If Medicare seems confusing to you, you’re not alone. You’ll find answers here to questions we hear regularly. If you don’t see the answer you’re looking for, please contact us to talk with one of our licensed sales agents. We are happy to answer your questions – there is no charge and no obligation. We are passionate about helping folks understand their benefits and to make it easy to pick a Medicare insurance plan you like.
Q. Do I have to sign up for Medicare Parts A and B, or is it automatic?
A. Yes, you must sign up for Medicare Parts A and B. Most people must enroll within three months of their 65th birthday. There are some exceptions. For example, enrollment is automatic for those younger than 65 with a qualifying disability. Learn more about Medicare enrollment periods or contact us to talk with a licensed sales agent for answers.
Q. Are There a Premiums for Original Medicare Parts A and B?
A. If you worked at least 40 quarters of Medicare-covered employment, you will not pay a premium for your Original Medicare Part A.
There is a premium for Original Medicare Part B; the premium will be deducted from your Social Security check each month. In 2021, the Part B premium is $148.50 per month for most people.
Medicare Advantage Plans (Part C) are an alternative to Original Medicare Parts A and B. Most Medicare Advantage plans have $0 monthly premium, provide more benefits than Original Medicare Parts A and B, and have caps that lower the amount you could pay each year for medical care and prescriptions.
Q. Is there a penalty for NOT signing up for Medicare Parts A and B?
A. If you delay signing up for Medicare Parts A and B, you may have to pay a lifetime premium penalty when you enroll. The penalty amount is based on the number of months you delayed signing up. The longer the delay, the higher the penalty.
Q. When can I sign up for Medicare?
A. The Medicare Initial Enrollment Period (IEP) is seven months. It starts three months before your 65 birthday, the entire month of your 65th birthday, and extends for three months after your 65th birthday. If you enroll before your birthday month, your coverage takes effect on the first day of your birthday month. If you enroll during or within three months of your birthday, your coverage will start the first day of the month following your enrollment.
Q. Are there disadvantages to only signing up for Original Medicare Parts A and B?
A. Yes, there are several disadvantages.
- Original Medicare doesn’t have any cap for out-of-pocket costs and, with a few exceptions, does not include prescription drugs.
- With Original Medicare alone, you will likely pay for more deductibles, co-pays, and prescription drugs. Medicare Advantage Plans and Medicare Supplement plans both pay some of the deductibles’ costs, co-pays, and more. Most Medicare Advantage plans include prescription drug coverage. Few Medicare Supplement plans cover prescription drugs. If you get a Medicare Supplement plan and want prescription drug coverage, enroll in a Medicare Prescription (Part D) plan, too.
- Original Medicare provides less coverage than Medicare Advantage Plans. Medicare Supplement Plans add essential benefits to fill in the gaps in Original Medicare Plan A and Plan B and reduce your out of pocket costs. Often, it doesn’t cost you one penny to have a Medicare Advantage (Part C) plan because there are many are zero-premium plans.
Q. Do Original Medicare Part A and B Provide Comprehensive Medical Coverage?
A. No. Original Medicare Part A provides hospital coverage and Part B covers doctor visits and related services. Plus, out-of-pocket costs are not capped. So, in addition to providing fewer benefits, with Original Medicare, your share of the costs could be much higher.
The most common benefits that Original Medicare Plans A and B do not include are:
- Routine dental services and dentures
- Hearing aids
- Eye exams and glasses
- Routine transportation to medical appointments
- Chiropractic services
- Annual physical exams
- In-home safety assessments and fall-prevention devices (for example, a walker)
- Worldwide urgently needed and emergency services
- Prescription drugs
- Over the counter drugs
Contact us for a free, no-obligation conversation with a licensed sales agent to ensure you get the Medicare insurance benefits you want and need at competitive rates.
Q. Can I change my Medicare insurance plan anytime that I want?
A. No. Specific enrollment periods and rules limit when you can change your plan. Learn more about the Medicare Advantage plan and Medicare Supplement plan enrollment periods.
Q. What is covered under Original Medicare Part A and Part B?
Original Medicare Part A is hospital insurance.
Part A covers
- Medically necessary inpatient hospital care including emergency room services, inpatient surgery, diagnosis, and treatment
- Medically necessary rehabilitation facility care and skilled nursing facility stays; does not include custodial and long-term care
- Radiation treatment
- Hospice care
- Some home health care
Original Medicare Part B is medical insurance.
Part B covers medically necessary services and preventive services, including
- Doctor visits, testing, diagnosis, and treatment
- Preventative services
- Outpatient surgery
- Outpatient care
- Ambulance services
- Medical supplies
- Durable medical equipment (DME)
Have questions about Medicare plans? Our licensed sales agents are ready to answer them.
Contact us now to talk with a licensed sales agent for answers to your Medicare questions; there is no cost and no obligation. We are here to help you make an informed decision with ease.