Enrolling in Medicare can be confusing. There can be so many questions and the answers can be different depending on which source you use.
Luckily, by using a resource from a licensed broker, you know that this information is accurate and will point you in the right direction.
Here are the most common questions that are asked and the answers to hopefully help you in your Medicare enrollment this Annual Enrollment Season!
Will my income situation affect my premiums?
Generally, Medicare premiums are based on your age at the time of application, your zip code and whether or not you use tobacco.
However, Medicare Part B and Medicare Part D premiums vary based on income level, and here is how:
Medicare Part B premiums are calculated using a 2-year look back on taxes, so they will consider your 2022 taxes to give you your final price.
The same goes with Medicare Part D as you may be charged more depending on your income level. While the base premium of the plan will be the same, your income level will be used to determine if you have any extra charges. This assessment is called Income Related Monthly Adjusted Amount (IMRAA). Usually, it only applies if your income is higher than a certain amount.
Learn More: Will my Part D increase because of IMRAA?
Similarly, if you qualify, you may qualify for the State Pharmacutical Assistance Progam, which will help lower your Part D premiums and cost of prescriptions. You can apply for this through the Social Security website and if you qualify, your premiums will decrease.
When should I apply?
You have a 7 month window to apply: 3 months before you turn 65, the month of your 65th birthday and 3 months after you turn 65. It is best to apply as soon as possible, as your Medicare is set to start the month of your birthday. However, if you are not taking Social Security, you must apply before your Medicare becomes effective, and it can take up to 30 days to get the paperwork processed.
Do pre-existing conditions affect the price of Medicare?
Yes and no. If you apply for a Medicare Advantage plan, then pre-existing conditions are not held against you. However, Medicare Supplement plans look into your health history. When you first become eligible you can enroll in one of these plans without your health history being considered, but if you decide to switch from an Advantage plan to a Medicare Supplement in a few years, your health history will be considered. If it changes, your prices can increase, or you can be denied this plan.
Because of this review of your health history, enrolling in a Medicare Supplement when you first become eligible for Medicare will give you the best rate because you are the youngest and healthiest you will be at the time of an application. Health questions include a history of hospital stay or use of prescriptions or medical treatments received. You never know if this can happen to you, so thinking about the future can be a good idea.
We’ll need parts A, B, and D, OR parts C and perhaps D, correct?
You will need parts A and B to cover hospital and medical coverage and drug coverage to avoid penalties. This can be satisfied through getting a Medicare Part D plan or enrolling in Medicare Part C (Advantage Plan) that includes drug coverage.
If you do not want the Medicare Advantage plan, you would have to get Medicare Part D and you can also enroll in the Medicare Supplement plan as well to cover any costs Medicare does not cover, but you can’t have a Medicare Advantage plan and a Medicare Supplement plan at the same time.
Can we get an Advantage plan that will include out- of- state care, at least major medical?
Generally, Medicare Advantage (Part C) plans do not have a nationwide network, so if you plan to travel it may not be the best option because it would only cover you for emergencies. Since these plans require you to pay a deductible, you can see providers out of network, but the deductible will then be doubled for the year.
Remember, if you are unsure what the answer is to a Medicare question, just ask! It is better to get the right information from a trusted source that get the wrong information and enroll in a plan that may not suit your needs.
Contact me today for a free 15-minute Medicare consultation.