Medicare Questions | Medicare FAQ
Medicare Questions, everyone new to Medicare has them. Entering Medicare can often lead to confusion and information overload. Everyone that has been on Medicare has the answer, but the problem with that is, it is normally only a partial answer at best and more of an opinion.
We believe that you must first understand Medicare and the process before you can make an informed choice about a Medicare Supplement. You can always call us at 844-528-8688 for answers, but for your convenience, we have built this page to answer the Medicare questions we get most often. We also have the FREE Medicare Academy video course that will help you navigate everything Medicare.
Medicare Frequently Asked Questions
- What is Medicare
- When do I sign up for Medicare
- When is the Medicare Supplement Open Enrollment
- What is a Medigap
- What is a Medicare Supplement Plan G
- What is a Medicare Supplement Plan N
- What is a Medicare Supplement Plan F
- When can I change Medicare Supplement Plans
- What is a Medicare Advantage Plan
- What is Medicare Part D
- Does Medicare Cover Vision and Dental
- Medicare Preventive Coverage
What is Medicare?
Medicare consists of 4 parts, but only two of them come directly from Medicare. The other two are offered by private insurance companies and are monitored and administered by Medicare.
- Medicare Part A: Medicare Part A is your hospitalization, it covers you anywhere that accepts Medicare. Without a Medicare Supplement Plan, Part A has a deductible and covers 80% of Medicare-approved expenses. There is no premium for Medicare Part A if you worked 40 quarters and paid Medicare taxes. If you did not pay Medicare tax, the premium you pay will be calculated by how many quarters you did pay in, up to a premium of $422.00 per month.
- Medicare Part B: Part B covers your doctor, durable goods, and some prescriptions (that are administered as an outpatient). Part B is accepted by anywhere in the United States that accepts Medicare. Medicare Part B has a deductible and a premium that is set by your income two years prior, most will pay $134.00 per month. See the chart below for premium rates.
- Medicare Part C: This is a Medicare Advantage plan. You do not lose your Part A and Part B, they are instead administered by a private insurance company. The insurance companies are contracted by Medicare (CMS) and must provide benefits at least as comprehensive as Original Medicare. You are not required to have this part. See our full Medicare Advantage Plan article HERE
- Medicare Part D: Part D is the prescription coverage. You are required to have a Medicare Part D even if you currently are not taking any prescriptions. The Part D is offered by private insurance companies that are contracted by Medicare. Plans are different depending on what state and county you live, and what prescriptions you are taking. Most have a deductible for tier 3, 4 and 5 drugs and you will have copay’s for most prescriptions. See our full Medicare Part D article HERE
Signing up for Medicare
For the majority of people, the Medicare enrollment period begins 3 months before you turn 65, includes the month you turn 65, and ends 3 months after your 65th birth month. There are other enrollment periods also, see our complete article on Medicare Enrollment periods HERE
Medicare Supplement Open Enrollment
Open Enrollment for purchasing a Medicare Supplement Plan starts the 1st of the month of your 65th birthday or the start date of your Medicare Part B. This is the best time to purchase a Medicare Supplement plan, as there is no medical underwriting requirement. Some states can charge tobacco rates during this open enrollment and some states have other open enrollment (guaranteed issue) periods. For a complete breakdown of states enrollment periods see our Medicare Supplement Open Enrollment Period Article HERE
What is a Medigap
Medigap is just another term for a Medicare Supplement Plan or Supplemental Insurance Plan. It is one of 10 Medicare supplement Plans A-N in all but 3 states (Wisconsin, Minnesota, and Massachusetts. For a complete explanation of a Medigap or Medicare Supplement Plan see our full article HERE.
What is a Medicare Supplement Plan G
The Medicare Supplement Plan G is, at this time, the most comprehensive Medicare Supplement Plan on the Market. This plan is very similar to the Medigap plan F other than with plan G, you will pay the Medicare Part B deductible out-of-pocket. After you pay the once-a-year deductible the benefits are identical to the Plan F and at a much lower premium cost. See our full article on the Medicare Supplement plan G HERE.
What is a Medicare Supplement Plan N
Plan N is fast becoming a favorite among Medicare participants, especially with people who live in states that do not allow Part B excess charges. It is low cost and is close to the benefits of the Plan G, but it does have some costs that Plan G does not expose you to.
With a Medicare Supplement Plan N you will have a copay for the doctor of $20.00, and a copay of $50.00 for the emergency room. Plan N also does not cover the Part B Excess charges that could be added to your bill if your doctor is not assigned by Medicare and you live in a state that allows the charges. See our complete article on Medicare supplement Plan N HERE.
What is a Medicare Supplement Plan F
The Medicare Supplement Plan F was the most popular Medigap plan by both agents and Medicare recipients. If you have a friend or family member on Medicare that says “I never see a bill” they have a plan F. While that sounds like a great deal, it really is not, plan F has the highest premiums of all of the plans but it covers everything resulting in what is called “first dollar coverage”.
There are many reasons that make a plan F a bad choice, with the most glaring being that as of 2020 the full coverage of Plan F will no longer be offered to new people entering Medicare. No new younger people entering a plan could have a negative impact on pricing. For more information see our detailed article on Medicare Supplement Plan F HERE
When you can change Medicare Supplement Plans
Simply put you are able to change a Medicare Supplement Plan anytime you want, there is no special period. While you are allowed to apply to change your Medicare Supplement Plan, you can be denied. In most states, you will need to go through the underwriting process and answer health questions.
The health requirements do vary from company to company so it is best to contact us to help guide you through the process, we know what carriers are diabetic friendly or only look back two years at cancer. Never a fee for our services. For more information on states with special open enrollment periods see our in-depth article Here.
What is a Medicare Advantage Plan
A Medicare Advantage Plan is NOT a Medicare Supplement, people confuse them all the time, but they are very very different. A Medicare Advantage Plan is a private insurance company that is contracted with Medicare to provide your Medicare benefits.
Medicare Advantage Plans normally have copays for almost every service and with most, you will have to stay in the provider’s network. Please see a full explanation of what a Medicare Advantage Plan is HERE.
What is Medicare Part D
The Medicare Part D is prescription coverage that you get from a private insurance company that is contracted with Medicare. Medicare Part D plans vary by state and county and should be chosen by what is best for prescriptions that you are taking currently. You can change prescription drug plans every year during the annual open enrollment period. This is just the simple answer for details on the donut hole and costs of a Medicare Part D see our full article HERE
Dental and Vision Care with Medicare
Medicare does not cover dental or vision unless it is due to illness or injury and deemed medically necessary. Some vision tests are covered, like Glaucoma or macular degeneration.
Medicare Preventive & Screening Services
Medicare covers many preventative and health screenings. There are special procedures for both males and females and when you can get the procedure is set by your risk classification. For example, if you are at high risk or screening is medically necessary you will be allowed to have the testing more frequently than someone that is low risk. See our complete guide to Medicare Preventive Services HERE
These are only the quick answers, for complete explanations of these subjects please see the corresponding article or call us anytime at
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