10 Questions About Medicare Answered by Experts

According to the stats, almost 62 million people in the United States are beneficiaries of the Medicare plan. 83% of them are people over 65 years old, and the remaining 17% are disabled. 

However, when it comes to Medicare, almost 99% of people are confused and have questions after questions. But don’t worry! If you are one of those confused with Medicare, you have landed at the right place. 

In this article, we will let you know all frequently asked questions regarding medicare and experts’ answers to those questions. Let’s dive into the article! 

1. What is Medicare?

Medicare is the health insurance program generated by the federal government. This program is usually for people above 65 years old or people who are unable to work due to any disability. Its coverage is essential in containing medical costs with your age. 

However, Medicare benefits do not cover everything.

2. How Many Parts of Medicare Are There?

Medicare is divided into four basic categories, i.e., part A, part B, part C, and part D. To understand the differences between all these parts, let’s dig the article deeper. 

• Part A

Medicare part A covers all the inpatient services. As for 2022, Part A has a $1,556 deductible, and you have to pay 20% after the deductible with no out-of-pocket maximum. However, if you qualify, there is no premium for Part A.

• Part B

Medicare part B covers all outpatient services. These services include:

• Appointments with doctors
• Precautions, such as specific examinations and screenings
• Vaccinations against the flu
• Mental health care (outpatient)
• Advice on alcoholism
• Chemotherapy
• Physical activity
• Diabetes self-management therapy, supplies, and screenings are all available.
• Wheelchairs and other reliable medical supplies.

Part B has a $233 deductible as of 2022. After the deductible, your responsibility remains 20%, with a monthly premium of $170.10.

• Part C

It is known as an Advantage Plan. Part C combines Parts A and B into a single plan administered by a private provider. It typically provides services that Original Medicare does not provide, like dental, vision, hearing, etc. 

The plans typically look and feel like standard health insurance policies. This is because they are similar to group health insurance and offer HMOs and PPOs.

• Part D

This part of the Medicare plan is very simple to understand. You just have to remember D for drugs. Part D covers all your prescribed medicines. However, to your surprise, part D is already included in Medicare part C. So, you do not have to get individual enrollment in part D. 

3. What is Income Limit for Medicare?

The income limit for the Medicare plan varies from state to state and country to country. Let’s take the example of Florida. 

The income limit for medicare in Florida ranges from $2,349 a month if single to $4,698 a month if married and both partners apply. However, the income limit for Medicare in Texas falls from $1359 to $1529 per month. Thus it is best to know the terms and limitations imposed by your state.

4. Who is Eligible for Medicare?

Medicare has a list of requirements you must meet before you can apply. And when you meet these requirements, you are eligible to apply and rfecceive its benefits. The first eligibility criteria is: your age should be 64 years and 9 months or older than it. However, if you are disabled, you can apply for medicare before your 65th birthday. 

Moreover, people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) are also eligible for the Medicare plan.

5. Will I Automatically Enroll in Medicare After Turning 65 Years Old?

The quick answer to this question depends on some factors. However, the answer is yes if you are a Social Security or Railroad Retirement Board member. But if you are not an SSA and RRB member, you must sign up for the medicare plan before your 65th birthday. 

6. Is Prescription Coverage Required With Original Medicare?

The simple answer is yes. You must have Part D prescription drug coverage to avoid the late enrollment penalty. 

Again, Part C usually includes Part D. The only times you should purchase a separate Part D policy are when you choose to stay with Original Medicare, which is a rare case or when you choose a Medigap policy, also known as a Supplement.

7. Is There Any Difference Between Medicare Supplement and Medicare Advantage?

A Supplement is a plan that supplements your Original Medicare Parts A and B. In most cases, you only pay the Part B deductible, and these plans cover the rest of your medical bills. Supplements typically have higher monthly premiums than Advantage plans and necessitate an additional stand-alone drug plan with a deductible.

Whereas Advantage plans are private health insurance plans with copays and deductibles. They have lower monthly premiums and no Part D deductible. Advantage plans typically include additional benefits such as dental, vision, and hearing coverage. 

Some plans include additional benefits such as gym memberships, meal plans, electronic alerts, etc.

8. Do Medicare Require Renewal Every Year?

Each year you are eligible, your original Medicare coverage is automatically renewed. As a result, you do not need to renew your Medicare parts every year.

Medicare Supplement plans and Advantage plans operate in the same manner. Once accepted, the plan is automatically renewed as long as the monthly premium is paid. However, if you do not like the benefits of your current plan, you have the option to change it each year.

9. What Happens to My Medicare Plan When I Shift From One Place to Another?

You must update your address with Social Security if you relocate to a new town or state.

Benefits are the same across the board because Original Medicare is a federally funded program. As a result, your advantages won’t alter.

However, you might need to select a new plan or pay a higher (or lower) monthly premium if you are enrolled in a Medicare Supplement or Medicare Advantage plan. 

10. Is Medicare Deductible?

Yes, the medicare plans are deductible. However, the deductibles and expenses for Medicare Parts A and B fluctuate every year.

Medicare Part A’s per-occurrence deductible is $1,556 in 2022, while Part B’s annual deductible is $233.

Before the relevant Medicare Part pays its share of the treatments you get, these deductibles must be satisfied. The Medicare Part A deductible is per occurrence, so you can pay that cost multiple times in one year. On the other hand, the Medicare Part B deductible is a yearly expense. As a result, you will only have to pay it once a year.

Annual deductibles for Medicare Part C plans are frequent and might vary from one plan to the next. You must look through the details of your plan to determine your yearly deductible.

Finally, annual deductibles are also a feature of Medicare Part D coverage. The highest deductible is $480 in 2022. Each plan, though, is free to choose its deductible.

Taking Away

These were the most frequently asked questions about the Medicare plan. After reading this article, we hope your confusion and doubts about medicare are wiped out of your mind.