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10 Medicare Questions
10 Medicare Questions
Where do I start?
Go to www.ssa.gov and sign up for benefits Part A (Hospital Insurance) and/or Part B (Medical Insurance)
Choose how you want to manage your Medicare health coverage
Original Medicare (Part A & Part B) with two options
Drug Coverage (Part D)
Supplement Coverage (Medigap)
Medicare Advantage (Part C)
Replaces Original Medicare but may include Part D
Medicare comes with a cost
Part A (Hospital Insurance) is $0 for most people since they have paid Medicare taxes while working
$1,556 Deductible for
you're admitted to the hospital per benefit period (not per year.)
Part B (Medical Insurance) is $170.10
for most people but could be higher if you had a larger income in the past 2 years.
$233 Deductible per year before Medicare starts to pay.
Part D (Drug Coverage) has a monthly premium that varies depending on the plan you choose.
This is optional but may include a penalty if you wait to enroll later.
Plans are handled by Insurance Companies and not by Medicare.
You also have a choice of a Medicare Advantage (Part C) or Medicare Supplement (Medigap)
You cannot be on both only one or the other.
Medicare Advantage (Part C) plans are handled by Insurance Companies not Medicare
Plans vary in cost for Deductibles, Co-Insurance, Co-pays, and other benefits
Many plans include a Part D drug coverage
Medciare Supplement (Medigap) plans are handled by Insurance Companies secondary to Medicare
Monthly premiums vary by the plan you choose and the coverage they provide.
You will still need a Part D Drug coverage plan
High Income Earners pay more for Medicare
If your income was above a certain threshol, you will pay more for Parts B and D.
The surcharges are based on your adjusted gross income from two years earlier.
When to Sign Up for Medicare
If you are already taking Social Security benefits, you will be automatically enrolled in Parts A & B.
If you are still working and have health insurance through your employer you may delay enrolling without a penalty.
Otherwise you have a 7 month opening to enroll, 3 months before your 65 birthday, the month of your birthday and 3 months after your birthday.
Other Medicare Enrollment Periods
There are several additional enrollment periods after your Initial Enrollment Period.
Annual Enrollment, Open Enrollment, Special Enrollment, each has it's own requirements to enroll.
The Doughnut Hole for Medicare Part D
The hole is a coverage gap in which you will be required to pay more out of pocket costs for your drugs.
Medciare offers more Free Preventive Services
Beneficiaries can receive a number of free preventive screenings, annual "wellness" visit, and flu shots
Medciare expands Telehealth offerings
When the Corona virus pandemic hit, telehealth was expanded, a feature that could become permanent
Medicare generally does not cover long term care, cosmetic surgery, dental, vision, or "custodial care"
You have the Right to Appeal a Medicare Decision
If you disagree with a coverage or payment decision made by Medicaree or a Medicare health plan, you can file an appeal.