Do I have to pay a deductible?

Yes. The Part A deductible for 2022 is $1,556. That means you will not receive any Medicare Part A benefits unless you fully pay off the deductible. This is a per-visit deductible, meaning that if you go to the hospital on Monday and then again on Wednesday for a different reason, you will have to pay for the deductible twice!

What happens after my deductible is met?

Great question! Once your deductible is met, you need to be admitted to a 2-night stay in a hospital before your hospital benefits kick in. After the 2 nights, you are fully covered at a 100% rate for nights 3 through 60.

What happens after 60 days?

Between days 61 and 90 at the hospital, you are responsible for a daily deductible of $352.

Am I covered after 90 days at all?

Yes, however, the daily deductible after day 90 becomes a whopping $704! This continues until day 150 at the hospital.

Am I covered after day 150?

You are not covered under Medicare Part A after day 150. This means that any incurred costs after day 150 needs to be fully covered out of pocket by the patient!

Am I eligible for Medicare Part B?

Anyone who is eligible for Medicare Part A is also eligible for Medicare Part B. Enrollment is required for Part B and the current 2020 premium is $144.60 (varies depending on income and marital status - see chart below for details).

That's the monthly premium. Is there also a deductible?

Yes, there is also a deductible for Part B. The current annual deductible for Part B is $198, so your Part B coverage won't start until that is fully paid.

That's a really low deductible!

Yes, it is! However, once the deductible is met, you have to pay a 20% coinsurance fee for every visit uncapped -which means you could be responsible to pay large sums of money for ongoing outpatient care and/or significant surgeries!

How can I protect myself and my wealth from this?

To protect from these excessively high medical bills, many seniors will consider purchasing private insurance called Medicare Supplement insurance policies (also known as Medigap policies).

Whew. Where can I learn more about these Medicare Supplement policies?

Click on the Medicare Supplement tab to learn more, or schedule a free appointment/consultation with one of our experienced agents by calling 855.200.6335 or by scheduling a free consultation session with us!

When Can I Switch Back To Original Medicare?

If you are currently on a Medicare Advantage plan and you're trying to switch back to traditional Medicare, you have two times to do so: Annual Enrollment Period - (October 15th – December 7th) Medicare Advantage Disenrollment Period (MADP) - (January 1st – February 14th)

Where can I learn more about Medicare Part C?

If you have any questions about switching your plans, feel free to contact us at 855.200.6335 or schedule your free consultation now!

How do I enroll in Medicare Part D?

here are two ways to enroll in a Part D Plan: A stand-alone Medicare Part D Plan (PDP). A Medicare Advantage plan that includes drug coverage (MAPD).

What is Donut Hole (Coverage Gap)?

The "donut hole" is a gap in coverage that can occur in certain Medicare prescription drug plans (Part D) when an individual's total drug costs reach a certain threshold. During the coverage gap, known as the "donut hole," the individual must pay more out-of-pocket for their drugs before their plan's coverage kicks in again. The Affordable Care Act (Obamacare) has closed this coverage gap over time so that by 2020, beneficiaries will pay no more than 25% of the cost of their drugs while in the coverage gap.

How much coverage does Medicare Part D give me?

Medicare can only give a certain amount of drug coverage for each person, so once your full cost (a combination of what you pay and the insurance company pays) reaches $4,020, you will go into the coverage gap where you would pay 25% of the cost of both brand name medication and generic medication. Once you reach $6,350 out-of-pocket, you will get out of the Coverage Gap and reach Catastrophic coverage and the costs of your medications will drop significantly to just 5% or $3.35 for generics and $8.35 for brand-name drugs, whichever is greater.

What is a late enrollment penalty?

