Although Medicare has been around since 1965, many changes are implemented each year. Plan options and premiums can change, but the rules for enrollments may stay the same. Here are five facts about Medicare today in 2022.
Medigap Plan Options
When you enroll in Medicare Part A and Part B, you can enroll in a Medigap plan or a Medicare Advantage plan. Both of these options help with your out-of-pocket costs after Medicare.
Medigap plans will be secondary to Original Medicare. They help cover your deductibles, copays, and coinsurance. However, the plans available to you may not be available to someone else.
For example, Medigap Plans F and C are unavailable to anyone who becomes Medicare eligible after January 1, 2020. Anyone eligible before then can still enroll in either plan. However, those who become Medicare eligible after that date cannot enroll in Plan F or Plan C but will likely find that Plan G or Plan N are more cost-effective. For more information on the difference between these plans, you can go to boomerbenefits.com/medigap-plan-f-vs-plan-g-vs-plan-n/.
Your Medicare Costs in 2022
Original Medicare consists of Part A and Part B. If you’ve worked at least 40 quarters in the U.S., you will pay $0/month for Part A. However, if you worked 30-39 quarters, you’ll pay $274/month, and if you worked less than 30 quarters, you’d pay $499/month in 2022. However, you can use your spouse’s work credits to qualify for premium-free Part A.
Everyone must pay the Part B premium, and in 2022, the standard Part B premium is $170.10. This will be deducted from your Social Security check each month if you receive Social Security benefits. If not, you will receive a quarterly bill in the mail.
Additionally, you could pay more for Part B if you are subject to an Income Related Monthly Adjustment Amount (IRMAA). Social Security looks at your modified adjusted gross income from two years before to determine what you will pay for Part B this year. If your income is above a certain threshold, you’ll pay more. However, you can appeal IRMAA if you qualify for a life-changing event such as work stoppage or divorce.
Vaccinations Covered in 2022
Medicare Part B does cover most vaccinations at 100%. You would not pay for the flu shot, COVID-19 vaccine, COVID-19 booster, pneumonia vaccines, or Hepatitis B vaccine. Be sure to speak with your healthcare provider about these vaccines and which ones you may want to get.
A vaccine that many people think Part B covers is the Shingles vaccine. However, Medicare Part D covers this vaccine. You may need to reach your Part D deductible first before the plan kicks in.
You Can Be Automatically Enrolled in Medicare
Some Medicare beneficiaries will be automatically enrolled in Medicare Part A and Part B. If you are receiving Social Security benefits for at least four months before your 65th birthday month, you will be automatically enrolled in Medicare. Additionally, if you collect SSDI for 24 months, you will be automatically enrolled in Part A and Part B.
If you are not collecting Social Security benefits, you will need to enroll in Part A and Part B when you are eligible. If you choose to delay Medicare past 65 and begin taking Social Security benefits, Social Security will automatically enroll you in Part A only.
Original Medicare Does Not Cover Drugs
Original Medicare generally does not provide drug coverage. Drugs administered by a healthcare professional or durable medical equipment can be covered by Part B. However, Medicare does not cover retail prescriptions that you pick up from the pharmacy. Instead, they are covered by Medicare Part D. Part D plans are sold by private insurance companies and vary by zip code. The plan that best fits your needs will likely be different from another Medicare beneficiary.
Medicare can be challenging to navigate through, and these five facts are just a tiny glimpse into the Medicare world. Working with a licensed Medicare broker can be beneficial as they can guide you through your options and help you with your enrollments.