Individual Guide to Medicare Basics | Kaiser Permanente (2023)

FAQs

What is the best source to learn about Medicare? ›

People with Medicare, family members, and caregivers should visit Medicare.gov, the Official U.S. Government Site for People with Medicare, for the latest information on Medicare enrollment, benefits, and other helpful tools.

Call 1-800-MEDICARE (1-800-633-4227) to talk with a customer support representative about your Medicare questions and concerns—or visit the Medicare.gov website to start a live chat. TTY users should call 1-877-486-2048. The Medicare Support Hotline is available 24/7, except for some federal holidays.

Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

Do you have questions about your Medicare coverage? 1-800-MEDICARE (1-800-633-4227) can help. TTY users should call 1-877-486-2048.

To get a paper handbook, call us at 1-800-MEDICARE (1-800-633-4227).

Does my income affect my monthly premiums for Medicare? It can. If you are what Social Security considers a “higher-income beneficiary,” you pay more for Medicare Part B, the health-insurance portion of Medicare. (Most enrollees don't pay for Medicare Part A, which covers hospitalization.)

If you've had a life-changing event that reduced your household income, you can ask to lower the additional amount you'll pay for Medicare Part B and Part D. Life-changing events include marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment.

To qualify for a Medicare giveback benefit, you must be enrolled in Medicare Part A and B. You must be responsible for paying the Part B Premiums; you should not rely on state government or other local assistance for your Part B premiums.

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $164.90 in 2023, a decrease of $5.20 from $170.10 in 2022.

Who is the largest Medicare Advantage provider? ›

UnitedHealthcare is the largest provider of Medicare Advantage plans and offers plans in nearly nine out of every 10 U.S. counties. UnitedHealthcare also partners with AARP, insuring the Medicare products that carry the AARP name.

Be age 65 or older; Be a U.S. resident; AND. Be either a U.S. citizen, OR. Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare.

For 2023, the Part A deductible will be $1,600 per stay, an increase of $44 from 2022. For those people who have not worked long enough to qualify for premium-free Part A, the monthly premium will also rise. The full Part A premium will be $506 a month in 2023, a $7 increase.

Medicare supplement plans are optional but could save you big $$$ on doctor bills. Your cost-sharing under Part B is similar. You are responsible for paying your Part B deductible, which is $226 in 2023. Then Part B Medicare only pay 80% of approved services.

Many returning Medicare agents say AHIP is easy — once you get the hang of it. Nobody's perfect, especially when learning something new! If you get more questions incorrect than you thought you would, or if you fail your first time taking the final AHIP exam, don't fret.

We provide general information about the Medicare program and can help you get a replacement Medicare card. Notify us timely of address changes, name changes, and deaths. Social Security enrolls you in Original Medicare (Part A and Part B).

Medicare Advantage (Part C): In 2023, the out-of-pocket maximum for Part C plans is $8,300 for approved services, but individual plans can set lower limits if they wish.

The Medicare Part D true (or total) out-of-pocket (TrOOP) threshold will bump up to $7,400 in 2023, a $350 increase from the previous year. The true (or total) out-of-pocket (TrOOP) threshold marks the point at which Medicare Part D Catastrophic Coverage begins.

In 2023, the Medicare Part A deductible is $1,600 per benefit period and the Part B annual deductible is $226. The Centers for Medicare & Medicaid Services (CMS) releases new premiums, deductibles and coinsurance amounts for Part A, Part B and the Medicare Part D income-related monthly adjustment amounts every fall.

At what age is Social Security not taxable? ›

Social Security benefits may or may not be taxed after 62, depending in large part on other income earned. Those only receiving Social Security benefits do not have to pay federal income taxes.

You can sign up for Medicare no matter how much money you make. You'll pay more for Medicare if you're an individual who earns more than $97,000 or part of a couple who earns more than $194,000. You can usually pay less for Medicare if you earn less than $30,000.

People can often make income adjustments before year end to dodge an IRMAA threshold, such as selling losing investments to offset capital gains. Cutting income by as little as a penny can slice almost $1,000 off an individual's annual Medicare premiums at the lowest levels, and thousands at higher levels.

If you don't get premium-free Part A, you pay up to $506 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($164.90 in 2023).

You must have worked and paid Social Security taxes in five of the last 10 years. • If you also get a pension from a job where you didn't pay Social Security taxes (e.g., a civil service or teacher's pension), your Social Security benefit might be reduced.

To acquire the full amount, you need to maximize your working life and begin collecting your check until age 70. Another way to maximize your check is by asking for a raise every two or three years. Moving companies throughout your career is another way to prove your worth, and generate more money.

