MEDICARE QUIZ & ANSWERS. How would you answer these 10 statements about Medicare – TRUE OR FALSE? Answers are provided after each question. Comments are welcome, below, if you wish to share something you learned today once you've read through this information.
*Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
1. Medicare is health insurance only for people age 65 and older.
FALSE – Besides people age 65 and older, Medicare covers people under age 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD – permanent kidney failure requiring dialysis or a kidney transplant).
2. Medicare Part A is generally described as “Hospital Insurance” and helps cover: Inpatient care in hospitals and skilled nursing facilities, hospice care and home health care.
TRUE - Part A covers these items but does NOT cover custodial care in a skilled nursing facility or long-term care in a nursing home.
3. If you’re close to age 65, but not getting Social Security or Railroad Retirement Board (RRB) benefits now, you will automatically be enrolled in Medicare Part A.
FALSE – Most people must sign up for Medicare Part A during the 7-month period that begins 3 months before the month you turn age 65 (includes the month you turn 65) and ends 3 months after the month you turn age 65. You are automatically enrolled in Medicare Part A only if you're already getting benefits from Social Security or the Railroad Retirement Board, are under 65 and disabled or have ALS, also called Lou Gehrig’s disease.
4. You must sign up for Medicare Part B (Medical Insurance) at the same time you enroll for Medicare Part A.
FALSE – You may want to delay signing up for Medicare Part B if you or your spouse are still working and you are covered under a group medical plan of an employer with 20 or more employees or have union coverage. Under those conditions you can sign up for Part B later without paying a penalty. Otherwise, if you delay signing up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have the coverage.
5. For most people age 65 and over Medicare Parts A & B are provided as a free benefit.
FALSE - You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. However, most people will pay the standard premium amount ($104.90 per month in 2015) deducted automatically from their Social Security monthly benefit amount.
6. You must be enrolled in both Medicare Parts A & B in order to buy Medicare Supplemental Insurance, also called Medigap to help pay the copayments, coinsurance, and deductibles not covered fully by Medicare.
TRUE – After you are enrolled in both Medicare Parts A & B, then you are eligible to purchase a supplemental Medigap policy from a private insurance company. By law, Medigap plans have standardized benefits and are available in 10 plans labeled Plans A, B, C, D, F, G, K, L, M or N. These plans are offered by various insurance companies and premiums vary between companies, plans and states of residence. Premiums are paid directly to the issuing insurance company.
7. You do not need to be enrolled in both Medicare Parts A & B in order to enroll in Medicare Part C, a MedAdvantage Plan.
FALSE – You must have both Medicare Parts A & B, live in the MedAdvantage Plan’s service area, not have End-Stage Renal Disease, and be a US citizen or lawfully present in the United States to enroll in Medicare Part C. MedAdvantage plans are offered by private insurance companies that Medicare approves and are another way to get your Medicare coverage. Your Medicare benefits are paid through the MedAdvantage plan’s insurance company (like an HMO or PPO) and may offer extra coverage like vision, hearing, dental and other health and wellness benefits. In addition to your Part B premium, you pay a monthly premium for the Medicare Advantage Plan direct to the issuing insurance company. If you have a MedAdvantage plan you are NOT allowed to also have a Medigap plan.
8. Medicare Part B (Medical Insurance) includes services from doctors and other health care providers, outpatient care and outpatient prescription drugs.
FALSE – Outpatient prescription drugs are not covered under Medicare Part B. Medicare prescription drug coverage is provided under Medicare Part D.
9. Medicare Part D provides prescription drug benefits as an optional coverage available only from an approved Medicare Prescription Drug Plan (PDP).
TRUE – To get Medicare prescription drug coverage, you must join a plan approved by Medicare that is available from various private insurance companies. Each plan can vary in cost and specific drug coverage.
10.Choose your Medicare Prescription Drug Plan carefully because once selected you can NOT change plans.
FALSE – You can switch to a new Medicare drug plan during Open Enrollment between October 15 and December 7 each year. You don’t need to cancel your old drug plan. Your old drug plan coverage will end when your new drug plan begins. You will be notified by your new Medicare drug plan telling you when your coverage with the new plan begins.
Contact Us: For most eligible Americans, Medicare benefits are supplemented by private insurance coverage. There is no additional cost to consumers to learn more about supplemental coverage by consulting with an AHIP certified and licensed Health Insurance Agent. Idaho and Washington State residents are invited to contact AMERICAN INSURANCE for more information.
Source: Centers for Medicare & Medicaid Services,
NOTE: Medicare benefits are complex and changes may occur after this article is published. The answers provided here are necessarily general and brief. Official Medicare Program legal guidance is only contained in the relevant statutes, regulations, and rulings. For more information visit Medicare.gov.
The content of FAQ articles are general in nature and are not intended as a substitute for professional legal, financial, or insurance counsel for individuals. Insurance coverage forms vary by issuing company and by state. For specific advice contact us.
American Insurance NW Inc. is an independent insurance agency with offices in Lewiston and Moscow, Idaho.