Understanding Medicare Archives • Ignite Insurance Group

Isn’t Medicare Part A Free?

Ignite Insurance — Tue, 23 Jun 2020 14:20:38 +0000

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Isn't Medicare Part A Free?

In most cases, Part A of Medicare plans come at no additional cost. But not everyone may qualify for premium-free Part A. Here are some reasons why someone might not qualify and (better) what can be done about it.

Defining Premium-Free Medicare Part A

Technically, no part of Medicare is "free." The reason that Part A usually comes at no additional cost, is because most U.S. citizens qualify based on how many years or quarters have been worked and have paid Medicare taxes during their working years. Part A comes at no additional cost if:

If age sixty-five or older (with a few exceptions)
AND You or your spouse have paid Medicare taxes for at least ten years (or 40 quarters)
OR have eligibility for Railroad Retirement benefits

Medicare Through Your Spouse

If neither spouse qualifies for Medicare Part A, bear a couple things in mind. If one spouse paid Medicare taxes, they need to be at least sixty-two years old to qualify the 65 year old spouse. Also, current marital status matters.

Medicare Parts B and D will almost always need premiums to be paid, regardless of whether you qualify for premium-free Part A or not.

Paying for Part A Out-of-Pocket

One option to obtain Medicare Part A, if you don't qualify for it premium-free, is to pay out-of-pocket. If you are sixty-five or older and meet the requirements set by Social Security for residency or citizenship, Part A can be purchased. The cost will depend on your work history and can be significant.

Partial Work Credits

Because Medicare is based on accruing payments over working years, if there is some work history in the United States then you will qualify for partial coverage under Medicare. If at least thirty quarters (approximately seven and a half years) have been paid into in the United States, the Part A premium will be discounted.. In 2019, if someone had a work history of at least thirty quarters, the monthly Part A premium would have been $240.

It is possible to continue working full-time or part-time to raise that to forty quarters, or ten years. At that point, Part A would have no cost.

No Work Credits

If the hours or quarter requirements have not been met, the full Part A premium amount would be required. In 2019, it was $437.

After paying for Part A, Part B and Part D are still important coverage, be sure to include them in cost calculations. Both Part A and B are required in order to enroll into a Medicare Supplement Insurance Plan or a Medicare Advantage Plan.

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What If I Don’t Sign up for Part A?

If someone is unable to sign up for Part A, there will be no hospitalization coverage and full exposer to those costs. Also, they would be unable to enroll into a comprehensive health plan and, once again, be exposed to most healthcare costs. This could be a more costly decision in the long term.

Depending on the circumstances, is important to consider all angles of cost, both short and long term. A licensed Medicare insurance agent who specializes in Medicare can help determine the right choice.

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Getting Surgery While on Medicare

Ignite Insurance — Tue, 16 Jun 2020 14:15:44 +0000

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Getting Surgery While on Medicare

Learning how Medicare covers surgery can be important. The part of Medicare that will cover surgery is dependent on the type.

Medicare Part A vs Medicare Part B

Part A of Medicare covers inpatient hospital care, so if admitted as an inpatient, Part A will cover it, minus the deductible. ($1408 for 2020)

If it is an outpatient procedure, Part B covers those medical expenses incurred once the Part B deductible ($198 for 2020) has been met.

Part B of Medicare covers 80% of outpatient costs. That leaves you responsible for the Part B deductible and the additional 20% of the cost of the surgery. If a Medicare supplement insurance plan is in place, it will help cover these costs.

Medicare Supplement Coverage of Surgery

Surgery is covered as an outpatient benefit by Medicare Part B. A Medicare Supplement Insurance Plan typically covers both inpatient and outpatient procedures in full once deductibles have been met. A good way to remember what a Medicare Supplement Insurance plan will cover is to remember that if Medicare covers a portion of the procedure then the Medicare supplement plan covers the remaining portion.

“The Ignite Team has been a fantastic resource for my wife and me. We couldn't be happier with the assistance they were able to provide us."

- Roger D

"All my expectations were met, which is why I called them first. They are efficient, knowledgeable and made the whole process very easy. You can trust them with all your Medicare needs!"

-Rosemary H.

"If you're looking for an experienced brokerage who know the system inside and out, look no further. You'll be guided to your to perfect solution that is most beneficial to you!"

