Medicare FAQs

Our mission is to educate you about Medicare.
We’ve listed our clients‘ most frequently asked questions & their basic answers.

When do I sign up for Medicare?

This is different for everyone, but the general answer is when turning 65 or in certain situations regarding disability status. When turning 65 you have three months before your birth month, your birth month, and three months after your birth month. If you are still working or covered by group insurance, that may change your circumstances. Contact us and we can discuss your particular situation in further detail.

How do I sign up for Medicare?

You will need to contact your local Social Security office or create an account online with the Social Security Administration, https://www.ssa.gov/.

What is the difference between Medicare and Medicaid?

Medicare is a national health insurance program started in 1965, supported by the federal government. The Medicare card is red, white, and blue. Medicaid is a state-based assistance program. Medicaid has eligibility requirements centered around financial needs which are different for each state. Contact us so we can answer your questions in further detail regarding Medicare and Medicaid

How much does Medicare cost?

There are a lot of variables to consider. In general, however, Part A is premium-free. Part B’s premium is typically adjusted each year; for 2022 the premium is $170.10 per month. However, if you are in a higher income bracket your premium could be higher.

You can read more about IRMAA determination at https://www.medicare.gov/forms-help-other- resources/mail-you-get-about-medicare/initial-irmaa-determination or contact us to discuss your particular situation.

What does Medicare cover?

Traditional Medicare has two parts, Part A & Part B.

Part A helps cover costs for inpatient care to hospitals, skilled nursing facilities, hospice care and some post hospital home health care. Think of it as “in patient” coverage.

Part B helps cover costs towards doctor visits, diagnostic testing, outpatient care and durable medical equipment. Think of this as outpatient care.

Both Part A & Part B only cover 80% of each claim. However, there are some deductibles that apply, especially when it comes to each hospitalization. These deductibles change yearly, as they are determined by CMS.

Part D is simply a drug plan, whether it be a standalone drug plan or prescription drug coverage through a Medicare Advantage plan.

Part C – It is important to know that Part C is not a program with Social Security. It is simply the technical term used for Medicare Advantage Plans.

Contact us today so we can go over this in more detail and answer all of your questions.

What is the difference between a supplement/Medigap and a Medicare Advantage Plan?

Supplement plans are also known as Medigap plans. That is because these plans cover the gaps that Medicare does not cover, such as the copays and coinsurance for certain services. These plans are offered by private insurance carriers. When enrolled in a Supplement plan, Medicare will be billed first and the Supplement secondary. Supplement plans do not include prescription drug coverage. You will need to purchase that separately. The insurance companies for your Supplement and Drug plan do not have to be the same.

Medicare Advantage Plans, also known as Part C, began being offered in 1997 after the Balanced Budget Act was signed into law by President Clinton. Congress designed these plans to give beneficiaries lower premium options. These plans are also offered by private insurance carriers. If enrolled in a Medicare Advantage plan, it is primary insurance and more or less “takes over” your Medicare, meaning the Advantage plan will be billed instead of Medicare when services are rendered. Most Advantage plans include prescription drug coverage so that it does not have to be purchased separately. Another bonus is most of these plans include benefits such as hearing, vision, dental and more.

Contact us today so we can go over these options in more detail.

Can I set up a Medicare health plan on my own?

While we prefer to be able to guide you through this process and make it easier for you, we realize that some folks may want to do this on their own. We have an option for that! To get started, click on the button below and see which policies we work with.

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What Medicare questions do YOU have?

Let us connect you with an agent in your area who can answer all of your questions, help you enroll in Medicare, and help you select the plan that will best fit your needs.