Medicare FAQ
What is Medicare Advantage (Part C)?
Medicare Advantage offers additional benefits like prescription drug coverage, dental, vision, and hearing services, and it caps your annual out-of-pocket costs, unlike Original Medicare. To explore whether Medicare Advantage is right for you, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Can I enroll in both Medicare and a private insurance plan?
Yes, you can have both Medicare and private insurance at the same time. Medicare and your private insurance will coordinate, with one being the primary payer and the other secondary. For advice on how they work together, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What is Medigap, and how does it work with Medicare?
Medicare Supplement (Medigap) plans complement your Original Medicare by helping cover out-of-pocket costs like deductibles, copayments, and coinsurance. For help choosing the right Medigap plan, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
How do I choose between Original Medicare and Medicare Advantage?
When deciding between Original Medicare and a Medicare Advantage plan, consider factors like coverage, costs, flexibility, choice of doctors, and additional benefits. For help choosing the right option, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What does Medicare Part D cover?
Medicare Part D covers prescription drugs and includes a formulary, copayments, coinsurance, and coverage stages like the coverage gap (donut hole) and catastrophic coverage. To explore your Part D options, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
How much does Medicare Part A cost?
Most people receive Medicare Part A (hospital insurance) premium-free if they or their spouse worked and paid Medicare taxes for at least 10 years. If you don’t meet this requirement, you may have to pay a monthly premium. For more details, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What are the premiums for Medicare Part B?
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In 2024, the standard monthly premium for Medicare Part B is $174.70, but if your income is higher, you may pay more. Medicare Part B premiums can also change annually based on healthcare costs. For personalized guidance, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Are there additional costs for Medicare Advantage plans?
You may need to pay an additional premium for a Medicare Advantage plan, and you'll also have out-of-pocket costs like deductibles, copayments, and coinsurance. The good news is that these plans include an annual out-of-pocket maximum to limit your expenses. For more information, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What is the “Medicare Part B penalty,” and how does it work?
The Medicare Part B late enrollment penalty is 10% for each 12-month period you delay enrollment without creditable coverage. This penalty lasts for as long as you have Part B. For help avoiding the penalty or understanding your options, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Are prescription drug costs covered by Medicare?
Medicare Part D covers prescription drugs, but you'll still pay some out-of-pocket costs, including premiums, deductibles, and copayments. To learn more about your prescription drug costs, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
How do Medicare deductibles work?
The Medicare Part A deductible is $1,632 per benefit period, while the Medicare Part B deductible is $240 annually. For help understanding your deductibles and costs, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What drugs are covered under Medicare Part D?
To find out if your medications are covered under Medicare Part D, you can review your plan’s formulary or use the Medicare Plan Finder Tool. For personalized assistance, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Can I get prescription drug coverage if I only have Medicare Part A?
Medicare Part A does not include prescription drug coverage. To get coverage for medications, you'll need to enroll in a standalone Medicare Part D plan or a Medicare Advantage Plan that includes drug coverage. For personalized guidance, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What happens if I don’t enroll in Medicare Part D?
Delaying enrollment in Medicare Part D without creditable prescription drug coverage can result in a late enrollment penalty. The penalty is 1% of the national base beneficiary premium for each month you delay and lasts for as long as you have Part D. For help avoiding the penalty, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Can I switch my Part D drug plan if my medications change?
You can change your Medicare Part D plan during the Annual Enrollment Period (Oct 15 - Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1 - Mar 31). Special circumstances may also qualify you for a Special Enrollment Period. For personalized assistance, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What is the Medicare “donut hole”?
The donut hole in Medicare Part D is a coverage gap where you pay 25% of drug costs after your total spending exceeds $5,030. Once your out-of-pocket costs reach $8,000, you enter catastrophic coverage. For personalized guidance, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What services are covered by Medicare Part A?
Medicare Part A covers hospital stays, skilled nursing facility care, home health care, hospice care, and inpatient mental health services. For personalized guidance on your coverage, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What does Medicare Part B cover?
Medicare Part B covers services like doctor’s visits, preventive care, outpatient services, and durable medical equipment, with 20% coinsurance after meeting your deductible. For help with your coverage, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
Does Medicare cover dental and vision services?
Original Medicare doesn’t cover routine dental or vision care, but many Medicare Advantage plans offer these benefits. You can also purchase standalone dental and vision insurance. For help finding coverage, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
What preventive services are covered by Medicare?
Medicare covers preventive care services like screenings for cancer, diabetes, and heart disease, as well as vaccines for flu, pneumonia, and more. For help scheduling your preventive services, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.