Medicare FAQ
The following Frequently Asked Questions will pertain mainly to the state of Connecticut.
Each state can change the answers/recommendations below.
These are my personal responses to the questions I receive the most when meeting with individuals.
However, every answer can be different for every person.
It's very important to talk to a professional to discuss your personal scenario.
When will I receive my Medicare card?
Depends. If you are receiving Social Security income already, the card will automatically be sent to you in the mail. If you are NOT receiving Social Security income already, you need to manually apply for Medicare yourself either online through ssa.gov or by calling your local Social Security office. Find your local office HERE.
What’s better MAPD or MediGap?
Everyone is different. What I always tell my clients, nobody has the same job, given the same benefits, have the same income, seeing the same doctors, taking the same prescriptions, have the same needs, wants and concerns. Again, EVERYONE IS DIFFERENT. Let me help you customize a plan to you!
Do I need Medicare if I’m still working?
Depends. I like to separate this into 3 different scenarios:
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Option 1, You are retired and need Medicare or… Medicare is better and/or cheaper than your current work coverage. Medicare can be a good alternative.
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Option 2, if your work coverage is better and/or cheaper and you ARE NOT contributing to a HSA (Health Savings Account). I will recommend picking up Medicare Part A only. This will make the transition to get Part B later on easier.
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Option 3, if your work coverage is better and/or cheaper and you ARE contributing to a HSA (Health Savings Account). Do not pick up Medicare at all, however you need to be aware that you need to STOP contributing to your HSA 6 months prior to picking up Medicare or you will be penalized. Their are a few extra steps you need to make if you take this route.
Let me help you confirm what option is best to take!
What do I do if I delayed Medicare past my turning 65 Initial Enrollment Period?
Depends on if you choose Option 2 or Option 3 from above. Regardless you need to complete 2 forms: CMS-40B (I want to pick up Medicare Part B) & CMS-L564 (I had creditable coverage through work) and send them to your local Social Security office. Completing these forms will avoid penalties from you delaying Medicare. Make sure you complete these forms in a timely manner so you don’t have a gap in coverage. Please give me a 3 month heads up for Option 2 and a 6 month heads up for Option 3 for a smooth transition!
How do I avoid penalties?
Their are a variety of different penalties associated with Medicare. The easy answer is by having a SEP (Special Enrollment Period), creditable coverage and no gap in coverage. There are many types of SEPs that you may qualify for. Be aware, COBRA and AHCT does not count towards having creditable coverage.
I am a Veteran, do I need Medicare?
Depends. Some Veterans only have Medicare Part A only and are happy with their existing VA benefits. Although Medicare can be a great alternative for getting a second pair of eyes outside of your VA clinic or if you are a traveler and don’t want to worry about the VA out of state. If you get your Rx’s through the VA, you have an option to not pick up a Part D or a MAPD plan, you have an option to pick up a MA (Medicare Advantage) plan without the PD (prescription drugs). If you choose to pick up a Part D or MAPD plan later on, you will not be penalized. If you are receiving TriCare for Life, I would usually only recommend picking up Medicare Part A and Part B alone, usually I would not recommend getting anything else since TriCare for Life is amazing! But you do have an option to get an alternative plan as well, however submitting claims would become a regular occurrence. Also, THANK YOU FOR YOUR SERVICE!
Can I just keep my Husky D (Medicaid) in Connecticut?
If you are Turing 65 you need to transition to MSP (Medicare Savings Program). Husky D is only for people 64 or younger. This transition to MSP will help you pay for Medicare Part B premiums and maybe pay for all medical services similar to Husky. Depends on what you qualify for based on your income. There are 3 different levels to MSP in Connecticut: QMB, SLMB, and ALMB. After you transition to MSP, you are now eligible for a DSNP Advantage Plan that can add some awesome extra benefits. Let me help you complete the proper paperwork for a smooth transition and shop your benefits! Click HERE to see the income levels in Connecticut.
How do I get the Medicare Part B premium paid for, $164.90 per month for year 2023?
You need to qualify for MSP (Medicare Savings Program) which is based on income only in Connecticut, not assets. Every state is different. Click HERE for income levels in CT.
How do I know what plan I should choose?
Do not call 1-800 tv commercials.
Do not call solicitations mailed to you.
CALL ME, your local Medicare Broker, for a FREE Medicare comparison schedule and FREE Medicare formulary review!
How much does it cost to speak to you?
You will never pay for my education and insurance services. I can promise you one thing, you will not be disappointed!
