Quizzes can be fun, especially if your academic or career future doesn’t hinge on your answers’ accuracy. Your score on this Medicare quiz will have no negative consequences, although misunderstanding Medicare’s rules could affect your health-care coverage, the premiums you pay or even your health status.
These are true-or-false questions. You will find answers at the end.
1 True or false: Although employers pay hundreds of dollars a month for employee health insurance, all Medicare insurance is free.
2 True or false: I’m going to wait until age 70 to draw my Social Security benefit. As a result, I can also wait until age 70 to enroll in Medicare.
3 True or false: I’m 65, retired and have health insurance through my spouse’s employer. I still need to enroll in Medicare, though.
4 True or false: When I retire at age 65, my employer has generously agreed to pay much of the premium for a year of COBRA health insurance. Now I can wait until my COBRA coverage ends to enroll in Medicare.
5 True or false: Medicare Advantage insurance plans that don’t charge a premium are pretty much all the same. All I need to do is be sure the insurance covers my prescription drugs and that my doctor accepts it.
6 True or false: My spouse and I have a monthly gross income of $2,020, but we still have to pay the Medicare Part B premium.
A Senior Health Insurance Benefits Assistance (SHIBA) volunteer counselor can help you with these and other Medicare subjects. If you would like to make an appointment, or to ask a question to be answered here, please see the end of this column.
Answers
1 False. Some Medicare Advantage insurance plans are free (that is, charge no monthly premium), but most do charge a premium. Even with zero-premium insurance plans the insured usually pays a co-pay for medical services. And most beneficiaries pay the monthly Medicare Part B premium of $165. That said, the cost of even the most expensive Medicare insurance is heavily subsidized by Medicare.
2 False. Medicare expects Americans to enroll in Medicare at age 65 unless they have “creditable” insurance through an employer. Not doing so can prove costly by triggering lifetime Part B and Part D penalties. (Persons with SSDI insurance will be automatically enrolled in Medicare in the 25th month of drawing disability benefits.)
3 False. You may enroll in Medicare, but it isn’t required if your spouse’s insurance is “creditable” as defined by Medicare (that is, it’s as good as or better than Medicare). Check that it is with the employer’s human resources (personnel) department. Enrolling in premium-free Medicare Part A is still a good idea, though, because that makes later Part B enrollment a bit easier.
4 False. Medicare does not define COBRA insurance as “creditable.” As a result, a person who does as described would be subject to significant lifetime penalties for not enrolling in Medicare Part B and for not having appropriate insurance for prescription drugs.
5 False. Those two factors – coverage of your prescription drugs and your doctor’s acceptance – are essential. Beyond that, though, even zero-premium insurance plans differ radically. Not only do a patient’s co-pays differ from one plan to another, but the maximum annual out-of-pocket cost for medical services ranges from $4,500 to $7,500.
6. False. A couple with a monthly income that doesn’t exceed $2,239 should be eligible to have the State of Oregon pay their Medicare Part B premium, which this year is $165 a month. (The figure for a single person is $1,660. This benefit has no assets test.) This benefit isn’t automatic, however. In Oregon, a Medicare beneficiary may apply for it by calling the Aging and Disability Resource Connection at 855-673-2372.
Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone, Zoom or in-person appointment with a volunteer Medicare counselor, call 800-722-4134.
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