Social Security recipients will get an 8.7% raise for 2023, compared with the 5.9% increase that beneficiaries received in 2022. Maximum earnings subject to the Social Security tax also went up, from $147,000 to $160,200.

They should also inform SSA that their anticipated 2024 AGI of $150,000 would put them below the high-income threshold and therefore only have it pay the regular Part B premium of $164.90 in 2024. The SSA requires tax returns and qualified life-changing event documentation for IRMAA reductions.

Is Medicare Part B going up in 2024? ›

The basic premium would increase by 2 percentage points at the beginning of each calendar year starting in 2024 until it reached 35 percent of expected costs in 2028 and then would remain at that percentage.

Also starting in 2024, the calculation of the base beneficiary premium will be adjusted, as needed, to limit increases in the base premium to no more than 6% from the prior year. (Premiums for individual Part D plan premiums and annual plan-level premium increases will continue to vary, however.)

Part A (Hospital Insurance) costs. $0 for most people (because they or a spouse paid Medicare taxes long enough while working - generally at least 10 years).

Many Medicare Advantage plans offer additional benefits , such as money toward dental or vision care, which isn't covered by original Medicare. About 1 in 4 people say extra benefits pushed them to choose Medicare Advantage, according to a survey by the Commonwealth Fund, a health care think tank.

Medicaid is the most affordable plan for seniors and retirees who have low incomes. The Medicaid public health insurance program provides free or affordable insurance for those who are eligible.

If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare Part A & Part B.

Medicare Eligibility for People Who've Never Worked? Regardless of your work history, you are eligible for Medicare at age 65 (or younger in some cases) if you're a U.S. citizen.

Average health insurance premiums by tier

The average rates paid for health insurance plans generally are inversely related to the amount of coverage they provide, with platinum plans being the most expensive and catastrophic and bronze plans being the cheapest.

Part A late enrollment penalty

If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.

Will Medicare be cut in 2023? ›

Physicians are facing a 2% cut in Medicare payment in 2023, and 2024 will bring at least a 1.25% cut.

Social Security and Supplemental Security Income (SSI) benefits for approximately 70 million Americans will increase 8.7 percent in 2023.

Because Medigap plans are sold by private insurance companies, they can charge different monthly premiums. While plans are standardized in regard to coverage and benefits, they are not standardized in regards to cost. Cost can even increase over time based on inflation, your age and other factors.

Medicare Supplement typically has a higher monthly premium compared to Medicare Advantage. Specifically, Medicare Advantage plans could cost between $0 and $100 a month, while Supplement coverage may vary between $50 and $1,000 per month.

Medicare Part B pays 80% of the cost for most outpatient care and services, and you pay 20%. For 2023, the standard monthly Part B premium is $164.90.

AARP/UnitedHealthcare is the most popular Medicare Advantage provider with 28% of all enrollment. Plans are well-rated and have affordable premiums and add-on benefits, a valuable combination that could account for AARP/UHC having the largest number of Medicare Advantage enrollees.

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You can join a separate Medicare drug plan to get Medicare drug coverage (Part D). You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

Funding for Medicare Comes Primarily from General Revenues, Payroll Taxes, and Premiums. Funding for Medicare, which totaled $888 billion in 2021, comes primarily from general revenues (46%), payroll tax revenues (34%), and premiums paid by beneficiaries (15%) (Figure 8).

What does ABCD mean in Medicare? ›

Part A provides inpatient/hospital coverage. Part B provides outpatient/medical coverage. Part C offers an alternate way to receive your Medicare benefits (see below for more information). Part D provides prescription drug coverage.

$0 for most people (because they or a spouse paid Medicare taxes long enough while working - generally at least 10 years). If you get Medicare earlier than age 65, you won't pay a Part A premium. This is sometimes called “premium-free Part A.”

What's the least expensive Medicare Supplement plan? Plan K is the cheapest Medigap plan, with an average cost of $77 per month for 2023. For those who are only interested in protecting themselves against major medical expenses, high-deductible Plan G costs $47 per month, on average.

If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($164.90 in 2023).

Although nearly everyone will get free Medicare Part A, the total cost for all components of Medicare will typically be between $165 and $370 per month. These costs are waived or reduced for those who qualify for low-income financial assistance programs.

Medicare hospital insurance benefits, aka Medicare Part A, are expected to fully pay out until 2031, a three-year improvement from the last trustee report.

Income taxes paid on Social Security benefits. Interest earned on the trust fund investments.