- Walt G

Medical Necessity is the Key

Medicare is designed to cover expenses that are considered reasonable or “medically necessary.” If receiving cosmetic and some elective surgeries, such as surgery related to routine foot care, then neither Medicare nor your Supplement will pay for it. The Medicare supplement insurance plan won't pay anything toward expenses that Original Medicare does not approve first. Therefore, if a bill is denied by Medicare, the supplement also will not pay. And it won't cover the 20% it would normally pay toward approved surgeries.

Does Medicare Cover Oral Surgery?

Sometimes. Most oral surgeries do not come under the purview of Medicare, except in instances of medical necessity. If, for example, it is for a broken jaw, Medicare will pick up the bill for repairing it.

Oral cancer is another example of a reason why Medicare would pay for oral surgery. If a doctor recommends oral surgery, Medicare may help cover the costs of surgical treatments for cancer. Your doctor will usually be able to confirm what Medicare will or will not cover, so it makes sense to get these questions answered prior to any procedure. Do not be afraid to ask for estimates!

Does Medicare Cover Open-Heart Surgery?

Heart surgery usually requires a hospital stay, so it is covered by Medicare Part A and certainly would be considered “medically necessary.”

Does Medicare Cover Cataract Surgery?

Medicare Part B covers cataract surgery, and it will also pay for a pair of eyeglasses or contacts in full, following the cataract surgery.

Will Medicare Cover ALL Surgery?

Contact a qualified Medicare agent if it looks like there may be a surgery coming up. We can help you determine whether the surgery will be covered under your plan and, if so, which party will be financially responsible.

Generally the answer is yes, most surgeries will be covered between Medicare and a Medicare Supplement insurance plan. It's just a question of medical necessity and using the right part to pay.

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Five Reasons to Feel Good about Medicare Insurance

Ignite Insurance — Tue, 02 Jun 2020 16:22:32 +0000

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Five Reasons to Feel Good about Medicare Insurance

Medicare Insurance has a mixed reputation. People complain about the prices for prescriptions, the "donut hole" concept, and lack of coverage for long-term care.

Interestingly, U.S. citizens are overwhelmingly satisfied with their Medicare Insurance Plan. A recent survey of people enrolled in Medicare revealed that nearly 90% of them are happy with their care and satisfied with coverage choices. As opposed to people still on employer plans who, when polled, revealed only an 80% satisfaction rate. So as eligibility for Medicare Insurance approaches, it's good to have an open frame of mind. Each person’s experience is different, based on the chosen plan and who you choose to work with.

Here's just five good reasons to like Medicare Insurance.

1. Lower premiums than many private health plans

Part A of Medicare typically comes at no additional premium, assuming you or a spouse have worked enough years or quarters. Almost everyone qualifies for it. For Original Medicare, Part B includes a monthly premium. During 2019, Medicare premiums averaged $135.50. On average, the health care premiums during the same time for a healthy twenty-five-year old were $403.

Medicare premiums also tend to rise at a slower rate than private health plans due to inflation. To calculate premiums, private insurance providers have a myriad of complex factors influencing how they set prices, which tends to drive their costs up at a faster rate than Medicare. Since 2013, private insurance premiums increased by more than a hundred percent. Part D of Medicare, however, only increased by 25%, or $30 per month at the most.

Remarkably, premiums for Medicare Advantage plans and Medicare Part D Prescription Drug Plans are actually trending down. In 2020, most people will be paying lower Medicare premiums than they did in 2019. That is rare in the private insurance sector.

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“The Ignite Team has been a fantastic resource for my wife and me. We couldn't be happier with the assistance they were able to provide us."

- Roger D

"All my expectations were met, which is why I called them first. They are efficient, knowledgeable and made the whole process very easy. You can trust them with all your Medicare needs!"

-Rosemary H.

"If you're looking for an experienced brokerage who know the system inside and out, look no further. You'll be guided to your to perfect solution that is most beneficial to you!"

- Walt G

2. There’s even “Extra Help” for people who need it

Programs have been put in place to make Medicare costs affordable for people on a set income, based on qualification. There are programs at both the state and federal levels to help pay premiums for Part B, deductibles, copayments, and coinsurance. Extra Help is an income-based assistance program to help pay for Part B and D premiums, which could lower the costs of medications considerably.

