Medicare Questions and Answers
1. What’s the difference between Original Medicare, an Advantage Plan, and Medigap coverage?
Original Medicare is a federal health insurance program that consists of two different parts:
- Part A — Inpatient hospital insurance, skilled nursing facility care, hospice care, and some home health care.
- Part B — Outpatient hospital services, medical supplies, and preventative services.
Related: How Does Medicare Work?
Medicare Advantage Plans
On the other hand, third-party insurance carriers issue Medicare Advantage (also known as Part C) plans, which provide care via Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-For-Service (PFFS).
From a high-level perspective, these plans include all of the coverage provided by Original Medicare but often feature extra coverages not offered through the federal government, such as vision, hearing, and/or dental services.
Related: How to Choose a Medicare Advantage (Part C) Plan
Medigap coverage (also referred to as Medicare supplement insurance) helps cover some of the gaps in Original Medicare. Each plan is lettered A through N and provides coverage for most out-of-pocket expenses (deductibles, coinsurance, copayments), Part B excess charges, and foreign travel.
Related: What is Medicare Supplement (Medigap) Insurance?
2. How much will you pay in Medicare premiums?
If you’ve worked at least 40 quarters while paying taxes during your lifetime, there’s no premium associated with Medicare Part A. If you worked between 30 and 39 quarters, you’ll pay $259 per month, or $471 per month if you worked less than 30 quarters.
Related: How Much Does Medicare Cost?
When it comes to Part B, you’ll pay between $148.50 and $504.90 per month, depending on your income.
Like traditional health insurance, Part C Advantage plan costs vary depending on several factors, including:
- Copayment amounts;
- The type of care it covers;
- Yearly limits on your out-of-pocket costs.
Similar to Part B, your Part D costs will range between $0 and $77.10 per month, depending on your earnings before enrolling.
3. Does everyone pay the same amount for Medicare coverage?
All variables being equal (e.g., age, income, etc.), Person A will pay the same premium for Original Medicare coverage as Person B. However, like a standard health insurance policy, there are many more factors (overall health, primarily) that can impact what you pay for coverage through an Advantage plan.
Furthermore, several programs can help eliminate or reduce what you pay for Medicare coverage, including:
- Qualified Medicare Beneficiary (QMB) Program;
- Specified Low-Income Medicare Beneficiary (SLMB) Program;
- Qualifying Individual Program;
- Qualified Disabled and Working Individuals (QDWI) Program.
Related: Are You Eligible for Programs that Help Lower Medicare Costs?
4. How can you choose the best Part C plan?
There are three main steps when it comes to choosing your best Part C (Advantage) Plan:
- Compare costs — Just like with traditional health insurance, what you pay for Part C coverage can vary widely between carriers based on factors like age, smoking status, where you live, and overall health. This is why it’s essential to compare quotes between several companies before deciding.
- Compare coverage — Along these same lines, not all carriers will provide the same coverage with their Advantage plans. Make sure you choose one that covers your unique combination of needs and preferences.
- Learn what customers are saying — What other customers say about their experiences could be an indication of what you’ll experience after signing on the dotted line.
Related: How to Choose a Medicare Advantage (Part C) Plan
5. Does Medicare cover COVID-19 infection?
The SARS-CoV-2 virus enters the body through droplets and particles ejected from an infected person after they breathe, talk, cough, or sneeze. Then, the virus hijacks healthy cells, especially those in the lungs, and can cause symptoms like fever, a cough, shortness of breath, fatigue, chills, body aches, and headache.
Fortunately, Medicare covers FDA-authorized COVID-19 vaccines at no cost to you. They also cover lab tests, antibody tests, monoclonal antibody treatments, and expanded telehealth services.
If you’re hospitalized, you’ll pay your $1,484 (for 2021) Part A deductible, plus a copayment of between $371 and $742, depending on your length of stay. If you’re quarantined, you won’t pay an additional deductible, but there are other costs related to skilled nursing facility care and outpatient services.
Related: Coronavirus and Medicare: What You Need to Know
6. Why is it In Your Best Interest to Work With an Independent Medicare Agent?
Instead of going directly through a company, here are the top reasons why you should choose an independent Medicare agent like IHS Insurance Group:
- Personalized service — IHS works for you, not the insurance company. Consequently, we’re not just here to provide maximum coverage at minimum cost. We’re also always available to answer your questions.
- Knowledge and expertise — Between all of our Medicare professionals, IHS has decades of combined experience helping clients like you make more informed coverage decisions.
- Saving you time — By having all of your insurance under one roof, you can streamline your life and save time.
Related: 3 Reasons Why You Should Choose an Independent Medicare Insurance Agent or Broker
Need Answers to Your Medicare Questions?
Whether you’re new to Medicare, plan to change coverage during the next open enrollment, or have questions about your existing coverage, the IHS team is here for you!
Need a FREE Quote or have questions regarding Medicare or Medigap Coverage? We have three convenient ways to reach us:
- If you prefer to talk to a licensed agent directly, please call (866) 480-5063
- If you prefer to fill out a quick form and have an agent get back to you at your convenience, use the GET A FREE QUOTE tool.
- Lastly, for those that want an immediate quote, please click HERE.
Also, check out our Medicare FAQs here.