Understand how Medicare works: 18 common questions

Do I need to sign up, or am I automatically enrolled in Medicare?

When turning 65, most individuals are automatically enrolled in Medicare Part A and Part B if they receive benefits from Social Security or the Railroad Retirement Board.

If their birthday falls on the first day of the month, benefits will begin the month prior

However, if they do not receive benefits from these sources enrollment is required. The enrollment window is seven months, including the birth month and three months before and after

When wanting to maintain private insurance through an employer, individuals must inform Medicare that they will not be retiring They can later schedule a special enrollment period

When is Medicare open enrollment?

Medicare’s open enrollment period runs from Oct. 15 to Dec. 7 During that window you can change Medicare and prescription drug plans

How can I qualify for premium-free Medicare Part A coverage?

To get premium-free Medicare Part A, you must be 65 or older, and you or your spouse must have paid Medicare taxes for at least 10 years

You may also qualify for premium-free coverage if you’re 65 or older and meet one of three requirements:

• You receive Social Security or Railroad Retirement benefits

• You are eligible for Social Security or Railroad Retirement benefits but haven’t applied yet

• You or your spouse were employed in a government job that was Medicare-covered

What are standard Medicare premiums?

Most people don’t pay a monthly premium for Medicare Part A which covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care

The monthly premium for Medicare Part B hasn’t been finalized but is expected to be $180 monthly

Part D drug plan premiums are expected to be $55.50 monthly

Premiums for Medicare Advantage or Part C plans vary depending on the plan.

Can I deduct Medicare premiums from my taxes?

You may be able to deduct some Medicare premiums from your federal taxes if you are self-employed

If you are not self-employed, you can file an itemized Schedule A (1040) tax return listing all your medical expenses for the tax year But you can only deduct expenses over 7.5 percent of your adjusted gross income

Does Medicare Part D cover medication costs?

Medicare Part D prescription drug coverage extends to generic and brand-name medications

Each plan has an approved list of covered medications

You can use Medicare’s Plan Finder tool to review different Part D plans and see which ones include coverage for your desired medication.

How much do Part D prescription drug plans cost?

When shopping for a Medicare Part D plan, compare prices and coverage options to find the best fit.

What are the most popular Medicare supplement plans?

Plan F: This popular plan covers out-of-pocket expenses for Medicarecovered services like deductibles, copays and other costs Plan F is no longer available to beneficiaries who became eligible for Medicare on or after Jan. 1, 2020

Plan G: Plan G beneficiaries must pay the annual deductible under Medicare Part B After that, all medical expenses that fall under Medicare coverage will be covered at 100%.

Plan N: Plan N covers all Medicare

Part B coinsurance costs, except $20 for office visits and $50 for emergency room visits Beneficiaries still must meet the annual Part B deductible

Is there financial help to cover Medicare costs?

Several programs help cover healthcare costs for seniors The PACE program provides all-inclusive care for elderly patients Medicare’s Extra Help program also helps with expenses

For those who need help with insurance premiums and other related costs, the State Health Insurance Assistance Program (SHIP) may help Medicaid covers many healthcare costs for low-income individuals, including those eligible for Medicare and Medicaid.

Medicare Savings Programs (MSPs) are also available, which provide financial assistance to qualified individuals based on need. Finally, Supplemental Security Income (SSI) is a needs-based program administered through the Social Security Administration that can help cover healthcare costs for seniors

Can I enroll in Medicare and keep my health savings account?

The simple answer is no You can’t contribute to a health savings account (HSA) after you enroll in Original Medicare An HSA lets you set aside tax-free money for medical expenses associated with high-deductible health plans

If you delay enrolling in Medicare until after you retire, stop contributing to your HSA at least six months before enrolling in Medicare to avoid tax penalties

When is the best time to enroll in a Medicare supplement plan?

Enroll in a Medicare supplement plan during your Medigap open enrollment period. That starts when you are 65 or older and enrolled in Medicare Part B

Can I enroll in both Medicare and Medicaid?

You may be eligible to enroll in both Medicare and Medicaid if you meet specific financial eligibility requirements

Even if you don’t qualify for Medicaid while enrolled in Medicare, you may still be eligible for a federally funded Medicare Savings Program to help people with limited income and resources Check with Colorado’s Medicaid office to determine if you qualify

How do I qualify for Medicare?

You may be eligible for Medicare coverage if you are 65 years or older and a United States citizen or permanent resident.

To qualify, you must have worked in the U.S for at least 10 years or be a government employee or retiree who has paid Medicare payroll taxes

Use the Medicare Eligibility Premium Calculator on Medicare’s website to determine your eligibility for coverage

To get Medicare, do I need to be on Social Security?

You don’t have to wait until you’re on Social Security to enroll in Medicare

But you must sign up during your initial enrollment period a sevenmonth window that includes your 65th birth month and the three months before and after

If you miss this enrollment period, you may have to pay a permanent surcharge on your Medicare Part B and Part D premiums

Am I eligible for a Medigap plan?

You can’t get a Medicare supplement insurance plan (Medigap) unless you enroll in Medicare You can buy Medigap coverage during a six-month open enrollment period

If you wait to enroll, you may have to pay more for a Medigap policy You also can be denied coverage due to current or past health conditions

You can’t simultaneously have a Medigap policy and a Medicare Advantage (Part C) plan.

What is the difference between Original Medicare and Medicare Advantage?

Original Medicare which includes Part A and Part B, is a federal government program. Private insurance companies contract with the federal Medicare