Question 1

Do I have to pay a deductible?

Accepted Answer

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!

Question 2

What happens after my deductible is met?

Accepted Answer

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.

Question 3

What happens after 60 days?

Accepted Answer

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

Question 4

Am I covered after 90 days at all?

Accepted Answer

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

Question 5

Am I covered after day 150?

Accepted Answer

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!

Question 6

Am I eligible for Medicare Part B?

Accepted Answer

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).

Question 7

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

Accepted Answer

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.

Question 8

That's a really low deductible!

Accepted Answer

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!

Question 9

How can I protect myself and my wealth from this?

Accepted Answer

​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).

Question 10

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

Accepted Answer

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!

Question 11

When Can I Switch Back To Original Medicare?

Accepted Answer

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)

Question 12

Where can I learn more about Medicare Part C?

Accepted Answer

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

Question 13

How do I enroll in Medicare Part D?

Accepted Answer

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).

Question 14

What is Donut Hole (Coverage Gap)?

Accepted Answer

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.

Question 15

How much coverage does Medicare Part D give me?

Accepted Answer

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.

Question 16

What is a late enrollment penalty?

Accepted Answer

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.

Question 17

Can I get additional help for Medicare Part D?

Accepted Answer

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.

Individual & Family (ObamaCare)

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