Medicare and Medigap Insurance: FAQ
Medicare and Medigap Supplemental Insurance: Frequently Asked Questions
- What Is Medicare?
- How Do I Apply For Medicare?
- What is Medigap Insurance?
- Where Can I Get Medigap Insurance?
- Who Qualifies For Medicare?
- How Much Will My Premiums Be?
- How Do I Pay My Premium?
- Does My Medigap Cover My Spouse?
- What If I Can’t Afford Medicare?
- What’s The Difference Between Medicare And Medicaid?
- When Can I Enroll In Medicare?
- What Are Medicare Parts?
- What Is The Medicare Donut Hole?
- What Is A Medicare Advantage Plan?
- What Is The Medicare Trust Fund?
- What Is A State Health Insurance Assistance Program?
- Can I Get My Medicare Through My Employer?
What Is Medicare?
Medicare is a federal health insurance program offered to U.S. citizens who are 65 and older, as well as some younger people with disabilities who qualify.
How Do I Apply For Medicare?
Some people get Medicare Part A and Part B automatically, and some have to sign up for it. Those responsible for paying a Part B premium have the option to decline coverage. To sign up for prescription drug coverage or additional coverage plans, you can contact your local Social Security Office or apply online at Medicare.gov
What is Medicare Supplemental Insurance?
Medicare Supplement Insurance (Medigap) is insurance that helps to fill the “gaps” in regular Medicare coverage.
Who Qualifies For Medicare?
Generally, you are eligible for premium-free Part A and Medicare Part B if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You may be eligible to get Medicare earlier if you have a qualifying disability, end stage renal disease (ESRD), or ALS (also known as Lou Gherig’s disease).
Where Can I Get Medigap Insurance?
You can sign up for a medigap plan through a licensed insurance agent, or directly with an insurance company. However, you can only sign up after you’ve signed up for Medicare A and B.
How Much Will My Premiums Be for Medigap Coverage?
The cost of premiums can vary, and fluctuate from state to state and year to year. To get an idea of what your Medicare expenses might be, the Centers for Medicare & Medicaid Services offers an Out-Of-Pocket Cost Calculator.
How Do I Pay My Premium for Medigap Coverage?
The premiums you pay are paid to the private insurance company through which you have enrolled in Medigap insurance. The premium you pay is on top of the Medicare Part B insurance premium you pay directly to Medicare.
Does My Medigap Cover My Spouse?
Medigap policies only cover one beneficiary. They do not cover your spouse, your child, or anyone else.
What If I Can’t Afford Medicare or Otherwise Cover My Healthcare Expenses?
If you find yourself struggling to afford the cost of your healthcare, you may qualify for federal and state subsidies. This often comes in the form of Medicaid.
What’s The Difference Between Medicare And Medicaid?
Medicare is a program provided by the federal government and consists of multiple parts Medicaid is a program administered by the states for those who qualify due to low income or other factors. It may covers some or all of the costs of Medicare.
When Can I Enroll In Medigap (Medicare Supplement) Insurance?
Medigap Insurance has a six month open enrollment period that starts on the first day of the month in which you turn 65 and are enrolled in Medicare Part B. Outside of the Medigap open enrollment period, you may still be able to enroll, but an insurance company is not required to accept your application and may take your health into account when determining premiums.
What Are Medicare Parts?
Medicare comes in different parts: Part A, B, C, and D, that cover different healthcare services. Click here for more information.
What Is The Medicare Donut Hole?
The “Donut Hole” is the out-of-pocket costs you will need to pay for your prescription drugs after you and your insurance have paid a certain amount, before your yearly limit is reached and Medicare begins to pay your costs again (subject to your coinsurance costs). From Medicare.gov, once you and your plan have spent $4,430 on covered drugs in 2022 ($4,660 in 2023), you are in the coverage gap. This amount may change each year.
What Is A Medicare Advantage Plan?
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all in one” alternative to Original Medicare offered by private insurance companies.
What Is The Medicare Trust Fund?
The Medicare trust fund finances health services for beneficiaries of Medicare. It is financed by payroll taxes, general tax revenue, and the premiums enrollees pay.
What Is The State Health Insurance Assistance Program (SHIP)?
The State Health Insurance Assistance Programs (SHIPs) provide local, in-depth, and objective insurance counseling and assistance to Medicare-eligible individuals, their families, and caregivers.
Can I Get My Medicare Through My Employer?
No. Medicare is not offered through union or employer health insurance programs.