Choosing not to enroll in Medicare Drug coverage when you are first eligible could lead to a late enrollment penalty. The penalty does not apply if you had other creditable drug coverage (such as employer/union coverage, VA benefits) or if you get Extra Help. The late enrollment penalty is 1% of the average cost of a Medicare Part D plan. That average for 2020 is about $32.74, which would be around $.30. That small penalty accumulates for the number of months you go without drug coverage. Once you do enroll in a drug plan, that extra penalty is added on to your monthly cost. For example, if you go two years without drug coverage and then enroll in a plan, Medicare would add on about $7.20 a month to the cost of your drug plan.

Can I get additional help for Medicare Part D?

You may qualify for very little to zero premium and co-pays on your prescription plans if you meet certain income and resource qualifications. You may qualify if in 2019 your annual income was below $18,735 if you're single ($25,365 for married) and your resources add up to $14,390 if you’re single ($28,720 for married). Resources that count are money in a checking or savings account, stocks, and bonds. Resources that don’t count are your home, one car, burial plot, furniture, and other household and personal products. If you’re on Medicaid or other state programs, you may automatically qualify for Extra Help. To find out more about Extra Help and to see if you qualify, fill out an application with Social Security.

Jawad Bushnaq
- Oct 10, 2023
- 3 min read

Making the Most of Medicare AEP with Ikhlas: Your Questions Answered

The Medicare Annual Enrollment Period (AEP) is an essential time for beneficiaries. But with myriad terms, options, and dates to keep track of, navigating Medicare AEP can be overwhelming. Let Ikhlas illuminate the path to understanding and maximizing your Medicare benefits.

1. The Power of AEP: What Can You Do? AEP is a special window when Medicare recipients possess the most flexibility. During this period, you can drop existing Medicare coverage to switch to an Advantage plan or make crucial changes to your policy. It's a golden chance to reassess and recalibrate your coverage to your current health needs.

2. Choosing Your Medicare Plan: Where to Begin? With the myriad of Medicare plans available, making a choice can feel daunting. The plan that's perfect for one person might not be ideal for another due to factors like health conditions, prescription needs, and budget.

So, how do you find your fit? Your best bet is to consult a licensed insurance agent, specifically from your state. They're trained to be in the know about all regulations and, uniquely, have access to live plan pricing. At Ikhlas, our agents bring sincerity and expertise to the table, ensuring you're guided with care and accuracy.

3. The Online Quote Dilemma: Is it Reliable? While some providers might offer quick online estimates, remember that these quotes can be rough approximations. Factors like your health condition can change these figures. Always approach online quotes as preliminary figures and not the final word.

4. Decoding the Medicare Lingo: AEP vs. OEP Understanding Medicare involves grappling with a host of acronyms. AEP allows for significant changes, including switching between Supplement and Advantage plans. In contrast, the Open Enrollment Period (OEP) caters primarily to those already enrolled in Medicare Advantage, wishing to change to another Advantage plan.

5. The Cost Factor: How Much to Switch During AEP? Many people are pleasantly surprised to find that several Advantage plans start at zero cost. However, Supplement plans can carry a heftier price tag. It's often possible to transition to a superior plan without digging deeper into your pockets or even saving some money.

The Facts Speak: According to the Centers for Medicare & Medicaid Services, in 2022, more than 26 million people had Medicare Advantage plans, indicating the popularity and trust beneficiaries place in these plans1. With every AEP, beneficiaries actively reevaluate and change their plans, aiming for optimal coverage and value.

Ikhlas' Sincere Call to Action: At Ikhlas, we believe that every individual deserves clarity, sincerity, and the best possible health coverage. This AEP, let our dedicated team guide you through the maze of Medicare. To embark on a journey of informed choices and genuine care, book an appointment with our seasoned experts.

Ikhlas Insurance Group is a privately held corporation operating under Ikhlas Inc. Submission of your information constitutes permission for a licensed insurance agent to contact you with additional information about the cost and coverage details of health plans. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-855-200-6335 to determine eligibility and to request a copy of the applicable policy. We do not offer every plan in your area. Currently, we represent 8 organizations which offer 527 plan products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Making the Most of Medicare AEP with Ikhlas: Your Questions Answered

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