If you qualify for both Medicare and Medicaid, there are special Medicare Advantage plans that cover all health care needs, including prescription drugs.

3. Choices, choices, choices

The company offers what it offers and it is typically non-negotiable, even if it doesn’t cover your particular needs.

Medicare, however, is designed to have options to meet specific needs.

Whether a Medicare Supplement Insurance Plan or Medicare Advantage Plan makes the most sense, there are multiple choices for each type and times of the year when it is possible to make changes, if needed.

With Medicare, you aren't restricted by someone else’s health concerns or costs. The option is available to choose a plan that works for you, based budget, and unique needs.

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4. Totally predictable health care costs—

Medigap

Original Medicare has the potential to create a lot of uncertainty in medical costs. If you have an unexpected surgery or treatment or a sudden sudden change in medications, it's possible the out-of-pocket payments for deductibles, copayments, or coinsurance amounts could change from month-to-month.

A Medigap Plan helps mitigate a some of the uncertainty. This coverage is designed to cover unexpected health-care costs not covered under Original Medicare. Once the premium is paid each month there is little to nothing to pay for after that, depending on the plan.

Medicare Advantage

Medicare Advantage Plans gives the beneficiary control of their health care costs. With a Medicare Advantage plan, only pay small copay are needed per service.

A further advantage is an out-of-pocket maximum amount that offers a cap on how much you can pay in a year. Meaning, the worst case scenario is set in stone, and the beneficiary will never be liable to pay more out-of-pocket than the maximum amount set by your plan, no matter what happens healthwise.

Changes happen to Medicare every year. For the most up-to-date reports on Medigap coverage, talk to a qualified insurance agent specializing in Medicare plans.

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5. New benefits to keep you healthy and safe at home

The one thing better than having great care in place is having the care you needed to prevent getting sick at all. Medicare health plans offer many tools for preventive care and wellness needed to stay healthy.

Medicare Advantage plan beneficiaries have more tools than ever for preventive healthcare. They are expanding their services in this area every year. New benefits include expanded coverage for telehealth services, non-medical transport, in-home meal delivery, home health care including custodial care and home-making services, and allowances for home safety equipment and devices, depending on need and qualification.

Get help with Medicare

It's different than coverage you've had in the past, sure. And, it may even make more sense in surprising ways. Get in touch with a qualified insurange agent who specializes in Medicare right now to learn more.

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"If you're looking for an experienced brokerage who know the system inside and out, look no further. You'll be guided to your to perfect solution that is most beneficial to you!"

- Walt G

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The post Five Reasons to Feel Good about Medicare Insurance appeared first on Ignite Insurance Group.

A Four Step Guide to Understanding Medicare

Ignite Insurance — Tue, 19 May 2020 15:48:00 +0000

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A Four Step Guide to Understanding Medicare

Every fall each Medicare beneficiary will get a big Medicare and You handbook in the mail. It's full of confusing terms and breakdowns of numbers that are only vaguely recognizable. And this comes in the middle of all the ads for all existing insurance companies. It can be overwhelming, and there's no clear way to tell what can be thrown away and what should be kept.

Being new to Medicare, it can be overwhelming and difficult. This is particularly true if the years prior have been spent on an employer or work-provided insurance plan where the options are clear or set in stone. Upon age sixty-five, everything changes and all of a sudden the options feel endless.

You Are Not Alone, We Are Here to Help!

It's quite common to feel frustrated or overwhelmed by the process. And that's okay. That's why we are here, to relive what may feel like a burden.

This article will outline Medicare in four brief steps to give as much clarification as possible, as simply as possible.

“The Ignite Team has been a fantastic resource for my wife and me. We couldn't be happier with the assistance they were able to provide us."

- Roger D

"All my expectations were met, which is why I called them first. They are efficient, knowledgeable and made the whole process very easy. You can trust them with all your Medicare needs!"

-Rosemary H.

"If you're looking for an experienced brokerage who know the system inside and out, look no further. You'll be guided to your to perfect solution that is most beneficial to you!"

- Walt G

1. Medicare Basics

Most Americans qualify for Medicare as soon as they turn sixty-five. This includes permanent residents who have lived in the United States for at least five years. If on disability for twenty-four months of Social Security disability, Medicare typically goes into place automatically, despite age.

