Frequently Asked Questions


How much does Medicare cost?

Your costs will depend on the type of coverage you choose. You will likely pay the Part B premium to Medicare. Beyond that, you may pay other premiums, deductibles, co-pays and co-insurance. The total amount will depend on the Medicare coverage you choose and the health care services you use.

How do I know what Medicare coverage is right for me?

The answer to this may be easy to say and maybe not as easy to do. You need to understand your personal needs and choose Medicare coverage to help meet them.

What do I do about Medicare if I work past age 65?

Many people enroll in just Part A when they turn 65 and have employer coverage. Generally, Part A is premium free if you or your spouse worked and paid Medicare taxes for at least 10 years. You may be able to delay enrolling in Part B without penalty if your employer provides creditable coverage.

How do I know what Medicare coverage is right for me?

The answer to this may be easy to say and maybe not as easy to do. You need to understand your personal needs and choose Medicare coverage to help meet them.

How can I get dental and vision coverage with Medicare?

Original Medicare (Parts A and B) does not cover routine dental or vision care, however, some private Medicare Advantage plans do. Plans include all the coverage provided by Parts A and B, and often additional benefits, all in one plan.

Where can I get help paying for Medicare?

Financial assistance programs for people with limited income and assets include Extra Help for prescription drugs, the Medicare Savings Program and Medicaid, to name a few. Qualifications for each program and the level of help offered vary.

What’s the difference between Medicare supplement insurance and Medicare Advantage?

Medicare supplement insurance is also known as Medigap. It’s private insurance you can buy to help pay for some costs not paid by original Medicare (Parts A and B). Medicare Advantage is an alternative to Original Medicare. It’s a different way to get your Medicare benefits.

How does Medicare automatic renewal work?

Your Medicare coverage choices will stay in place year after year unless you make a change. This ensures that your coverage continues, but plan benefits and costs may change. It’s a good idea to review your Medicare choices every year during Medicare Open Enrollment, Oct. 15 – Dec. 7, to make sure you have the Medicare coverage that fits your needs.

What’s the difference between a Medicare Advantage HMO and a PPO?

A Medicare Advantage HMO plan usually helps pay only for care you receive from providers in the plan network. A PPO plan will generally help pay for care received outside the plan network, but it may pay less than for the same care received within the network.

What’s the difference between Medicare and Medicaid?

Medicare and Medicaid are both government health care programs but they are very different. Medicare is generally for people who are older or disabled. Medicaid is for people with limited income and resources.

What is Short Term Care (STC)?

STC is a form of critical care insurance that functions much like Long Term Care insurance—except, as the name suggests, STC is in effect for one year or less. It is also known as Home Health Care insurance or Recovery Care insurance. Policyholders who purchase STC usually become eligible for benefits when they need assistance performing two or more activities of daily living (ADLs), such as eating, bathing and dressing.

I am Disabled - when can I get Medicare?

In general, you are eligible for Medicare after receiving Social Security disability benefits for 24 months. There are exceptions for people with certain medical conditions.

The Top Four Things to Know About Medicare Before You Retire

When to Enroll

Perhaps the simplest enrollment occurs when you are already receiving Social Security benefits.

If you are already taking Social Security benefits, you will be automatically enrolled in parts A and B. You have the option to turn down Part B since it has a monthly cost. If you keep it, the cost will be deducted from your Social Security. If you choose to turn down Part B you could incur a late enrollment penalty in the future and be limited as to when you can start your Part B benefits.

For those not yet receiving Social Security you will have to sign yourself up for parts A and B. There is a seven-month initial enrollment period beginning three months before the month you turn 65 and ending three months afterward.

If you are working and have health insurance through your employer, or if you’re covered by your spouse’s employer coverage, you may be able to delay signing up for Medicare. However, be mindful that you will need to sign up for Medicare within eight months of losing your employer’s coverage to avoid significant penalties when you eventually enroll.

What You will Pay

For Part B and Part D, your monthly payment depends on your income level. Part A, which pays for hospital services, is free if either you or your spouse paid Medicare payroll taxes for at least 10 years. If you did not pay the Medicare payroll taxes for at least 10 years, you will still be able to take part in Plan A, but it will cost a monthly premium.

Part B and Part D have surcharges when your adjusted gross income is more than $85,000 if you are single or $170,000 if married filing jointly. For example, Part B, which covers doctor visits and outpatient services will cost new enrollees about $134 per month if income is below these thresholds, and will increase if income exceeds these thresholds.

Part D, which covers prescription drug costs, also has a monthly charge that varies depending on which plan you choose. In addition to premium costs, you’ll also be subject to co-payments, deductibles and other out-of-pocket costs. If you choose not to enroll in Part D you may incur a late enrollment penalty if you enroll in the future.

Options Available through Medicare

Medicare offers several coverage options.

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care.

Part B covers certain doctors’ services, outpatient care, medical supplies and preventive services.

Part D adds prescription drug coverage to some Medicare programs.

Often referred to as “Part C,” Medicare Advantage Plans are health plan options approved by Medicare and run by insurance companies.  These plans often have networks, which means you may have to see doctors who belong to the plan or go to certain hospitals to get covered services.

Medicare Doesn’t Cover Everything

While Medicare is meant to be a wide-ranging health benefit for you in your retirement years, it doesn’t cover everything. In fact, Medicare does not cover final expense, preventive vision, dental or hearing services. Because many seniors require services they enroll in additional plans outside of Medicare to get coverage for these needs.

When you need supplemental coverage to take care of the gaps in Medicare, or when you aren’t sure what coverage you need, reach out to Kellogg Insurance Marketing for help.

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