Frequently Asked Questions

Medicare enrollment is complex and not one-size-fits-all; a licensed agent can answer your specific questions to ensure you find an Alabama Medicare plan that is well-suited for your health care and financial needs.

Many Medicare Advantage plans offer additional perks, such as vision coverage, hearing coverage, affordable over-the-counter (OTC) supplies, meal services, and transportation assistance.

There are over one million Alabama residents enrolled in Medicare, and over 50% of them utilize Medicare Advantage Prescription Drug plans for comprehensive coverage.

We have extensive knowledge about the Alabama Medicare market and have helped clients in areas including Mobile, Montgomery, Huntsville, and cities such as Birmingham, Madison, and Auburn.

Our consulting services are provided at no cost to you because Advocator Advantage is compensated by the insurance carrier after a Medicare enrollment.

We are committed to helping you understand and compare Medicare Advantage (Part C), Medicare Supplement (Medigap), and Medicare Part D (prescription drug coverage) plans across Alabama.

Advocator Advantage provides no-cost, personalized Medicare assistance from licensed agents to help you explore and enroll in a plan that fits your needs and lifestyle.

The most important thing is understanding that Medicare is not one-size-fits-all. It is crucial to evaluate your personal healthcare needs (doctors, prescriptions, frequency of care) and financial situation to find a plan that truly works for you. Using a dedicated, licensed agent can help you ask the right questions and compare all your local options confidently.

Yes! While we highlight the major areas, our licensed agents can help you explore Texas Medicare Advantage and Medicare Supplement (Medigap) options across the entire state. We serve cities including Abilene, Lubbock, Waco, Laredo, and more, to ensure you find a suitable plan for your local healthcare needs.

There is no cost to you for our consulting services. Advocator Advantage is compensated directly by the insurance carrier after you enroll in a Medicare plan. This allows you to receive personalized guidance from licensed agents at no charge.

No. These rich extra benefits (such as comprehensive dental, healthy food allowances, hearing, and utility assistance) are specific to certain Texas Medicare Advantage plans. They are most commonly offered in counties with a high number of plan options, such as Hidalgo County, El Paso County, Harris County, and Bexar County. You need to check the specific plan details and your county’s offerings to see which benefits are included.

The key difference lies in network flexibility. HMO (Health Maintenance Organization) Plans generally require you to use doctors and hospitals within the plan’s specific network (except in emergencies) and often require a referral to see a specialist. They typically have lower monthly premiums. Local PPO (Preferred Provider Organization) Plans offer more flexibility. You can see doctors outside the network without a referral, but your out-of-pocket costs will be higher for out-of-network care. PPO plans typically have higher premiums but offer broader access.

Staying on top of your benefits can bring peace of mind. You can download the SSA’s 2025 payment schedule using the link below! It’s a helpful way to plan ahead with confidence! https://www.ssa.gov/pubs/EN-05-10031-2025.pdf

If your benefits ended because you returned to work, but you stopped working because of your disability, you may request Social Security to restart your benefits under Expedited Reinstatement. You may not need to file a new application and can receive provisional benefits for up to six months while a final determination is made about the reinstatement.

There are federal work incentives that allow SSDI/SSI beneficiaries to remain eligible for medical coverage while participating in the Ticket to Work Program. We can assist you in understanding state-specific requirements if you are receiving SSI and Medicaid. 

Should your SSDI benefits end, but your impairments continue to meet SSA’s criteria for disability, you may be eligible to receive ongoing Medicare coverage for at least an additional seven and a half years. Continued Medicaid eligibility may vary if your SSI benefits end. Our certified benefits counselors can assist you with understanding your state’s Medicaid guidelines to determine how long you can continue to receive Medicaid coverage while working.  

SSA offers SSDI beneficiaries the chance to utilize a trial work period to test their ability to return to work. This provides you with the opportunity to earn more than the Substantial Gainful Activity level, while continuing to receive monthly benefits. Your cash benefits will end after nine months of earnings that exceed trial work period levels.

SSI beneficiaries are unable to utilize the trial work period, and their monthly benefits are typically reduced as a result of earnings. In either instance, our experienced career counselors will help you understand any impact on your benefits, so you are prepared and fully understand your future income.

