone drug plan, or change drug plans, once a month. If you have full Medicaid, you can also join or switch to certain D-SNPs that are paired with your Medicaid plan once a month.

These monthly options started in 2025 and replaced the old once-a-quarter option. Switching to most other Medicare Advantage plans still has to wait for Open Enrollment or another special period.

How do I apply for Medicaid or a Medicare Savings Program in Tennessee?

Apply through TennCare Connect online at tenncareconnect.tn.gov or by calling 855-259-0701. For help with a Medicare Savings Program (QMB or SLMB), call 1-877-801-0044. You can also apply at your local Department of Human Services office.

If you have a hearing or speech need, call Tennessee Relay at 800-848-0298 and ask for TennCare Connect. More at tn.gov/tenncare.

How do I apply for Medicaid or a Medicare Savings Program in New Mexico?

Apply online through YES New Mexico at yes.state.nm.us or call the New Mexico Health Care Authority at 1-800-283-4465 (agents are available Monday through Friday, 7 a.m. to 6:30 p.m.). You can also apply at your local Income Support Division office.

More at hca.nm.gov. In other states, contact your state Medicaid office or call 1-800-MEDICARE and ask about Medicare Savings Programs.

Does Medicaid pay for nursing home care?

It can. Medicare only covers short nursing home stays for rehab, but Medicaid can pay for long-term nursing home care, and often care at home, for people who qualify both medically and financially. In Tennessee, this is through TennCare CHOICES.

The financial rules for long-term care are stricter and include a look-back at money or property given away in the past 5 years. If a married person needs care, special rules protect some income and savings for the spouse at home. An elder law attorney can help you plan.

Can Medicaid take my house after I die?

In some cases. States must try to get back what Medicaid paid for long-term care for people 55 and older, usually from their estate after they die. This is called estate recovery. States can’t do this while a surviving spouse, a child under 21, or a blind or disabled child is still living.

Rules and protections differ by state, so talk with an elder law attorney if you own a home and may need long-term care.

What happens if I lose my Medicaid?

Medicaid checks every year that you still qualify, so open and answer your renewal mail quickly. If you do lose Medicaid, you get a Special Enrollment Period to change your Medicare coverage, and many D-SNPs give you a short grace period before you’re removed from the plan.

Losing Medicaid can also change your Extra Help and Medicare Savings Program status. Call us right away and we’ll help you find coverage that fits your new situation.

What is IRMAA in Medicare?

IRMAA, the Income-Related Monthly Adjustment Amount, is an extra charge added to your Part B and Part D premiums if your income is above a certain level. For 2026, it starts at incomes above $109,000 for individuals and $218,000 for married couples filing jointly.

IRMAA isn’t a penalty and isn’t permanent. It’s figured again every year based on your income.

What are the 2026 IRMAA brackets?

In 2026, the standard Part B premium is $202.90 a month. If your income is higher, you pay between $284.10 and $689.90 a month for Part B, plus an extra $14.50 to $91.00 a month for Part D. The 2027 brackets are usually announced in November.

How does Medicare decide if I owe IRMAA?

Social Security looks at your modified adjusted gross income (MAGI) from your federal tax return from two years earlier. For 2026 premiums, that’s your 2024 return. MAGI is your adjusted gross income plus any tax-exempt interest, like interest from municipal bonds.

If you owe IRMAA, Social Security mails you a letter explaining the amount and the income it used. Read it carefully: it also tells you how to ask for a review.

Can I lower my IRMAA if my income went down?

Yes, if your income dropped because of a life-changing event. These include retiring or cutting back on work, marriage, divorce, the death of a spouse, losing a pension, an employer settlement payment, or losing income-producing property through no fault of your own. Fill out form SSA-44 and send it to Social Security with proof, like a letter from your employer.

Many people pay IRMAA in their first year or two of retirement only because Social Security is still looking at the years they were working. If that’s you, it’s worth filing form SSA-44. If you think Social Security used the wrong income or made a mistake, you can ask for a reconsideration instead.

Can selling a house, a Roth conversion or a big IRA withdrawal cause IRMAA?

Yes. A one-time jump in income, like a large IRA withdrawal, a Roth conversion, selling stocks or investment property, can push you into IRMAA two years later. It usually only affects that one year’s premiums. A one-time sale you chose to make doesn’t count as a life-changing event for form SSA-44.