Next we'll start with Original Medicare. Once you have a basic understanding, then it is time to look at the other types of Medicare plans to figure out which type of additional coverage makes the most sense for you.

Original Medicare consists of Part A and Part B.

Parts A and B are both provided by the Federal government and handled by the same offices as Social Security.

Make a note: mail received from the Social Security office is mail to keep and review later, as well as information and mail from the Centers for Medicare and Medicaid Services.

The Parts of Medicare

Part A is Hospital Coverage. It pays for room and board at hospitals or skilled nursing facilities.

Part B covers Outpatient Coverage. Outpatient coverage includes almost everything else: doctor visits, equipment, lab-work, surgeries, durable medical equipment, diagnostic tests, etc. Keep in mind these things are only partially covered as you would still be responsible to pay a coinsurance, or percentage of the cost out of pocket.

Next, it is important to understand Part D. Part D represents prescription drugs coverage. When enrolled in a stand-alone Part D plan, a card from that insurance carrier would arrive by mail to be used at the pharmacy when purchasing medication. Part D is a very important piece of the Medicare puzzle even if you do not take any prescription medication. Going without a “creditable” Part D plan, can result in the government penalizing that person for each month they go without part D coverage. This penalty would kick in once a Part D plan has been purchased.

On the first day of the month someone turns sixty-five they become eligible for these three parts of Medicare. It might be earlier if on disability coverage too.

2. Medicare Costs

Time to answer some important questions: what are the costs involved? It is important to understand what costs come into play. If someone plans to continue working past sixty-five for an employer with health benefits, there is no need to enroll into Medicare Part B until retirement. There is no penalty as long as that person continues working and keeps the creditable group health coverage.

Part A of Medicare is free for most people. If you or a spouse have worked for at least ten years in the United States, Medicare Part A will come at no additional cost.

Costs for Part B

Part B comes with an additional monthly plan premium, based on income.

In 2020, Medicare's base rate for new beneficiaries is $144.60 per month.

People in higher income brackets will pay an "income adjustment” and will typically pay more for their Part B and/or D premium. Social Security bases this on tax returns from the two previous years to determine this income adjustment and will notify someone directly with exactly what the Part B premium will be.

If there has been a drop in income, you may file a reconsideration request to try to get a lower rate. Proof of lowered income will be needed, such as pay stubs. Social Security will consider the request and decide if they can lower it.

Social Security will deduct that Part B premium from your monthly income benefits. Take note: if not yet drawing from Social Security, an invoice for Part B on a quarterly basis. Once you begin drawing on Social Security income, this will change to a monthly automatic payment.

Is Part B Necessary?

If Medicare will be the primary insurance after you turn sixty-five, Part B is necessary. You can't enroll into a Medicare supplemental insurance or Medicare Advantage plan unless both Part A and Part B of Medicare are in place.

Again, if planning to continue working after turning sixty-five and stay on your employer's insurance, making Medicare your secondary insurance, you may delay Part B without a problem. Just check with a qualified agent to see if that would make sense for you.

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Costs for Part D

Medicare Part D has premiums that vary based on location and what is available. As with Part B, beneficiaries may also pay more if they fall into a higher tax bracket.

The national average cost for Part D premiums is around $35 per month. It varies from state to state, and may be higher or lower.

There are options. You can request that Social Security pays Part D premiums directly to the insurance carrier to avoid that every month. Any surcharge from an income adjustment will be added to Part D monthly premium.

To find the most appropriate Part D plan or to estimate your prescription drug costs, be sure to talk directly with a licensed Medicare insurance agent.

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3. What’s Covered and What’s Not

Medicare pays for most health care costs. The beneficiary’s share comes in the form of deductibles, coinsurance, and copays.

If coming from an employer health plan, costs can vary significantly. Paycheck deductions would purchase your insurance. A copay or some other fee would be required at the time of your doctor's visits, and there may be a coinsurance after surgery or hospital stays.

Medicare works similarly.

What Medicare Pays For:

Part A pays for the first sixty days in the hospital. The share the beneficiary is responsible for will come in the form of a deductible. In 2020 that will be a deductible of $1,408, and is subject to change each year. After sixty consecutive days in the hospital, Medicare will pay gradually less and you will be responsible for more. It could potentially mean hundreds of dollars per day, so you may benefit from a Medicare Supplement Insurance Plan.

