Notes, guides and field reports from the Seniors Insurance Hub team.
COBRA keeps a group health plan for a limited time after a job ends, but it does not restart or extend the Medicare Part B special enrollment period. That period runs up to 8 months from the end of current employment or job-based coverage, whichever happens first.
An HMO generally requires in-network care and a specialist referral, except for emergency care, out-of-area urgent care, and temporary out-of-area dialysis. A PPO covers out-of-network care for covered services, usually at a higher cost, and does not require a referral.
Medicare Plan Finder annual enrollment means comparing next year's Medicare Advantage and drug plans at Medicare.gov/plan-compare, then choosing to join, switch, drop, or keep a plan. The window runs October 15 through December 7, and new coverage starts January 1.
Medicare splits adult vaccines between Part B and Part D, and North Carolina follows those federal rules. You pay nothing for flu, COVID-19, pneumococcal, and eligible hepatitis B if the provider accepts assignment, and nothing for shingles, RSV, and Tdap if you have Part D.
Medicare outpatient physical therapy coverage is a Part B benefit when the care is medically necessary, and the same terms cover occupational therapy and speech-language pathology. After the 2026 Part B deductible of $283, you pay 20% of the Medicare-approved amount, and Medicare does not cap yearly payment for necessary outpatient therapy.
Medicare TRICARE for Life is wraparound coverage for TRICARE-eligible people who have Part A and Part B. Medicare pays first when you are not on active duty, TFL pays second, and skipping or dropping Part B ends TFL.
In 2026, a one-month supply of each covered insulin under Medicare costs no more than $35, and the deductible does not apply. The cap is per product, not a combined monthly limit.
Original Medicare Part B can cover medically necessary ambulance rides when other travel would endanger your health. After the 2026 $283 deductible, you generally pay 20% of the Medicare-approved amount.
In 2026, Original Medicare Part A starts a covered inpatient stay after a $1,736 deductible per benefit period. You pay $0 a day through day 60, then daily coinsurance if the stay lasts longer.
If you receive SSDI, Medicare Part A and Part B usually start after 24 months of those benefits, even before age 65. ALS skips the wait, and ESRD follows dialysis or transplant dates.
