FAQ
Questions people actually ask.
Including the ones agencies usually avoid. If yours is not here, telephone (866) 346-1635 — Monday to Friday, 9:00am – 5:00pm ET.
Working with us
Does it cost me anything to use Healthbase?
No. The insurer pays us a commission when you enroll, and it comes out of the carrier’s own budget rather than being added to your bill. Your premium is identical whether you come through us, through another agent, or straight to the carrier — premiums are filed with state regulators and an agent cannot mark one up or discount it. So the fair question is not what we cost you, but whether our advice is worth having; the page on how we are paid sets out where our incentives do and do not line up with yours.
Do you show me every plan available?
No, and no agent can. An agent may only quote carriers they hold an appointment with, and nobody holds every appointment in every county. That means our shelf has an edge, and a plan that suits you may sit just past it. We name the carriers we work with so you can see the edge rather than guess at it. For the complete list where you live, the Medicare Plan Finder and HealthCare.gov are free, exhaustive, and take no account of who gets paid.
Will you call me if I do not ask you to?
No. We do not cold-call, we do not buy lead lists, and we do not use automated diallers to find new business. You hear from us because you asked to. Text messages are separate again: they only start if you tick the optional box on a form, that box is never pre-ticked and never required, and ticking it is not a condition of getting help or of enrolling in anything.
Do I have to give a telephone number?
No. The telephone field on every form here is optional and the form will submit without it. Give an email address instead and we will reply that way. The only cost is speed — a complicated enrollment question that would take four minutes on the telephone can take a couple of days by email.
What happens if I decide not to enroll?
Nothing at all. There is no follow-up sequence, you do not go onto a nurture list, and nobody rings back in a fortnight to see whether you have reconsidered. Declining is a complete answer and does not need a reason. If you later change your mind, telephone and we pick up where you left off.
What can I expect on a first call?
Questions before recommendations. We ask which doctors you want to keep, what you take regularly and at what dose, roughly what your household looks like for tax purposes, and whether anything is changing in the next year — retirement, a move, a spouse’s coverage ending. Most first calls are twenty to thirty minutes and end with nothing bought. If somebody leads with a plan name before asking any of that, be careful, whoever they work for.
Can you help me if I already have a plan and something has gone wrong?
Yes, and telephone rather than using a form if it is time-sensitive. A denied claim, a prescription refused at the counter, or a doctor who has left the network mid-year all have deadlines attached, and some of those deadlines are short. Bring the letter or the pharmacy message if you have it — the exact wording usually decides which route is open to you.
Do you work with people outside the states you are licensed in?
No. Insurance licensing is granted state by state and we may only transact business where we hold a current license. Tell us where you live and we will confirm whether that includes your state before anything else happens. If it does not, we will say so rather than string you along, and the free official services below cover every state.
Medicare
When can I first join Medicare?
Around your 65th birthday, in a seven-month window: the three months before your birthday month, the month itself, and the three months after. Which part of that window you act in matters — enrolling in the first three months generally starts coverage sooner than leaving it to the last three, and the tail end of the window can leave a gap. If you are already drawing Social Security you may be enrolled automatically; if you are not, nobody does it for you.
I am still working at 65 — do I need Part B?
It depends on the size of your employer, and the answer flips at a threshold set in federal rules. Above it, the group plan generally pays first and delaying Part B is usually safe. Below it, Medicare pays first whether or not you have enrolled — so delaying can leave you with claims that neither the group plan nor Medicare covers, sometimes discovered months later. Ask your plan administrator, in writing, whether your coverage is primary or secondary to Medicare. That sentence is the whole decision, and a verbal answer from a colleague is not it.
What is the difference between Advantage and a Supplement?
They are two different roads rather than two grades of the same thing. Original Medicare with a Supplement lets you use any provider who accepts Medicare, anywhere in the country, with no network and no referrals — you pay more each month for that freedom, plus a separate drug plan. Medicare Advantage bundles hospital, medical and usually drug coverage into one plan run by an insurer, often at a much lower monthly cost, in exchange for a network, a service area, and rules like prior authorization. Neither is the better plan in the abstract. Which suits you turns on your doctors, your prescriptions, and how much you travel.
Can I switch from Advantage to a Supplement later?