Part B pays for outpatient care. It includes things like doctor checkups, lab-work, imaging tests, surgeries, medical equipment, and things like chemotherapy and dialysis. The beneficiary will pay a small deductible once per year ($198 in 2020), then Part B will cover 80% of the remaining outpatient medical expenses.

The beneficiary is responsible for the other 20% of outpatient services. There's no cap on the dollar amount, so it can become expensive fast for things like surgery or cancer treatment. Choosing additional health insurance coverage can reduce these out of pocket costs.

Part D is designed to help cover prescription medications. That means medications to be picked up at pharmacies or through the mail. Part D probably won't require any supplemental plans to enhance its coverage. Its designed to make it so you won't need to pay for a hundred percent of your medication.

4. Understand Your Additional Coverage Options

It's time to talk about Medicare Advantage plans and Medigap plans, which enhance your Medicare coverage.

Medigap Plans (also called Medicare supplements)

Medigap plans are designed to fill in the gaps from what Medicare does not cover. They pay for things that you might normally be responsible for, like that 20% of bigger medical expenses we mentioned above. Medicare covers the 80%, then Medigap will cover the other 20% of outpatient expenses handled by Part B of Medicare.

Some Medigap plans also cover Part A and B deductibles.

With a Medigap plan, the choice of medical professionals to visit is available, as long as they are willing to accept you as a “Medicare patient.” Medicare works with nearly 900,000 medical professionals across the country.

Medigap plans typically require a higher monthly plan premium, with little to nothing additional out of pocket above the premium. They do not include Part D prescription drug coverage. That would need to purchase that separately.

Medicare Advantage Plans (also called Part C)

Told you we'd get to Part C.

Medicare Advantage plans, or Part C, are additional health plans that can come with a premium as low as $0. These plans are provided through private insurance carriers and become the primary insurance, instead of Medicare. They can offer large networks of providers as well as additional benefits and services above and beyond what Medicare covers. Get in touch with us to help figure out the best details of a Part C plan to suit your needs.

On a Medicare Advantage plan, the beneficiary is typically responsible for a small copay paid directly to the provider at the time of medical services. You pay for co-pays, hospital stays, and a handful of other Medicare-approved services. You're agreeing to share more costs of your medical expenses as a trade-off for lower monthly premiums.

A Part D prescription drug plan is included in most Medicare Advantage plans at no additional cost per month.

Ask yourself a few questions while choosing between plans. Which plans do my preferred providers work with? Do I plan to travel? What will give me the most peace of mind? What are the most important services to me?

The right plan is available and please do not hesitate to contact us to help you find it!

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So what mail should you keep and what should you toss:

Save mail from the government, especially anything from the Social Security Administration or the Centers for Medicare & Medicaid Services. Mail from those organizations generally has information about Original Medicare benefits. Keep them for review.

Review the fourth step of the above process and see whether any of the ads will be useful in light of that information. If so, feel free to keep them. But even if you throw them away, getting in touch with a qualified insurance agent who specializes in Medicare, will be your best bet. They will have information about plans available to you in your area.

Likewise with any mailers relating to Part D. The mailings received are not a one size fits all. They provide a general overview to assist in making an informed choice.

Get in contact with us and let us be an ally through the process, leaving you in confident control of your healthcare!

Subscribe to our Monthly Newsletter

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Our newsletter helps to educate about Medicare.

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855-600-0137

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The post A Four Step Guide to Understanding Medicare appeared first on Ignite Insurance Group.

7 Common Medicare Misconceptions/Assumptions

Ignite Insurance — Wed, 06 May 2020 15:37:32 +0000

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7 Common Medicare Misconceptions/Assumptions

Retirement planning, for many, begins in our thirties and forties. We plan out our hobbies. We plan the cruises we'll be taking. It's going to be a grand adventure!

What we don't plan for is the staggering cost of medical expenses that a person needs during retirement. On average, a couple retiring in 2019 at age 65 will need $285,000 to cover health care and medical costs in retirement, according to Money.com.

That number can come as a shock. It's an especially unpleasant surprise if coping with some common misconceptions about Medicare insurance circulating the internet these days. Here's a few to ensure a clear understanding and plan accordingly.

