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Frequently Asked Questions

We speak with thousands of Medicare beneficiaries each year. Here are some of questions that we hear frequently.

Enrolling in Medicare

If you are not taking social security benefits yet, the default payment method for Medicare is quarterly billing via mail. Your first bill is for 3 months of coverage, which is why it is so large!

It is a good idea to set up “Medicare Easy Pay” through your Medicare.gov account. This will allow your payment to come directly out of your bank account each month.

If you don’t have creditable health insurance coverage and you fail to enroll in Medicare, you will charged a lifetime penalty when you do decide to enroll in Medicare.

If you are covered under creditable health insurance coverage, many times it makes sense to delay your enrollment into Medicare. When you sign up for Medicare in the future, you should not have any penalties.

If you don’t sign up for Part A at Age 65, make sure you are covered under a creditable health insurance plan. Most employer coverages will do.

Most enrollees get Medicare Part A at no monthly premium, so there are not many reasons why one would choose NOT to get Part A.

Yes, but only if you don’t have other creditable coverage. If you’re going to continue working past age 65, you won’t have a penalty as long as your employer coverage is deemed “Creditable Coverage”.

Yes, many people decide to delay Medicare because they have good employer health insurance.

Typically they will then decide to enroll in Medicare once they retire.

If your income is below a certain threshold, you may qualify for the government to pay for your Part B premium. Check with your state’s Medicaid office to see if you qualify.

Technically, you do NOT have to sign up for Medicare if you don’t want to. Even if you have it currently, you are able to cancel your Original Medicare and go without health insurance coverage.

However, if you don’t have creditable health insurance coverage, you will have a penalty if you ever decide to take Medicare in the future.

Medicare Supplemental Coverage

Yes, you must continue to pay the $164.90/mo for Part B (or higher if you have a higher income). Your Medicare Supplement or Advantage plan will not work if you don’t keep your Medicare Part B.

Original Medicare – Automatically taken out of your Social Security check. If you’re not receiving SS yet, the default setting is quarterly bill. You can set this to be taken out of your bank account monthly by submitting the Medicare EZ Pay form.

Medicare Advantage / Drug Plans – Monthly premium can be deducted from SS or from bank account. No credit cards accepted.

Medicare Supplements – Monthly bank draft is the preferred method.

Most Medicare Advantage plans will include at least some dental coverage.

Medicare Supplements do not include ANY dental coverage.

For most, the best way to get dental coverage is with a stand-alone dental plan.

Read more about dental plans here.

Every paycheck, part of your FICA payroll taxes go towards Medicare, so no, you cannot opt out of contributing to Medicare.

Exceptions may exist for government workers and railroad retirees who have separate retirement systems.

Medicare Drug Plans

Technically No.

But if you do not have creditable drug coverage and you decide to get Medicare Part D – Drug Coverage at some point in the future, you’ll be given a monthly penalty based on how long you went without coverage! In our opinion, its best to pickup a cheap drug plan just to avoid the penalty.

Learn more about Medicare Penalties here.

The most popular Part D drug plan changes each year and is different based on location. We typically see the cheapest plans be very popular each year for those who take little or no prescriptions. Big brand names like United Healthcare, Humana, Wellcare, and Aetna also consistently have plans with many members.

Medicare & Employer Coverage

Absolutely. If an employer has less than 20 employees, Medicare is the primary insurer. This means that you will have to get Medicare Part A and Part B in order for your employer group insurance to work properly.

If an employer has over 20 employees, Medicare is secondary. In this situation, it typically does not make sense to sign up for Medicare.

Also known as a “Part B Rebate”, some Medicare Advantage plans will give you back money towards your Part B premium. These plans are not available in all areas, so check with an expert to see if this in an option that makes sense for your situation.
Medicare premiums are not based on your age, so a 62 year old will pay the same as a 65 year old (all things equal).

Medicare Advantage Plans

Some doctors dislike Medicare Advantage plans because the plans negotiate to get low prices and the doctors have to deal with the plan’s guidelines such as Step Therapy and Prior Authorization requirements.

Yes, many areas of the country have AARP medicare health plans available for 62 years olds.

It is important to note that some states do not offer Medicare Supplement plans (F, G, N) to Medicare beneficiaries until they reach age 65, so it is important to check with an advisor for the plans available in your area.

Medicare Advantage and Prescription drug plans receive a “Star Rating” from CMS each year based on several factors to judge their quality.

Since these change each year, check the latest ratings on Medicare.gov or have your Medicare agent get you a list of highly rated plans in your area.

There is no “one size fits all” best plan when it comes to Medicare. Depending on your health, wealth, location, and many other factors, one plan may be the best plan FOR YOU.

The easiest way to find the best plan for you is to speak with an expert who can help you compare all the plans in your area. That’s where we can help!

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