Selling your main home may not count much, if at all: married couples can usually leave up to $500,000 of profit off their taxes ($250,000 if single). If you’re planning a big withdrawal or sale near 63 or later, talk with a tax professional about the timing.

Do I pay IRMAA if I have a Medicare Advantage plan?

Yes. With Medicare Advantage you still pay your Part B premium, so a Part B IRMAA still applies. If your plan includes drug coverage, the Part D IRMAA applies too. The same goes for Medicare Supplement plans and stand-alone drug plans.

IRMAA goes to Medicare, not your insurance company, and it’s the same no matter which plan you pick.

How do I pay IRMAA?

If you get Social Security, IRMAA is usually taken out of your monthly check along with your Part B premium. If you don’t, Medicare sends you a bill. The Part D IRMAA is paid to Medicare even if you pay your drug plan’s premium to the plan.

Don’t skip a Part D IRMAA bill: if it goes unpaid, you can lose your drug coverage.

How does Medicare work with VA benefits or TRICARE?

VA health care and Medicare are separate. Many veterans keep both, using the VA at VA facilities and Medicare everywhere else. If you have TRICARE, you generally must enroll in Medicare Parts A and B to keep coverage through TRICARE For Life.

VA coverage does not let you delay Part B without a penalty, so if you might ever use non-VA doctors, it’s worth thinking about Part B carefully. VA drug coverage counts as creditable for Part D.

Can I keep contributing to my HSA once I’m on Medicare?

No. Once you enroll in any part of Medicare, including premium-free Part A, you can no longer contribute to a Health Savings Account. You can still use the money already in it, tax-free, for qualified medical costs, including Part B, Part D and Medicare Advantage premiums, but not Medicare Supplement (Medigap) premiums.

If you sign up for Medicare after 65, Part A can be backdated up to 6 months (but not before the month you turned 65). To avoid a tax penalty, stop HSA contributions about 6 months before you apply.

I’m under 65 and on disability. When do I get Medicare?

Most people under 65 get Medicare automatically after receiving Social Security Disability Insurance (SSDI) benefits for 24 months. People with ALS get Medicare as soon as their disability benefits start, and people with end-stage renal disease have their own rules.

Your Medicare card usually arrives in the mail about 3 months before coverage starts.

Does Medicare cover me when I travel or move?

Original Medicare works anywhere in the U.S. with providers who accept Medicare. Medicare Advantage plans must cover emergency and urgent care anywhere in the U.S., but routine care is often limited to the plan’s area. If you move out of your plan’s area, you get a Special Enrollment Period to switch.

Original Medicare generally doesn’t cover care outside the U.S. Some Medicare Supplement plans, including Plans G and N, cover emergency care outside the U.S. if it starts within the first 60 days of your trip. They pay 80% after a $250 yearly deductible, up to a $50,000 lifetime limit.

I have Marketplace (Obamacare) coverage. Do I need Medicare at 65?

Usually, yes. Once you’re eligible for premium-free Part A, you generally can’t keep getting tax credits to lower your Marketplace premium, and Marketplace coverage doesn’t let you delay Part B without a penalty. Most people should sign up for Medicare during their Initial Enrollment Period.

Time your Marketplace plan to end when your Medicare coverage starts so you don’t have a gap or pay for both. If you keep receiving tax credits after you’re eligible for Medicare, you may have to pay them back at tax time.

Does Medicare cover my spouse?

No. Medicare covers each person individually, so there’s no family or spouse plan. Your spouse may qualify for premium-free Part A based on your work record when they turn 65, but a spouse younger than 65 needs their own health coverage until then.

If your spouse is on your employer plan and you retire, plan ahead so they have coverage, like COBRA, a Marketplace plan or their own employer plan, until they’re eligible for Medicare.

What Medicare plans are available in Nashville for 2027?

According to Medicare’s Plan Finder in October 2026, people in Davidson County (Nashville) can choose from 37 Medicare Advantage plans from 8 insurance companies, plus 11 stand-alone Part D drug plans from 6 companies, for 2027. There are also special needs plans for people who qualify.

Medicare Supplement plans are also sold in Tennessee by many insurance companies. If you have Medicare and TennCare (Tennessee’s Medicaid program), you may qualify for a special needs plan built for people with both. Plans, costs and networks vary by county and change every year. We can compare the plans we offer at your ZIP code with you for free.

What Medicare plans are available in Albuquerque for 2027?

