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The Six Most Frequently Asked Questions About Medicare

Are you confused about the many rules and regulations in Medicare? You are not alone. We answer the most frequently asked questions about Medicare.
Monday, 24 October 2022

Are you confused about the many rules and regulations in Medicare? You are not alone. We answer the most frequently asked questions about Medicare.

If you are approaching your 65th birthday, no doubt you have many questions about Medicare. That makes sense - there is much to understand about this complicated, government-sponsored program with many rules and conditions for eligibility, coverage, costs, and more. The official website, Medicare.gov, is full of helpful information, but you must know where to look. Fortunately, we have the answers to some of your most pressing questions about Medicare.

Answers to Questions About Medicare

What is Medicare?

Let’s start by answering what are quite possibly the most frequently asked questions about Medicare. First of all, what exactly is Medicare? 

Medicare is a health insurance program created by the United States federal government to help people with certain medical needs pay for their expenses. It is made up of Part A and Part B. Part A is also known as Hospital Insurance, and Part B is also known as Medical Insurance.

Can Everyone Receive Benefits from Medicare?

Unfortunately, not everyone in the U.S. can receive Medicare benefits. For instance, eligibility requires you to work and pay Social Security taxes for at least ten years, be at least 65, and have been diagnosed with certain diseases. 

You can find out which parts of Medicare you’re eligible for using the online Medicare estimator. You’ll need to enter your current situation, like your age and health conditions. The estimator will provide information about your current health and coverage options. You can also use the estimator to help you decide on a Medicare plan if you’re eligible for Medicare Advantage.

What Benefits Does Medicare Provide?

The two parts of Medicare are Part A (hospital insurance) and Part B (medical insurance). 

Part A covers a portion of costs related to having a hospital stay and additional care in the home after being discharged. It also covers some skilled nursing facility costs. 

Part B covers some of the costs related to regular doctor’s visits, diagnostic screenings, and many prescription drugs.

Does Medicare Have A Monthly Premium?

For many individuals approaching retirement age, this is one of the most critical questions about Medicare. Planning costs for a fixed income requires exact information. 

Of course, the cost of Medicare varies based on which parts of Medicare you have and whether you have supplemental insurance to cover the parts that Medicare doesn’t cover (more on these options below). However, for most individuals, the monthly premium for Part A is $0. There is also a yearly deductible of $1,600 for 2023 and other co-insurance costs for inpatient, skilled nursing facilities, specific medical equipment, and respite care.

Part B monthly premiums vary by year, but in 2023 the cost is $164.90. Like Part A, there is a yearly deductible of $223 (for 2023). After you reach the yearly deductible, typically, other costs are paid by Medicare at 80%, leaving the remaining 20% for the Medicare recipient to pay. 

Questions About Medicare Supplement Plans

Despite what many Arizonans believe, traditional Medicare is not free to enrollees. Because of this, many seniors are exploring the options available to them in the form of Medicare supplement plans. What are these plans, and how do they work?

What Are Medigap Policies?

Medigap insurance plans, which private companies issue, are available to reimburse Medicare recipients for services Medicare does not provide. 

Because Medicare does not cover all expenses, Medigap insurance plans fill the gaps and pay for care that would otherwise be extremely costly. Medigap policies have low monthly premiums but cover a wide range of services and come in various price ranges. 

For more information: Why Do I Need Medigap Insurance?

What Are Medicare Advantage Plans?

Medicare Advantage Plans (also known as Medicare Part C) are Medicare-accredited private insurance policies that follow the same rules as traditional Medicare policies. 

Advantage plans essentially take the place of traditional Medicare Parts A and B. These may include Drug coverage (Part D) and other supplemental benefits that may differ depending on the plan you purchase.

Additional information: FAQs: What Are Medicare Advantage Plans?

Who Can Answer Your Remaining Questions About Medicare?

Medicare can be a complicated program with many rules and conditions for eligibility, coverage, costs, and more. Many of the most frequently asked questions about Medicare do have easy questions. But that does not mean you have to figure it out on your own., Southwest Health Insurance Experts of Arizona are ready to guide you through the confusing world of Medicare, all at no cost to you. 

Find a licensed Medicare health insurance agent near you in Arizona. We look forward to answering all your questions about Medicare options. 

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