SSDI beneficiaries have a 9-month trial work period where they are able to continue receiving their cash benefits while testing their ability to work full-time. For SSI recipients, there are federal work incentives that allow you to work while minimizing the reduction of your cash benefits. In either case, you should reach out to one of our credentialed benefit counselors for more information. 

Your benefits will continue when participating in at least one of the Ticket to Work program services. To further protect your ongoing benefits, SSA will not perform a medical Continuing Disability Review (CDR) during any time you are utilizing the services of the Ticket to Work program, provided you meet the Timely Progress guidelines. Should you successfully enter the workforce, your benefits may continue for at least a period of time, depending on how much you earn. 

Anyone between the ages of 18 and 64 receiving SSDI and/or SSI benefits who wants to return to the workforce may participate in the services offered through the Ticket to Work program. You will typically become eligible for the program once your disability benefits begin.

Unlike SSDI, Supplemental Security Income (SSI) is a welfare program. SSI is a Federal income supplement program that is funded not by Social Security taxes but by general tax revenues. The program is designed to help aged, blind, and disabled individuals who have little or no income and provides cash benefits to meet basic needs for food, clothing, and shelter. If you have limited income and resources, you should also consider applying for SSI.

Yes. You will become entitled to health insurance through Medicare 24 months after the date that SSA determines that you first became eligible for SSDI cash benefits. When you become eligible for Medicare, Aevo Insurance Services, a subsidiary of Advocator Advantage, can assist you with your health plan selection and enrollment process.

You will continue to receive SSDI benefits as long as you continue to meet SSA’s definition of disability. SSA may find that you are no longer disabled due to medical improvement or if you return to work at a Substantial Gainful Activity level.

You are required to inform Advocator Advantage and/or SSA of changes in your work status or if your health improves. This is necessary to avoid incurring an overpayment to SSA.

Our fees are statutorily capped by SSA. Generally, we receive a percentage of your retroactive, lump-sum award, up to a maximum amount established by SSA. There are no hidden fees or costs associated with our services. We only earn a fee if we help you obtain an award, so you can be sure that we are working as hard as we can to get your claim approved.

Unfortunately, the process of applying for and being awarded SSDI benefits can be extremely long. Depending on the number of appeals needed to get your case awarded, the process can take anywhere from six months to three or four years. 

It can take up to 60 days to receive your first check after you have been awarded. Processing time is generally faster at the initial claim and reconsideration levels, while it tends to take longer for clients who are awarded at the hearing level.

SSA can delay the processing of a claim for many different reasons and will not release any benefits until all necessary documentation is in order. This may include a copy of your birth certificate, citizenship papers, representation payee documents, or proof of other public payments such as state disability or workers’ compensation. We will help you provide these documents to SSA in a timely fashion to avoid unnecessary delays in processing your monthly payments

If your application is approved, your first SSDI monthly benefit will be paid for the sixth full month after the date that SSA determined that you became disabled (Disability Onset Date). For example, if SSA finds that your disability began on June 15, 2021, your first monthly benefit would be paid for the month of December 2021. Social Security benefits are paid in the month following the month for which they come due, so the benefit due for December would actually be paid to you in January.

The amount of your monthly benefit is based on your lifetime average earnings covered by Social Security and is reduced if you receive other government benefits, such as workers’ compensation – including Black Lung payments – or public disability benefits.

Yes. Children up to 18, or those who have not graduated from high school, may be entitled to benefits if you become disabled. Generally, dependent children receive 50% of the amount of your monthly SSDI benefit, which is divided equally among all eligible dependents.

While Medicare costs can add up fast depending on an individual’s needs and coverage selections, many people may find Medicare to be surprisingly affordable. In fact, many people are surprised to discover that Medicare can lower their medical expenses. If you are wondering how much Medicare costs, you should explore the many customizable Medicare plan options with the guidance of an experienced Licensed Insurance Agent so you can find coverage options that may fit your unique healthcare and financial needs.

Most people become eligible for Medicare in the months leading up to their 65th birthday, but this is not the only way to qualify for Medicare health insurance. Younger people may qualify if they have been entitled to Social Security disability Insurance (SSDI) benefits for at least two years, or if they have certain health conditions. You may even be automatically enrolled in Medicare if you meet certain criteria.