According to Medicare’s Plan Finder in October 2026, people in Bernalillo County (Albuquerque) can choose from 21 Medicare Advantage plans from 5 insurance companies, plus 10 stand-alone Part D drug plans from 5 companies, for 2027. There are also special needs plans for people who qualify.

Medicare Supplement plans are also sold in New Mexico by many insurance companies. If you have Medicare and Turquoise Care (New Mexico’s Medicaid program), you may qualify for a special needs plan built for people with both. Plans in Santa Fe, Las Cruces and rural counties can be different, so we always check your ZIP code. Averee Martinez is licensed in New Mexico and can help by phone or video.

What Medicare plans are available in my area for 2027?

It depends on your county and ZIP code. Medicare Advantage and Part D drug plans are offered by private insurance companies in specific service areas, so the plans, costs and doctor networks near you can be different from a town just a few miles away. Medicare Supplement (Medigap) plans are sold in every state.

Plans change every year, so check your options during Open Enrollment, October 15 to December 7. You can search plans on Medicare.gov’s Plan Finder, or we can compare the plans we offer at your ZIP code with you for free in any of our 35 licensed states.

How do I find a licensed Medicare agent near me?

Your agent doesn’t have to be nearby, but they do have to be licensed in the state where you live. Many people now get Medicare help by phone or video from an agent in another city.

You can look up any agent’s license on your state Department of Insurance website. Avelan Health agents are licensed in 35 states and help by phone and video, at no cost to you.

Which states are Avelan Health agents licensed in?

Avelan Health can help people with Medicare in 35 states: Alabama, Arizona, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia and Wisconsin.

Averee Martinez is licensed in Tennessee and New Mexico, and Landen Martinez is licensed in all 35 states listed. We help by phone and video, so you don’t need to live near us. See them on our licensed states map. Don’t see your state? Reach out anyway and we’ll point you to free help.

Will I be signed up for Medicare automatically?

If you’re already getting Social Security retirement benefits at least 4 months before you turn 65, you’re usually enrolled in Medicare Parts A and B automatically, and your card arrives in the mail about 3 months before your birthday. If you aren’t getting Social Security yet, you need to sign up yourself through Social Security.

You can apply online at ssa.gov. See our Social Security page for how the two programs work together.

Is Medicare the same as Social Security?

No. Medicare is health insurance, run by the Centers for Medicare & Medicaid Services. Social Security pays retirement and disability income. Social Security handles Medicare enrollment, and your Part B premium is usually taken out of your Social Security check.

Medicare still starts at 65 even though full retirement age for Social Security is 67 for anyone born in 1960 or later.

Do I have to start Social Security to get Medicare?

No. You can sign up for Medicare at 65 even if you wait to claim Social Security. If you aren’t getting Social Security yet, Medicare sends you a bill for your Part B premium, and you can pay it online, by mail or with automatic payments through Medicare Easy Pay.

Once you start Social Security, your Part B premium usually switches to being taken out of your monthly check automatically.

When can I start collecting Social Security?

You can start as early as 62, but your monthly check is permanently smaller. If your full retirement age is 67, starting at 62 cuts it by about 30%. Full retirement age is 67 for anyone born in 1960 or later. For each year you wait past full retirement age, up to 70, your check grows by 8%.

The right age depends on your health, savings, work and marriage. Social Security can show your own estimates at each age in your my Social Security account at ssa.gov. We’re not financial advisors, but we can show you how your timing affects your Medicare sign-up.

Can I work and collect Social Security at the same time?

Yes. If you’re younger than full retirement age, Social Security holds back $1 for every $2 you earn over $25,560 in 2027. In the year you reach full retirement age, it holds back $1 for every $3 over $67,920, counting only what you earn before that birthday month. Once you reach full retirement age, there’s no limit.

The money held back isn’t lost. Social Security raises your monthly check once you reach full retirement age to make up for it. (The 2026 limits are $24,480 and $65,160.)

Is Social Security taxed?

It can be. If your “combined income” (half your Social Security plus your other income, including tax-free interest) is over $25,000 for a single person or $32,000 for a married couple filing together, part of your benefit may be taxed by the IRS. At most, 85% of your benefit can be taxable.

You can ask Social Security to withhold federal tax from your check using Form W-4V. Tennessee doesn’t tax Social Security. New Mexico doesn’t tax it for single filers with income under $100,000 or married couples filing jointly under $150,000. A tax professional can help with your own situation.

