Medicare Frequently Asked Questions

In Reality…

Whether you are turning 65 and just new to Medicare or, currently enrolled with Medicare, questions as to how well you know your coverage and options may loom to the horizon. It may not always be as easy as it may seem, but we have listed down some of the Frequently Asked Questions to help you.

What is Medicare?

Medicare is the federal health insurance program for people:

• aged 65
• younger people who have certain disabilities
• with End Stage Renal Disease

What does it cover?

Medicare has four basic parts that cover all the health care and services that are necessary and reasonable.

Here is a quick recap of each part and what they cover.

• Medicare Part A also known as Hospital Insurance primarily covers all the health services that you need to keep you well. This includes inpatient hospital stays, inpatient skilled nursing facility, home health care and hospice care.
• Medicare Part B is your Medical Insurance that covers all the supplied and services that are needed to treat your condition. This includes outpatient care, ambulance services and preventive care and diagnosis tests.
• Medicare Part D is your Prescription Drug Coverage. Prescription Drugs are covered through this plan and is offered by private companies approved by Medicare.

Did we skip a letter?

Medicare Part C refers to Medicare Advantage Plan. This is an alternative to Original Medicare. It covers your Part A and Part B plus benefits like vision, dental, hearing and fitness to some providers

How much would Medicare cost me?

Medicare requires premiums, deductibles and other cost-sharing for certain services. Here are the basic costs for people with Medicare.

When is the best time for me to enroll in Medicare?

You can enroll three months before your 65th birthday, the month of your birthday and three months after that.
Let’s take this as an example:
If your birthday is April 22, your enrollment window runs from January to the end of July. If you enroll in Medicare during the three-month window before April, your coverage will start April 1. On the other hand, if you enroll on May, your coverage will kick-in June1: June on July 1 and July on August 1.

What If I missed my window, will there be a late enrollment penalty?

You have the option to enroll during Annual Open Enrollment, which runs from October 15 to December 7 each year.
However, There’s a penalty for late enrollment in Medicare Part B, amounting to a 10% premium increase for each full 12-month period that you could have been in Medicare-but did not sign up.
More often, you won’t be charged a premium for Part A if you or your spouse paid Medicare taxes for at least 10 years. But if you do not qualify for premium-free Medicare Part A, then your monthly premium may increase by 10%, and you have to pay it for twice the number of years that you could have had Medicare Part A-but did not enroll.
Your monthly premium for Part D may increase if you go 63 or more consecutive days without prescription coverage.

How does Medicare calculate your late enrollment fee?

1% Penalty rate of the “national base beneficiary premium” X the number of full uncovered months you were eligible for Medicare Part D, but did not sign up. Note that: National Base Beneficiary Premium is $35.63 in 2019, but may go up each year, meaning your penalty amount may also go up each year.

Do I have to sign up for Medicare again every year?

No, Medicare automatically rolls over every year, unless you decide to change it. You have the option to change from Original Medicare to Medicare Advantage and vice versa, during Annual Open Enrollment.