Sometimes, but not always on the same terms, and this is the asymmetry that catches people. During your initial eligibility period a Supplement generally must accept you regardless of health. Outside it, in most states, a Supplement can put you through medical underwriting — and underwriting can decline you, or price you differently. Going the other way, into Advantage, is usually straightforward. So the first choice is not as reversible as it looks, and it is worth making as though you may be living with it.
Do I need a drug plan if I take no medication?
Usually yes. Going without creditable drug coverage can attach a late-enrollment penalty, and that penalty is generally permanent once it starts — it does not clear when you eventually join. The plans with the lowest monthly cost exist largely for this situation. The exception is if you already hold drug coverage that counts as creditable, such as through an employer or the VA; your plan should tell you in writing whether it does.
What are the four enrollment windows and which one am I in?
The seven-month window around your 65th birthday is the first. The Annual Enrollment Period each autumn is when anyone can change Advantage or drug plans for the following year. The Medicare Advantage Open Enrollment Period in the new year lets people already in an Advantage plan make one change. Special Enrollment Periods open outside all of that when something specific happens — a move, losing employer coverage, a plan leaving your area. Most Medicare problems we are asked to fix started as a date somebody did not know applied to them, and the guide on enrollment windows sets out the current dates.
Does Medicare cover me when I travel?
Within the United States, Original Medicare travels with you and a Supplement generally does too. Advantage plans are the ones to check: they are built around a local network and a defined service area, so routine care away from home may not be covered even though emergency care is. If you spend months of the year in another state, say so early — it can decide the whole question.
What is prior authorization and does it affect me?
It is the plan requiring approval before it will pay for something — a scan, a procedure, certain drugs. Original Medicare uses it rarely; Advantage plans use it considerably more, and the requirements differ between plans in the same county. It is not a reason to avoid Advantage, but if you have a condition needing regular imaging or a specialist drug, ask which of your specific treatments need approval before you choose. That answer is checkable in advance and worth checking.
Marketplace
How is my subsidy worked out?
From two things: your household size and your expected income for the year you are being covered — not last year’s. Household is a tax concept rather than a headcount, so it follows who is on your return, which does not always match who lives with you. The Marketplace decides eligibility, not us and not the carrier; we can help you assemble an honest estimate, but the determination is theirs.
What happens if I estimate my income wrong?
The credit paid on your behalf during the year is reconciled against your actual income at tax time. Earn less than estimated and you may be owed more; earn more and some of it comes back. It is arithmetic rather than a penalty, but it lands more than a year after the decision that caused it, which is what makes it sting. If your income changes mid-year — a new job, hours cut, a good quarter in self-employment — update the Marketplace when it happens rather than waiting.
What do Bronze, Silver and Gold mean?
How the cost is split between you and the plan across a year, not how good the plan is or how large its network is. Bronze asks less of you each month and more at the point you use care; Gold reverses that; Silver sits between. Two plans on different metal tiers can share the same network and the same doctors. The tier is a statement about cash flow, not quality.
Why does everyone say Silver?
Because extra help with cost sharing, where your income qualifies you for it, is generally only available on Silver plans. Someone who qualifies and buys Bronze for the lower monthly figure can be giving up assistance worth considerably more than they saved — and nothing on the shopping screen shouts about it. This is the single most common avoidable Marketplace mistake we see.
Can I get a Marketplace plan if my job offers coverage?
You can buy one, but if the employer offer meets the federal tests for affordability and minimum value you generally cannot get a subsidy — which usually makes the Marketplace plan the more expensive route. The tests are applied to the offer, not to whether you accepted it. Get the plan details from HR before assuming either way.
What if I might qualify for Medicaid or CHIP?
Then that is very likely the better route, and we will say so. Medicaid and CHIP have no enrollment window — you can apply at any point in the year — and for households that qualify the cost is generally far below anything on the Marketplace. We are not paid for sending you there. Your state Medicaid agency and HealthCare.gov both screen for it free.
Dental, vision & hearing
Does Medicare cover dental?
Original Medicare largely does not cover routine dental, routine vision, or hearing aids. It covers some things that happen to occur in the mouth or eye when they are part of treating a covered medical condition, which is a narrower door than it sounds. Many Advantage plans include an allowance for these — an allowance is a pot of money, not a full benefit, and running out of it is the normal outcome for major work rather than an unlucky one.