I Have to Choose Between Original Medicare and Medicare Advantage … Forever

Most breakdowns of Medicare say that you need to choose between two paths:

Original Medicare (parts A and B) + Medicare Supplement Insurance Plan
Or a Medicare Advantage Plan

Simplified explanations of Medicare make it sound like once you've made a choice between these two paths no changes can be made.

However, that is not the case! No one is locked into a decision about your Medicare insurance plan forever. If you're unhappy with the chosen path, a switch can be made at any time during the year if a Special Enrollment Period is available, or in the fall during Annual Enrollment. If you are going from a Medicare Supplement Insurance Plan to a Medicare Advantage Plan, there is a 12 month “free look” period to test out the Medicare Advantage Plan. If you decide to go back to the exact Medicare Supplement Insurance Plan you started with, you may do so during the “free look” period, no questions asked and NO UNDERWRITING. Guaranteed issue rights for a Medigap plan last during the first 6 months of eligibility for Medicare, as well as during the 12 month “free look.”

The Annual Enrollment Period, or Annual Enrollment, is a period lasting from October 15th through December 7th. Changes can be made to your Medicare plan at this time each year, including switching from Original Medicare to Medicare Advantage plans and vice-versa. Things like adding or dropping Part D can also take place, or change a Part D plan altogether.

There's also a special Medicare Advantage Open Enrollment Period that lasts from January 1st through March 31st each year. The purpose of this Medicare Advantage Open Enrollment Period is to offer an opportunity to switch to a different Medicare Advantage plan or insurance carrier. You can even drop a Medicare Advantage plan entirely between January 1 and February 14 if you decided to go back and enroll in Original Medicare only.

Also, suppose you move. Or suppose the exact Medicare Advantage plan you had stops operating in your area. Changes can be made to your plan if that happens as well. The good news is options are available to make changes throughout the year based on qualification, and as life circumstances evolve.

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Medicare Covers Long-Term Care

90% of Americans believe that Medicare covers long-term care, but this isn't the case. After treatment in hospitals for illness or serious injuries, Medicare may cover time in skilled nursing facilities, but the time will be limited.

Approximately 70% of seniors will need long-term care at some point during retirement. On average, seniors may need between 2.2 and 3.7 years of long-term care, and about 20% will need more than five years of nursing-home care. It can get pricey real quick when you take costs of things like semi-private rooms into consideration. You can expect to spend around $7000 a month for rooms in long-term care facilities. Making the mistake of misunderstanding whether Medicare covers long-term care can be catastrophic.

It's prudent to plan for these costs far in advance since Medicare won't cover them. Do your best to make sure that your retirement plan reflects the need to budget for long-term care insurance or some type of planning for these costs, separate from Medicare coverage. Plans of this kind can cost anywhere from $1,500 to $2,500 annually, with variation based on coverage you choose. But it might be a reasonable expense to plan for if you have any doubt your retirement fund will be able to cover long-term care.

“The Ignite Team has been a fantastic resource for my wife and me. We couldn't be happier with the assistance they were able to provide us."

- Roger D

"All my expectations were met, which is why I called them first. They are efficient, knowledgeable and made the whole process very easy. You can trust them with all your Medicare needs!"

-Rosemary H.

"If you're looking for an experienced brokerage who know the system inside and out, look no further. You'll be guided to your to perfect solution that is most beneficial to you!"

- Walt G

You Can Enroll in Medicare As Soon As You Retire

We usually think of Medicare as retirement insurance. That's the purpose of it, but Medicare doesn't actually have anything to do with when you retire. You could decide to retire at sixty-one, but Medicare still wouldn't be available to you until you turn sixty-five years old. The only exception to this rule is if you have a qualifying disability. If you retire early, you'll need a different plan for insurance.

It makes sense to start figuring out your Medicare plan a good year in advance of your sixty-fifth birthday. If you miss signing up for coverage when you are first eligible, it's possible that you'll incur late enrollment penalties which would be due with your monthly premiums.

If you're late to enroll in Medicare and you don't get health insurance from another qualifying source, it can make late enrollment in Medicare quite expensive. How long you went without coverage informs the size of the Late Enrollment Penalty. Part A (although you may qualify for premium-free Part A) and Part B can take a long time to pay off. Part D late enrollment penalties never go away.

