Medicare Q and A

Get Your Medicare Questions Answered!

As you navigate Medicare plans and options, you need a little bit of knowledge for each step of the way: when to enroll, which plan to choose, what is covered and not covered, how to switch plans, and information about other intricacies about Medicare. It may be tough and time-consuming to ask Medicare directly, so below find Medicare questions answered that patients most often ask.

  • What are the differences in Medicare “Parts”?

Part A covers hospital visits; Part B covers doctor’s visits, lab tests, and procedures; Part D covers prescription drugs. Medicare Part C (Medicare Advantage) is a combination of Part A, B, and D and additional benefits through a private insurance company and is typically an HMO or PPO.

  • How much do you charge to help with my Medicare decision?

There is never a charge to you for working with NJ Medicare Brokers.  We are compensated by becoming your agent on your policy.  The price of the plans available is the same whether you work with us or go directly through the insurance company, so you might as well have a local Medicare resource!

  • Am I eligible for Medicare?

New Jersey Medicare recipients are typically age 65 and over or on Social Security disability for two years.

  • How are some Medicare Advantage plans $0 a month?

Some Medicare Advantage plans are offered at $0 monthly fee and this can be confusing.  First off, you must continue to pay your Medicare Part B premium with these plans (for most people $148.50 a month).  Secondly, you’ve paid taxes for Medicare your whole working career and this money is now being used to offer you healthcare plans at an affordable rate.  With Medicare Advantage plans the private insurance company takes over your healthcare and Medicare pays the insurance company a monthly stipend to do so.  This amount is based on the county you live in and the star rating of the plan. So when you see $0 a month, know that the insurance company is actually getting a monthly fee from Medicare, but they are not charging you an additional premium.  

  • Does Medicare have out-of-pocket costs?

Yes. Medicare has premiums, deductibles, and other costs such as coinsurances and copays. All plans (even Part A) have deductibles and other associated costs. In order to bridge this gap, Medigap plans are available.

  • What the difference between Medigap and Medicare Supplement?

There is no difference, they are two ways of saying the same coverage.  A Medigap plan (Medicare Supplement) carries a monthly premium, usually taken out when the regular Medicare premium is paid, and it is available through a broker. Medigap plans can cover the many out-of-pocket costs associated with Medicare. Just like Original Medicare, there are several different plans available.

  • Can I switch plans if I’m not happy with my current plan?

It depends on the type of plan you have, when you qualified for it, and whether you receive any extra help with drug costs.  Most of the time you can only switch Medicare Advantage and Drug plans during the Open Enrollment period, which is October 7 through December 15 of every calendar year. It is also possible to make certain changes to plans during January 1 through March 31. If you want to make changes to your Medigap plan, you can usually do this any time of year but medical underwriting may apply.  Speak with one of our trained brokers who will ask the right questions to determine if you are eligible to switch now or have to wait until the open enrollment.

  • What is the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A or B) has a different fee structure than Medicare Advantage (Part C).  For example, Original Medicare has a 20% coinsurance for a doctor whereas Medicare Advantage may have a copay which varies based on the plan.  Original Medicare include medications and must be added on separately, but Medicare Advantage does. Finally Medicare does not have a network of doctors and hospitals but Medicare Advantage is typically HMO or PPO meaning you must stay in a network of doctors and hospitals.

Do you need additional Medicare questions answered? Contact agents at New Jersey Medicare Brokers LLC for informed, unbiased assistance.

Not connected with or endorsed by the United States government or the federal Medicare program.