FAQ

This depends. If you have “qualified coverage” under an employer group plan (and that employer has over 20 employees), then you will not be penalized for delaying Medicare. However, it may still make sense for you to talk with a qualified insurance advisor to find out what makes the most sense for your unique situation. 

No, they are two different ways to fill in the gaps of Medicare. There are pro’s and con’s of each, so it is best to speak to your qualified insurance advisor in order to discern which one might be best for you. 

There are many Medicare Advantage plans with a $0 monthly premium, but nothing is truly “free.” There are typically copays and/or coinsurance that come with a Medicare Advantage plan and there are many pro’s and con’s to each plan. It’s best to speak with your qualified insurance advisor in order to find out what makes the most sense for you. 

There is a Medicare drug “Late Enrollment Penalty” that applies if you don’t get qualified drug coverage within 63 days of when you’re first eligible for Medicare. The penalty generally doesn’t kick in unless you later get a drug plan after your gap in coverage and it’s calculated by the # of months you went without drug coverage. There are certain exceptions to the penalty, like if you have qualified drug coverage through an employer plan, VA coverage, Medicaid, or Senior Care (in Wisconsin). Overall, it’s usually advised to get some sort of drug plan in place when you’re first eligible so that you have it when you need it. But as always, it’s best to talk to your qualified insurance advisor to determine what’s best for your specific situation.  

You’ve likely been paying into Medicare Part A, the hospital coverage. In most cases, there will still be a premium for Medicare Part B, the medical/outpatient coverage. The standard Part B premium in 2023 is $164.90/month. There could be an additional IRMAA (Income Related Monthly Adjustment Amount) based on your household income, so be sure to talk with your qualified insurance advisor to make sure you’re planning appropriately. 

Yes, if you qualify for a “Special Enrollment Period” based on a list of qualifying events. Also, there are Temporary plans that can be applied for at any time and could potentially help bridge the gap to the next Open Enrollment period. Talk to your qualified insurance advisor to find out if you qualify for any of these options.

There have been updates to the Affordable Care Act since it was first implemented and, in most cases, if your income is over the amount that you estimated on your application, you will not have to pay it ALL back. There is a sliding scale based on household income and household size. Be sure to talk with your qualified insurance advisor to find out the specific amount of tax credit that you may be eligible for. 

No, these are completely optional coverages. You’ll need to discuss with your qualified insurance advisor to determine if any/all of these make sense to add to your insurance portfolio.