Medicare – Frequently Asked Questions

If you are already receiving Social Security benefits, you will automatically be enrolled in Medicare Part A and Part B when you turn 65. If you are not currently receiving Social Security benefits, then you typically would enroll online during your Initial Enrollment Period, depending on your work situation. To learn more review Chapters One through Six in this section of the website. Begin with Chapter One, “Medicare Part A – Hospital Insurance.” 

Medicare Part A is the first half of what is often called “Original Medicare.” It covers inpatient hospital stays, skilled nursing care, home health care, and hospice. There are some exceptions to what Part A will cover, and the program can change over time. To learn more, go to Chapter One, “Medicare Part A – Hospital Insurance.”

If you or your spouse has enough credits with the Social Security Administration, then you will not have a monthly premium for Medicare Part A. If you are single, or if you’re married and neither of you has enough credits with the Social Security Administration, you may still sign up for Medicare Part A, but you will have to pay a monthly premium, and the cost will vary depending on how many credits you have earned. You may also incur expenses when you see a Medicare provider. To learn more, go to Chapter One, “Medicare Part A – Hospital Insurance.” 

Medicare Part B, is the second half of what is often called “Original Medicare.” It covers routine health services such as doctor visits, medical testing, lab services, outpatient services, preventive care, durable medical equipment and supplies, ambulance services, and more. Everyone who is a US citizen is eligible for Part B. To learn more, go to Chapter Two, “Medicare Part B – Medical Insurance.”

Medicare Part C is an alternative to “Original Medicare.” Part C is known as the Medicare Advantage Plan. It allows you to “bundle” Medicare Parts A and B, into one plan, and it provides the coverage of Medicare, but is offered by private insurance companies.  Medicare Advantage Plans operate like traditional insurance and have networks, like a PPO or HMO. Most Medicare Advantage Plans include Part D for prescription drug coverage, and some even include additional benefits such as dental and vision that are not covered by “Original Medicare.” To learn more, go to Chapter Five, “Medicare Part C – Medicare Advantage Plans.”

Costs can vary for a Medicare Part C – Medicare Advantage Plan.  Each insurance company sets the amounts for monthly premiums, deductibles, and your copay or coinsurance. Some Medicare Advantage Plans cover a portion of your Part B premium. Your copay or coinsurance may vary, depending on whether or not you use in-network providers. Medicare Advantage Plans must be renewed annually, and costs associated with your plan may change each year. To learn more, go to Chapter Five, “Medicare Part C – Medicare Advantage Plans.”

Medicare Part D covers prescriptions and is offered through private insurance companies. It is optional, but it is offered to everyone who has Medicare. It may save you money on your current or future prescriptions. To learn more, go to Chapter Three, “Medicare Part D – Prescription Drug Plans.”

There are several costs associated with Medicare Part D, including a monthly premium, drug costs, a deductible and coinsurance. To learn more about the costs associated with Medicare Part D, go to Chapter Three, “Medicare Part D – Prescription Drug Plans.”

A Medicare Supplement Insurance Plan helps cover out-of-pocket costs associated with Medicare Parts A and B, such as copayments, coinsurance, and deductibles. It is provided by private insurance companies and is also often called Medigap. To learn more, go to Chapter Four, “Medicare Supplement Insurance.”

Medicare Supplement Insurance policies have a monthly premium, and are based on your age, gender, geographic location, and the plan you select. The premium may change annually. Along with the Medicare Supplement Insurance premium, you will also have your Part B premium. There is a window of time for enrollment, and if missed, your coverage may cost more. To learn more, go to Chapter Four, “Medicare Supplement Insurance.”

A Medicare Advantage Plan is an alternative to “Original Medicare.” It provides the coverage of Medicare but is offered by private insurance companies and operates more like traditional insurance. A Medicare Advantage Plan allows you to “bundle” Medicare Parts A and B, into one plan. Most plans even allow you to add Part D, which covers prescription drugs. In addition, some Medicare Advantage Plans include dental and vision benefits, which are not covered by “Original Medicare.” To learn more, go to Chapter Five, “Medicare Part C – Medicare Advantage Plans.”

Each Medicare Advantage Plan sets the amounts for monthly premiums, deductibles, and your copay or coinsurance. To learn more, go to Chapter Five, “Medicare Part C – Medicare Advantage Plans.”

Possibly. The premium you pay for Part B and Part D can change annually. In 2020, if you are single and earning more than $87,000 per year, or if you are a married couple with an income of more than $174,000 annually, you will pay a larger percentage of your monthly Medicare Part B and Part D costs.  See the Social Security Administration website for more information.

No, but you can get vision and dental benefits with some Medicare Advantage Plans. Medicare Advantage Plans are sold by private insurance companies and operate similar to traditional insurance plans. To learn more, go to Chapter Five, “Medicare Part C – Medicare Advantage Plans.” 

Often at age 65, individuals are still working, or are covered through military benefits like Tricare. If you or your spouse is covered by another insurance provider, you may want to delay enrollment in Medicare. Review your insurance coverage with your employer or current insurance provider before making any changes.

Contact a licensed insurance agent. Our team at Provision Retirement would be happy to help you with your Medicare needs. Call us at 1-888-509-8205.