Medicare seems straightforward, but as you dig a little deeper you may have lots of unanswered questions. Here are short answers to some of the most common Medicare questions we get at MedicareFAQ, with links to articles that will help you learn more.
- Are you automatically enrolled in Medicare?
- Do I have to re-enroll in Medicare each year?
- How many people are on Medicare?
- How is Medicare funded?
- Who qualifies for Medicare?
- When was Medicare established?
- What is the Medicare tax?
- Who do you call for Medicare questions?
- Can Social Security office answer Medicare questions?
- When can I enroll in Medicare?
- How do I enroll in Medicare?
- What does Medicare Part B cover?
- What are Part B excess charges?
- What is the Part B Penalty?
- Can I appeal a Medicare Part B premium?
Are you Automatically Enrolled in Medicare?
If you are already receiving Social Security, you will be automatically enrolled in Part A and Part B when you turn 65. If you are not yet receiving Social Security, you will not be automatically enrolled in Medicare.
Do I Have to Re-Enroll in Medicare Each Year?
You do not have to re-enroll in Medicare—once enrolled, you are covered for the rest of your life. However, there is an Open Enrollment Period from October 15-December 7th every year where you can make changes to your coverage.
How Many People are on Medicare?
About 60 million people are enrolled, according to the Centers for Medicare and Medicaid Services. About two-thirds of them are enrolled in Original Medicare, and about a third have Medicare Advantage plans.
How is Medicare Funded?
Medicare’s money is in two trust accounts held by the U.S. Department of the Treasury. The money in these accounts comes mainly from payroll taxes paid by working Americans. Funding also comes from taxes on Social Security benefits, interest earned by the trust accounts, and premiums paid by people who aren’t eligible to receive Part A benefits for free.
Who Qualifies for Medicare?
US Citizens and permanent residents living in the U.S. for at least five consecutive years are eligible for Medicare if they are age 65 or older. People under age 65 may be eligible if they have been receiving Social Security Disability benefits for at least 24 months, or if they have end-stage renal disease.
When was Medicare Established?
Parts A and B were established by law in 1965. Since then, the law has been amended to make more people eligible and expand the benefits offered by Medicare. The Medicare Modernization Act of 2003 added prescription drug coverage and established the Medicare Advantage program of private Medicare coverage.
What is the Medicare Tax?
To fund the Medicare system, there’s a 2.9 percent tax on every worker’s pay. Your employer pays half the tax, and the other half is taken out of your pay. If you make more than $200,000 in wages in 2019, you will pay an additional Medicare tax of .09 percent of your wages beyond $200,000.
Who do you Call for Medicare Questions?
Can Social Security Office Answer Medicare Questions?
Yes, you can call 1-800-772-1213 which is the National Social Security Hotline. It’s best to ask them questions over the phone.
Medicare Enrollment Questions
When Can I Enroll in Medicare?
If you are turning 65, the best time to enroll in Medicare is during your Initial Enrollment Period. This is a seven-month period that begins three months before the month you turn 65, includes your birth month and ends three months after your birth month. If you enroll during this period, you will not pay any late enrollment penalties and you can also enroll in a Medigap plan with guaranteed coverage.
How Do I Enroll in Medicare?
If you are already receiving Social Security, you’ll automatically be enrolled in Parts A and B when you turn 65. Otherwise, you can enroll online on the Social Security Website.
You can also enroll by phone or in-person at your local Social Security office. You can work with an insurance company or agency to enroll in Medigap, Medicare Part D, or Medicare Advantage plans.
If you’re enrolled in Part A, but not Part B, you can sign up for Part B by completing the CMS 40B form on CMS.gov.
Medicare Part B Questions
What Does Medicare Part B Cover?
Part B covers 80 percent of your medical costs, including doctor visits, lab work, tests, outpatient procedures and trips to the emergency room. Basically any necessary medical care that happens when you are not an inpatient in a hospital.
What are Part B Excess Charges?
In most states, doctors can charge you an extra fee of up to 15 percent if they believe Medicare’s payment rate is too low. If your state allows excess charges, you can avoid them. You can enroll in a Medicare Supplement plan that includes coverage for excess charges, like Plan G.
What is the Part B Penalty?
If you don’t sign up for Medicare Part B when you first become eligible, you will pay a penalty when you do sign up. The penalty amount is added to your monthly premium every month for the rest of your life.
There are exceptions to this rule. This includes an exception for people who wait to sign up for Medicare because they have primary medical coverage through their employer.
Can I Appeal a Medicare Part B Premium?
If your income is above a certain amount, you may be charged a higher premium for Part B and/or Part D. This is known as an Income Related Monthly Adjustment Amount (IRMAA).
In deciding whether you owe an IRMAA, Medicare looks at your tax return from two years ago. If you believe you shouldn’t owe an IRMAA, you can request a new initial determination or appeal Medicare’s decision.
At MedicareFAQ, we want you to be an informed consumer. We answer your most pressing questions about Medicare coverage and help you find plans and policies that are right for your needs. Get started with a free quote by calling us or filling out our form.