Q: What is Medicare?
A: Medicare is a federal health insurance program for people 65 and older and people under 65 with certain disabilities. It is run by the Centers for Medicare & Medicaid Services or CMS, a branch of the Department of Health and Human Services.
Q: Who is eligible for Medicare?
A: If you are over 65, you must be a US citizen or permanent legal resident. If you are under 65, you must be entitled to Social Security for at least 24 months, have End-Stage Renal Disease, or ALS.
Q: What are the different parts of Medicare?
A: Part A is hospital insurance, Part B is medical insurance, Part C is a Medicare Advantage plan, and Part D covers Prescription Drugs.
Q: What doesn’t Medicare cover?
A: Original Medicare does not include coverage for prescription drugs or routine care like vision and hearing exams. It also does not cover dental care, worldwide emergency or urgent care outside the United States, or long-term care.
Medicare does not have a maximum out-of-pocket limit and does not include coverage for Annual Physicals.
Q: What is the difference between a Medicare Advantage plan and Medicare Supplement plan?
A: Medicare Advantage plans cover Part A (hospital) and Part B (medical) benefits and most include Part D prescription drug coverage under a single health plan. They also often include benefits beyond Original Medicare such as routine care and worldwide emergency and urgent care and supplemental benefits such as dental coverage.
Medicare Supplement plans help with some of the out-of-pocket costs Medicare doesn’t cover—such as deductibles and coinsurance. It essentially supplements your Original Medicare coverage by filling the gaps in coverage rather than taking over Medicare coverage like a Medicare Advantage plan.
Q: How do I avoid Medicare's Health Savings Account (HSA) tax penalty?
A: Medicare Advantage plans cover Part A (hospital) and Part B (medical) benefits and most include Part D prescription drug coverage under a single health plan. They also often include benefits beyond Original Medicare such as routine care and worldwide emergency and urgent care and supplemental benefits such as dental coverage.
To avoid a tax penalty, you and your employer should stop contributing to your HSA at least 6 months before you apply for any part of Medicare. You can withdraw money from your HSA after your Medicare coverage starts to help pay your share of costs (like deductibles, premiums, coinsurance or copayments). If you have a Health Savings Account (HSA) with a High Deductible Health Plan (HDHP) based on your or your spouse’s current employment, you may be eligible for a Special Enrollment Period to sign up for Part B without penalty.