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Medigap Pays All Out-of-Pocket Costs

It's almost, but not entirely true, that a Medigap plan means no out-of-pocket expenses for you.

Medigap or Medicare Supplement Insurance plans only work with Original Medicare. You can't buy a Medigap plan in addition to a Medicare Advantage plan. It would be one or the other.

It will be important to check with an insurance agent who specializes in Medicare health plans and has up-to-date information regarding Medigap plans to get the most up to date rate. Each lettered Medigap plan will have different coverages and costs but are standardized across the board with each insurance carrier. As recently as January 2020, new Medigap plans don't cover Part B deductibles. But since Medigap plans are backed by the Federal government, Plan G Medicare plans won't change much from one insurance provider to the next. Also, Medigap won't cover Medicare part A or B premiums.

Medigap benefits have limited uses. It won't help with Part D out-of-pocket drug prescriptions. It will only cover portions of Parts A and B. Medigap doesn't cover routine health visits, like vision and dental, which aren't covered by Medicare anyway.

If you have concerns about meeting premiums and out-of-pocket expenses, a health savings account, or HSA, will be a good idea. An HSA is an account where you can deposit pre-tax dollars. Money grows in them tax-free, and unused funds roll over from year to year. Then withdrawals from them incur zero income tax if you make those withdrawals after turning sixty-five. HSAs are good options for putting a resource in place early to pay for premiums and out-of-pocket healthcare expenses.

I Can Buy Medigap Whenever I Want

This is sort of true. You can APPLY for a Medigap policy any time. Your insurance carrier doesn't need to sell you one necessarily unless you have guaranteed issue rights. If you don't, your insurance carrier will assess your case through an underwriting process. If they don't approve your health history, you might not be accepted in a Medigap policy, or it might come at a higher premium.

Medigap Open Enrollment begins the month you turn sixty-five and have enrolled in Part B of Medicare. That open enrollment period lasts for six months. During those six months, you can enroll in a Medigap plan at the lowest available premium (prices for plans vary from state to state). You may enroll into a Medigap plan and then switch to a Medicare Advantage Plan. If you do, the only health assessment question would be for End Stage Kidney Disease, or current kidney dialysis.

There aren't a lot of times other than those when you will get guaranteed issue rights for Medigap. There is no annual opportunity to buy a Medigap plan.

You won't be able to upgrade your plan later if your health or financial circumstances change. Spend some time with a qualified insurance agent who specializes in Medicare, talking through all your options to make sure you're getting the best coverage for you.

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There Is an Annual Cap on Out-of-Pocket Medicare Costs

Medicare is very different from traditional health coverage. Under Original Medicare, there is no maximum limit to out-of-pocket medical expenses. A Medigap plan will protect you from this.

There is cap to out-of-pocket expenses on a Medicare Advantage plan, however. The Federal government sets these caps, so it's possible that they might change every year. Ask a qualified insurance agent specializing in Medicare to tell you what the current out-of-pocket spending cap on the Medicare Advantage plans available in your area. That being said, individual Medicare Advantage Plans often set much lower limits. In-network spending versus out-of-network spending might have a different cap, as well.

Part D has its own framework for unexpected costs and emergencies. Bear in mind that prescriptions drug costs aren't included in the out-of-pocket cap for other parts of any Medicare plans.

Medicare Covers Dental and Vision Services

It depends on your plan whether Medicare covers dental or vision services. Original Medicare will not offer coverage for routine dental, vision or hearing services. Medigap plans don't either. Eye exams and new glasses generally will be an out of pocket expense.

Original Medicare does cover dental care and vision care in certain situations. Injury to teeth and eyes, for example. Medicare also covers glaucoma screenings for people at high risk of glaucoma. After cataract surgery, Medicare will cover one purchase of glasses or contacts. But you're on your own for most common dental or vision services.

Medicare Advantage plans, in most cases, provide coverage for routine vision, dental, and hearing services. Some more rare services, such as dental crowns or implants, might not be covered, and your benefits will likely have a cap placed on them. How much a Medicare Advantage plan will cover varies from one plan to another, since Medicare Advantage plans are private insurance plans offered through individual carriers. Shop around and see what different plans offer before making a decision.

It's important to understand as many of the benefits and options available to you as possible in order to make an informed decision to avoid unpleasant surprises about health care costs during retirement.

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