Medicare Surprises

Medicare surprises

For most people who are eligible for Medicare Part B, the monthly premium in 2023 is $164.90. However, some people may pay more, up to$560.50 per month, due to their income exceeding certain levels. This additional cost is known as an income-related monthly adjustment amount (IRMAA)and may also apply to Medicare Part D.

If you sign up for Original Medicare, it is often recommended that you also purchase a Medicare supplement insurance plan (Medigap) to cover costs such as copayments, coinsurance, and deductibles. Private insurance companies sell Medigap policies at an additional cost to your standard Original Medicare premium. If you choose Medicare Advantage coverage instead, you do not need to purchase a Medigap policy and can’t have both a medigap and advantage plan in place at the same time.

While Medicare covers most healthcare needs in retirement, there are some services not covered by Original Medicare, such as dental and routine vision care, care received outside the U.S., long-term care, and chiropractic care. Medicare Advantage plans may offer additional benefits, including some of these items.

When you first sign up for a Medigap plan, no insurer can deny you coverage or charge you more due to pre-existing conditions. However, if you drop your Medigap coverage and later decide to return to Original Medicare, you may not have the same protections when you first signed up for Medigap, making it costly or difficult to obtain a policy.

If you sign up for Original Medicare and do not purchase a private add on plan (medigap or advantage), there is no yearly limit on your out-of-pocket costs. This means you could be responsible for a large sum of money if you experience a serious and expensive health issue. Medicare Advantage plans have out-of-pocket cost limits, and once you reach that limit, all costs are covered at 100% for the rest of the calendar year.

Late enrollment for Medicare Part B or Part D results in a penalty added to your premium, and this increased cost lasts for the rest of your life. There are no opportunities for a "do-over."

Medicare Advantage plans typically limit your provider choices Some Medicare Advantage plans limit which doctors you can see, as they try to keep costs down. It's important to compare plans to find the coverage that best fits your needs.

Contact us here to learn more about your options and find out how we can help you.

‍