Frequently Asked Questions

Navigating Medicare insurance can be complex. Our aim is to simplify this process, providing clear answers to your Medicare questions. Let’s explore these frequently asked questions about Medicare insurance.

How do I qualify for Medicare?

You qualify for Medicare if you have worked in the US and paid Medicare taxes for at least 10 years or 40 quarters. You can enroll in Medicare when you turn 65.

When do I apply for Medicare?

You can apply for Medicare during a seven-month period that begins three months before you turn 65 and ends three months after the month you turn 65.

What does Medicare cover?

Medicare has two parts: Part A covers hospitalization, and Part B covers outpatient services and drugs that require professional supervision.

What do I do after I got my Medicare card with Part A and Part B?

There are two options you can choose to cover for those things which Medicare Part A and Part B do not cover, and that depends on your Financial Situation:
I. Medicare Advantage Plan C
II. Supplemental Medicare

What is Medicare Advantage Part C?

Medicare Advantage Part C is a type of Medicare health plan offered by private companies, approved by Medicare. It is also known as a Medicare Advantage Plan (MA Plan). If you enroll in a Medicare Advantage Plan, the plan will provide all of your Part A, Part B with little or zero copays, and Most Medicare Advantage Plans also include prescription drug coverage (Part D).

Medicare Advantage Plans also offer a Maximum Out of Pocket which is a maximum spending limit which provides financial protection in the event of a catastrophic illness. Additionally, these may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs.

Medicare pays a fixed amount for your care every month to the private companies offering Medicare Advantage Plans, and these companies must follow the rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services. These rules can change each year.

How much do I have to pay for my Medicare Advantage Part C?

Most Medicare Advantage Plans have zero-dollar premium cost to the clients, however there are some Plans for which you pay a little premium.

Do I need to apply for Medicare if I am already receiving Social Security benefits?

No, if you are receiving Social Security benefits, you will automatically get your Medicare card in the mail.

Why do I need to choose a health insurance plan? Why can’t I just stay with Part A and B?

Because Part A and B have deductibles and coinsurance which are unlimited, that means you could face high out-of-pocket costs if you need a lot of medical care. By choosing a health insurance plan, you can limit your financial risk and get additional benefits.

How much do I have to pay for Part A and B?

Part A is usually free, but Part B has a monthly premium that is set by CMS (the Centers for Medicare and Medicaid Services) every year. The standard premium for example in 2023 was $164.90, in 2022 was $170.10, which was an increase from $148.50 in 2021. The premium depends on your income and other factors.

How do I pay for the Part B premium to Medicare?

You can either select to have that premium deducted from your Social Security retirement pension if you are already collecting it, or you can pay by having the Government deducting it from your bank account or choose to send the payment each month.

What is Part D Coverage?

Medicare Part D is the Prescription Drug Coverage.

What is Supplemental Medicare?

Supplemental Medicare, also known as Medigap, is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. It works alongside Original Medicare Part A and B to provide additional financial protection and peace of mind for you.

Medicare Supplement Insurance policies are standardized and identified by letters A through N. Each standardized policy must offer the same basic benefits, no matter which insurance company sells it. However, some policies offer additional benefits such as dental vision and hearing with additional premiums, so you can choose which one meets your needs.

When you choose a Medigap Plan to supplement your free Medicare coverage, you will have to pay for its premium, the Part B premium to the Government, and additionally you will have to buy a Prescription Plan D.

What is the difference between Medicare Advantage and Medigap?

Medicare Advantage is a bundled alternative that includes coverage of Original Medicare (Parts A and B) and extra benefits, often with no monthly premium, while Medigap is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare.

Medicare Advantage plans have a network of doctors and hospitals, and you must get care within the plan’s network of doctors and hospitals unless it’s an urgent or emergency situation, while Medigap works alongside Original Medicare and allows choosing any doctor who accepts Medicare, for additional financial protection and peace of mind for you.

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