Can I get Social Security from my spouse’s work record?

Yes. A spouse can get up to 50% of the other spouse’s full retirement benefit, if that’s more than their own. The amount is smaller if you start it before your full retirement age. A divorced spouse can qualify too if the marriage lasted at least 10 years, you’re 62 or older, and you’re currently unmarried.

Your spouse’s record can also give you premium-free Medicare Part A at 65 (once your spouse is at least 62), even if you didn’t work enough yourself. See our Social Security page for more on spousal, survivor and divorced spouse benefits.

What Social Security benefits does a widow or widower get?

A surviving spouse can get up to 100% of the deceased spouse’s benefit at full retirement age, or a reduced amount as early as 60 (50 if disabled). If you’re already getting your own benefit, you get whichever amount is higher, not both.

Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to report a death and ask about survivor benefits. If you had health coverage through your spouse’s job or retiree plan, or your income or address changes, you may be able to change your Medicare coverage. Give us a call and we’ll check.

I was a teacher or government worker. Did the Social Security rules change for me?

Yes. The Social Security Fairness Act, signed in January 2025, ended two rules, the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO), that used to cut Social Security for many people with a government pension. The change applies to benefits payable for January 2024 and later, so many people also got back payments.

If you think you’re affected and haven’t seen a change, contact Social Security. Learn more at ssa.gov.

How do I apply for Social Security?

You can apply online at ssa.gov, call 1-800-772-1213 (TTY 1-800-325-0778), or visit your local Social Security office. You can apply up to 4 months before you want your benefits to start.

Make a free my Social Security account at ssa.gov first. It shows your work history, benefit estimates and, later, your Medicare and tax forms.

What is a Social Security COLA?

A COLA, or cost-of-living adjustment, is a yearly raise in Social Security and SSI benefits so they keep up with rising prices. It’s based on how much prices went up from one summer to the next, using a government measure called the CPI-W. Social Security announces the new COLA each October.

The raise happens automatically. You don’t need to apply or do anything to get it.

How much is the Social Security COLA for 2027?

Social Security and SSI benefits go up 3.6% for 2027. Social Security says the average retirement benefit will rise by about $75 a month, from about $2,095 to about $2,170. The raise affects about 76 million people.

Source: Social Security’s 2027 COLA announcement and 2027 fact sheet.

When will I see the 2027 COLA in my check?

The raise starts with your January 2027 Social Security payment. If you get SSI, your higher payment arrives December 31, 2026. Most people are paid on the second, third or fourth Wednesday of the month, depending on their birthday.

If your birthday is between the 1st and 10th, you’re paid on the second Wednesday; the 11th to 20th, the third Wednesday; the 21st to 31st, the fourth Wednesday. People who started benefits before May 1997, or who get both Social Security and SSI, are usually paid on the 3rd of the month. (For January 2027, that payment arrives December 31, 2026, because January 3 is a Sunday.)

How do I find out my new benefit amount?

If you have a my Social Security account, your COLA notice appears in your online Message Center starting in late November. If you don’t use online notices, Social Security mails your notice in December. It shows your new benefit and any Medicare premium taken out.

You can sign up for my Social Security at ssa.gov and choose to get a text or email when your notice is ready. Create your account by November 18 to see your 2027 notice online.

Will my Medicare Part B premium take part of my COLA?

It can. If your Part B premium comes out of your Social Security check, a higher Part B premium for 2027 is taken from your raise. The 2027 Part B premium is usually announced in November, so your COLA notice will show both.

A “hold harmless” rule keeps most people’s Social Security check from going down because of a Part B increase. It doesn’t protect people who are new to Part B that year, people who pay IRMAA, or people whose premium isn’t taken from their check.

What were Social Security COLAs in past years?

Recent COLAs were 5.9% for 2022, 8.7% for 2023, 3.2% for 2024, 2.5% for 2025, 2.8% for 2026 and 3.6% for 2027. The amount changes every year based on inflation.

See the full history at ssa.gov.

Can the COLA affect my Extra Help, Medicaid or IRMAA?

Usually not by much, but it can. The raise counts as income, so if you’re right at the edge of a limit, it’s worth checking. For Medicare Savings Programs, the January raise generally isn’t counted until the new federal poverty guidelines come out each year.

IRMAA uses your tax return from two years earlier, so the 2027 raise can’t affect IRMAA until 2029. If you get a letter saying your help is changing, call us and we’ll walk through it with you.