We get asked a lot of questions about Medicare, so we thought we would put together this list of questions and answers to help you. If you do not see your questions asked below, just contact us, and we’d be happy to help.
Frequently Asked Questions
Commonly Asked Questions About Medicare
Medicare is broken up into 4 distinct parts, each categorized by one of the first four letters in the alphabet:
Medicare Part A:
This coverage pays for your inpatient hospital stay, skilled nursing care, home health care, and end-of-life Hospice care.
Medicare Part B:
This coverage is for doctor’s office visits, procedures (outpatient), Durable medical equipment (like wheelchairs, walkers, hospital beds), and some medications that are administered in the office or in another clinical setting. Many preventative services.
Medicare Part C:
This is considered an all-in-one plan or a Medicare Advantage plan. In essence, you’re trading in your original Medicare to be covered by a private insurance plan. These plans are required to be approved by Medicare and cannot turn down most people based on health problems. These plans may come with drug coverage or if you have other drug coverage in place you can choose a plan without. Most experts consider these plans a lower form of coverage compared to Original Medicare, hence, the lower prices but they may be a necessary evil for lower-income Americans.
Medicare Part D:
Part D stands for drugs. If you have original Medicare Part A or B then you are eligible to sign up for a Medicare Part D standalone drug plan or PDP (prescription drug plan). These plans work best in conjunction with Medicare parts A & B, as well as a Medicare supplement or Medigap. These plans are administered by private insurance companies that contract with Medicare for approval.
A Medigap plan, also known as Medicare supplement, is a private insurance contract that is standardized by the Centers for Medicare Services (CMS) that helps Medicare recipients pay the deductibles, coinsurances, and 20% that Medicare does not cover.
Social Security is a government program designed to pay a monthly payment to Americans 62 years old and older (or disabled) based on their previous work history and payments made into the Social Security Administration by the way of taxes. Americans of all ages can log on to the Social Security administration at ssa.gov to check their work history and get an estimate of their future Social Security monthly earnings.
Medicare, on the other hand is a federal government health insurance program designed to cover Americans 65 years old and over (or disabled) against the growing cost of health care.
They were both signed into law as part of the Social Security act of 1965.
Yes, if you are receiving a monthly Social Security check and receiving Medicare benefits, you have no option other than allowing Medicare to debit their monthly premium from your Social Security check. This will happen automatically when you are receiving both benefits simultaneously.
You can sign up for Medicare starting three months prior to the month in which your 65th birthday falls and up to three months after that same month (7-month total period). For example, if your birthday is April 18th, you can make an application on January 1st through July 31st and your effective date will be at soonest April 1st or the first day of the month after you make an application if later than April 1st. If you miss this window you will need to apply January 1st through March 31st (Medicare open enrollment) of the following year for a future July 1st start date and lifelong penalties may be applied.
If you have paid into the system for at least 40 quarters or 10 years you will receive your part A free and the large majority of people will pay a $170.10 (2022 prices) premium for Part B. For those with higher than average incomes ($91k single/$182k married), premium costs may be higher.
Having original Medicare only opens you up to a tremendous amount of risk in the event that you become seriously ill or injured. Medicare has deductibles and coinsurances, but most dangerous is the fact that you are responsible for 20% of an unlimited hospital bill. There is no cap on your responsibility and this can devastate your finances.
If you start your Medicare before receiving a Social Security check you will receive a bill for three months of Medicare premiums. For 2022 this bill can range from $510.30 to $1734.90 based on the income you declared (MAGI) in tax year 2020.
Not yet, Unless you are receiving a social security check (which would trigger an automatic monthly withdrawal/payment) Medicare requires your premium to be paid 3 months at a time in advance. Medicare does offer and online auto pay feature, maybe one day soon they will catch up with the rest of the world and offer a monthly option.