COLUMN: Test your Medicare knowledge with this quiz

When families and friends gather around the Thanksgiving table, they usually have a wealth of subjects to share, discuss, perhaps even debate. Yet people of a certain age might enjoy spending a few minutes on this quiz delivering Medicare questions.

Or the Thanksgiving host might wish to offer the quiz to divert the conversation from more contentious topics.

If your Thanksgiving get-together falls into such a category, you could offer this true-or-false quiz. You will find the answers below the 12 questions.

(If you desire help with Medicare questions of your own, consider making an appointment with a SHIBA volunteer Medicare counselor, described at the column’s conclusion.)

Medicare quiz

1. True or false: A Medicare beneficiary with a Medicare supplement (Medigap) Plan F insurance policy would almost certainly save money by switching to Medigap Plan G.
2. True or false: Oregonians must meet an assets test to qualify for any of the three income-related Medicare benefits – reduced pharmacy costs (LIS), not having to pay the Medicare Part B premium (MSP), or having all medical expenses paid for them (QMB).
3. True or false: The couple, both Medicare beneficiaries, are moving to Oregon from another state. To enroll in Medicare insurance here, they must wait for Oct. 15-Dec. 7 open enrollment.
4. True or false: Adding insurance beyond Medicare may be a good idea, but if you’re in poor health you’ll always pay a higher monthly premium.
5. True or false: Medicare Advantage insurance plans available in Oregon are statewide, so you have the same choice of MA insurance plans no matter where you live in the state.
6. True or false: Your Medicare Advantage insurance company has denied a treatment that you are seeking. If you appeal, odds are reasonably good that the company’s denial will be reversed.
7. True or false: If you qualify for SNAP (formerly food stamp) benefits or other income-related state benefits, you will automatically be enrolled in an income-appropriate Medicare benefit.
8. True or false: Original Medicare – that is, Medicare Part A and Part B without additional insurance – puts a ceiling on the amount of money the beneficiary could be billed for medical expenses during the calendar year.
9. True or false: The “Medicare for All” policy that some politicians have promoted would cost Americans about the same as Medicare beneficiaries pay today.
10. True or false: Those Medicare Advantage insurance plans that charge no monthly premium must have coverage that is less than Medicare’s coverage.
11. True or false: If I enroll in Medicare insurance beyond straight Medicare, I will still be required to pay the monthly Medicare Part B premium.
12. True or false: Because the Social Security Administration knows your age, you will be automatically enrolled in Medicare upon turning age 65.

Quiz answers

1. True. Most Medigap Plan F premiums have risen substantially because the plan is no longer offered. As a result, younger, healthier Medicare beneficiaries are no longer enrolling. Plan F is attractive because it pays the annual Medicare Part B deductible ($240 in 2024). However, annual premium savings with Plan G will almost always exceed $240. To make the change without risking a premium surcharge for a pre-existing medical condition, use Oregon’s birthday rule.
2. False. Although the benefit that reduces drug costs at the pharmacy does impose an assets test, the other two benefits have no assets test.
3. False. If they are losing their Medicare insurance because of the move, they will have a special enrollment period to enroll in a new Medicare Advantage or prescription drug insurance plan. They will also have guaranteed issue (that is, no premium surcharge for a pre-existing medical condition) to enroll in a Medicare supplement (Medigap) insurance policy.
4. False. Medicare Advantage insurance plans have the same premium for all enrollees regardless of health status or age. Pre-existing health conditions may increase premiums for Medicare supplement (Medigap) insurance policies, although premium surcharges can be escaped during periods of guaranteed issue (see page 39 of the Oregon Guide to Medicare Insurance Plans).
5. False. In Oregon’s more populated areas, including Marion and Polk counties, a Medicare beneficiary may have a choice of 25 or more Medicare Advantage insurance plans. By contrast, Medicare beneficiaries in several of Oregon’s less-populated counties have access to no MA insurance plans.
6. True. KFF (formerly Kaiser Family Foundation) reviewed appeals made during 2022. It found that, on appeal, 83% of denials were reversed. That’s the good news. The bad: Only 10% of denials are appealed, according to KFF.
7. False. Benefits such as SNAP and Temporary Assistance to Needy Families are managed by the state. Medicare is an unassociated federal program.
8. False. Medicare puts no ceiling on possible medical costs during the year, which is why most beneficiaries add insurance. An expense ceiling exists if the Medicare beneficiary enrolls in insurance, or if a limited-income beneficiary has an income-related benefit (QMB) that pays all medical costs.
9. False. Promoters of “Medicare for All” usually envision coverage with no premiums, no copays for medical services and no deductibles. Most current Medicare beneficiaries experience one or more of these expenses.
10. False. Medicare Advantage plans are required by law to cover at least as much as Medicare does, and they cover more to be competitive with one another. The reason insurance companies can offer no-premium MA plans, as well as low-cost ones, is that Medicare subsidizes the monthly premium by more than $1,000 for all enrollees regardless of their income.
11. True. Medicare beneficiaries are not exempted from paying the Medicare Part B premium if they enroll in Medicare insurance. All beneficiaries pay this monthly premium ($174.70 in 2024) unless they meet income-related eligibility requirements that waive the premium.
12. False. It’s true that Social Security knows your age. But it automatically enrolls people in Medicare only if they have already opted to receive their Social Security benefit or if they have received Social Security Disability Insurance benefits for 24 months.

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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