Can I switch my plan, MAPD to MediGap, MediGap to MAPD?
Every state is different but yes you can. In Connecticut no medical underwriting and no pre existing conditions necessary for plan selections. You can change to any plan you desire during AEP (October 15th to December 7th) that will be effective for a January 1st start date for the following year. Also, in Connecticut, every plan has fixed rates so a 65 year old will get the same rate as a 95 year old and all plans are guaranteed issue.
How much will I pay for my Rx’s?
Let’s run a formulary review so we can find the best plan that will save you the most money throughout the year. However, Rx formulary’s in every plan do change on an annual basis. Generic Rx’s will always be cheaper than brand name Rx’s. And yes, pharmacies can make a difference, their are preferred and standard pharmacies for every plan, as well as mail order options. You can also consider using 3rd party Rx discount providers such as GoodRx or SingleCare to help reduce your costs for some Rx’s. Give me a call for a formulary review!
I don’t have any Rx’s, do I need an Rx plan?
No. However, every month you do not have a Rx plan (Part D or MAPD) Medicare will penalize you. This penalty is for your entire lifetime. Having that said, I do recommend you have a Rx plan in place from the start.
Does Original Medicare cover dental and vision?
No. Medicare alone does NOT cover dental and vision. However, your MediGap plan might offer you a discount only, a standalone Dental/Vision plan might be recommended if you take this route and if it is important to your healthcare needs and wants. Your Part C - Medicare Advantage Plan might have dental and vision insurance built into the plan. Whatever you choose, every plan and every company has there own unique benefits.
Should I shop my plan every year?
Depends. I would recommend shopping your MAPD/PDP plan at least every other year. New plans do come out every year and you can be missing out on better benefits or saving money. As your health and Rx changes, I might recommend making a transition to another plan. My service to my clients is to reach out every AEP (October 15th to December 7th) for our annual review to make sure you will be best suited for the next calendar year.
What if I’m planning on moving out of Connecticut?
I have great connections with local brokers in all 50 states thanks to my partnerships. You will be required to change to a plan in your new servicing area. As I mentioned before, EVERY STATE IS DIFFERENT. I will be able to help you with a smooth move!
Will I be cover out of the country?
Yes. MediGap and MAPD plans generally coverage out of the country for EMERGENCY and URGENT care only. Not for regular doctor visits. The amount of coverage depends on the plan you have.
Will my premium increase on me?
Depends. Medicare Part B in 2021 was $148.50/month. Medicare Part B in 2022 was $170.10/month. Medicare Part B in 2023 is $164.90/month. Medicare Part B does change every year, however so does your Social Security income. When it comes to your MediGap and MAPD plan, premiums can change as well. I will make sure to keep you informed about premium changes on an annual basis!
Why is my Medicare Part B and Part D more than $164.90/month?
This will apply to higher income earners. Medicare Part B and Part D premiums are based on your income from 2 years ago. Example: what you pay for 2023 is based on your income from 2021. Income is based on your MAGI (Modified Adjusted Gross Income). The increase in premium is called IRMAA (Income Related Monthly Adjustment Amount). This increase in premium can be reduced by completing an IRMAA Form since you might have had a life changing event, like retirement/reduction of income.
How do I pay for my Medicare Part B premium?
If you are collecting your Social Security income, they will automatically deduct the $164.90 from your retirement benefits. If you are not collecting, Medicare will bill you by mail, quarterly. If you do not want to pay quarterly and do not want to collect your benefits. You can create an account on MEDICARE.GOV to set up automatic bank deductions.
When should I start collecting my Social Security Income?
Depends. Everyone is different. You can collect as early as 62 and delay collecting until 70. The longer you wait, the more it will accumulate over time. After 70 years old, your income will no longer increase and you should definitely start collecting then. Your Full Retirement Age (FRA) is based on the year you are born. Example. If you are born in 1957, your FRA is 66 and 6 months. If you are born in 1958, your FRA is 66 and 8 month. If you start collecting your income before your FRA, you are limited to making less than $21,240 for 2023. However you can make more than $21,240 but for every $2 you make over, they will take $1 from your retirement benefits. Starting with the month you reach full retirement age, there is no limit on how much you can earn and still receive your benefits.
How do you get paid if all of your services are FREE?
Since I represent all major healthcare carriers in CT, once I help you choose the best possible plan, the carriers are the ones who compensate me. Not you. This goes for all areas of your retirement planning. I am here to help!
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