What is a waiting period?
A stretch of time after the policy starts during which major work is not covered, even though you are paying. Cleanings are often available immediately; crowns, bridges and dentures typically are not. If you are buying dental cover because you already know you need significant work, the waiting period is not a detail — it is the entire question, and it is the first thing to check on any policy you are shown.
What is an annual maximum?
A cap on what the plan will pay out across a policy year. Once it is reached, you pay the rest yourself. Routine care rarely troubles a cap; a single crown or a bridge can consume a large share of a typical one. When you compare two dental policies, compare the caps before you compare the monthly cost — the cheaper policy with a low cap can easily be the more expensive one in a year you actually need work.
Are hearing aids covered?
Usually through an allowance rather than as a full benefit. Two questions decide what an allowance is really worth: whether it is per aid or per pair, and how often it renews. Both vary widely between plans, and the difference between per-aid and per-pair can be the difference between mostly covered and barely dented. Ask both questions explicitly; the summary page rarely volunteers the answers.
Is a standalone dental plan worth it, or should I use an Advantage allowance?
It depends on the work you expect. Allowances built into Advantage plans tend to suit routine maintenance. Standalone dental policies tend to carry higher caps and broader coverage for major work, at the cost of a separate premium and, usually, waiting periods. If you know a crown or a denture is coming, the arithmetic usually favors the standalone policy started well in advance. If you just want cleanings covered, it usually does not.
Privacy and security
Do you sell my information?
No. We do not sell, rent or share your details with anyone for their own marketing — not lead buyers, not data brokers, not advertising networks. We do not buy lists either, which is the other half of the same promise and the half most agencies leave out. Your information is used to help you with coverage and for nothing else.
Will you ask for my Social Security number?
Never by telephone, and never through a form on this site. No legitimate agency or government body will cold-call you for it either — that request is one of the most reliable signs of a scam. The forms here actively reject text that looks like a Social Security number rather than storing it. There are later points in a real enrollment where a number is genuinely required, and when that moment comes it happens through the carrier or the official exchange, not through us over the telephone.
Can I send you documents through the website?
No — there is deliberately no upload anywhere on this site, and that is a design decision rather than a missing feature. If we need paperwork we send you a secure link by reply. Medical records, benefit letters and anything with a policy number on it should not travel through a general web form or an ordinary email attachment.
How do I stop text messages?
Reply STOP to any message, or send STOP to (866) 346-1635. It takes effect straight away, it needs no explanation, and it has no effect whatsoever on your coverage, your application, or your standing with us. Reply HELP to the same number for contact details. The full terms are on the SMS Terms page.
How do I know a call claiming to be from you is really from you?
Hang up and telephone (866) 346-1635 yourself. That is the correct response to any unexpected call about your coverage, including one claiming to be us — a caller ID can be forged and a plausible manner costs nothing. We will never be annoyed by it. If somebody pressures you to stay on the line, or says the offer expires today, or asks for a bank or card number to "hold" a plan, that is not us and it is not any legitimate agency.
What do you do with my details if I never become a client?
They stay only as long as there is a reason to keep them, and they are not passed on or repurposed for marketing in the meantime. Ask us to delete what we hold and we will. The Privacy Policy sets out what is collected and why in full.
You may not need an agent at all
These services are free, independent, and will show you every plan in your area — including plans we cannot sell. If your situation is simple, they may be all you need.
- Medicare.gov Plan Finder — every Medicare Advantage and Part D plan where you live. Call 1-800-MEDICARE, 24 hours a day, TTY 1-877-486-2048.
- Your State Health Insurance Assistance Program (SHIP) — free one-to-one Medicare counselling from people who sell nothing.
- HealthCare.gov — Marketplace plans and subsidy eligibility, plus free local Navigators.
We list these because the alternative is you finding out later. If you call us and a free route fits better, that is what we will tell you.
Still have a question?
Telephone and a person answers. No menu, no queue, no cost.
No obligation. We'll tell you if a free option through Medicare.gov or HealthCare.gov suits you better. Monday to Friday, 9:00am – 5:00pm ET.