Most individuals will become eligible for Medicare at age 65, but not everyone is automatically enrolled in Medicare at that time. However, there are some circumstances in which you are automatically enrolled in Medicare. You will likely be automatically enrolled in Medicare Part A if you meet one of the following conditions at age 65:

• You have been entitled to Social Security Disability Insurance (SSDI) benefits for 24 months.
• You receive Railroad Retirement Board benefits.

If you’ve been automatically enrolled in a Medicare health plan, you will receive a Medicare card and welcome package in the mail three months before your 65th birthday. If you don’t receive anything prior to turning age 65 or are concerned about your Medicare enrollment status, contact Social Security directly. If you don’t qualify for automatic Medicare enrollment or have other questions about who qualifies and how to enroll, сall 844-378-5784.

Many people are surprised to learn that Medicare covers a wide range of medical services, as well as many durable goods and medical supplies. Your current doctor is likely to accept Medicare, and Medicare may cover equipment ranging from hearing aids to wheelchairs, depending on the coverage you select. Some Medicare plans also provide additional benefits such as dental, vision, hearing, and services like transportation to healthcare facilities, meal preparation, and gym memberships.

While Medicare costs can add up fast depending on an individual’s needs and coverage selections, it is a myth that Medicare is unaffordable or that it is always more expensive than other forms of healthcare coverage. In fact, many people are surprised to discover that Medicare can lower their medical expenses. There are customizable options available for individuals considering Medicare, and these are worth exploring with the guidance of an experienced Licensed Insurance Agent to better understand all the Medicare available options and their associated costs.

While there are several types of Medicare coverage, two of the most common are Medicare Advantage and Medicare Supplement – also known as Medigap – plans. While both pay for expenses not covered by Original (“Governmental”) Medicare, you cannot be enrolled in both Medicare Advantage and Medigap coverage simultaneously, as they each serve different functions. There are also several important distinctions between Medicare Advantage and Medigap that you should know if you are looking to enroll in Medicare.

No, Medicare is not offered as a family or dependent benefit. People must qualify on an individual basis. For example, a person under age 65 does not receive Medicare automatically because their spouse turns 65 and enrolls in the Medicare program.

Medicare is a federal health insurance program for people age 65 and older, people under age 65 who are entitled to SSDI benefits, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Your income does not affect your eligibility for Medicare. Medicaid, on the other hand, is a joint federal and state program that helps with medical costs. To qualify for Medicaid, you must have a low income and limited resources.

It’s possible. The Low-Income Subsidy (LIS) program, also known as “Extra Help,” is available to help pay a portion of Part D prescription drug costs, including premiums, copayments, and deductibles, for certain people with low income and minimal assets. Depending on your income and assets, the Extra Help program may provide a full or partial subsidy. Some people are automatically enrolled in the Extra Help program, while others must apply for the subsidy.

It depends. Medicare rules allow you to delay enrollment in Medicare Part B and Medicare Part D without penalty if you are covered by an employer group health plan that covers 20 or more employees, so long as that health coverage is based on your or your spouse’s current, active employment.

If your other health insurance coverage is NOT based on the current, active employment of yourself or a family member, you will likely need to enroll in Medicare. We recommend that you follow up with your current health insurance provider to see if you are required to enroll in Medicare Part B when you become entitled.

If you do not fully understand your Medicare enrollment options and you choose the wrong plan or do not enroll during the allotted enrollment period, you may find yourself incurring significant out-of-pocket expenses. If you enroll late in certain Parts of Medicare, you will have to pay a penalty each time you pay your premiums for as long as you are enrolled.

Upon approaching eligibility for Medicare at age 65, you can enroll in a Medicare Plan three months before, the month of, or three months after your Medicare entitlement date. For Supplement Plans, the enrollment period lasts five months after your entitlement date.

Upon becoming eligible for Medicare because you have received 24 months of SSDI benefits, you will be automatically enrolled in Part A and Part B.

No. Receipt of private LTD benefits does not impact your claim for SSDI benefits. Likewise, if at some point your LTD benefits are terminated, the fact that you no longer receive LTD benefits would not have a negative impact on your SSDI claim.