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Medicare 101: A Must-Read Guide to the Basics

Answers to frequently asked questions about the health insurance program for people 65+

Q: Will I pay a large deductible before getting Medicare coverage?

A: Medicare does have some deductibles, but they’re relatively small compared with the ones many people pay in high-deductible health plans outside of Medicare. In 2013, the annual Part B deductible is $147; the maximum annual Part D deductible is $325; and the maximum Part A deductible for a hospital stay is $1,184 in traditional Medicare. (Medicare Advantage health plans charge differently for inpatient care.)

Q: Will my health issues and preexisting medical conditions count against me?

A: No. Current and past health problems don’t bar anyone from Medicare coverage or cause anybody to pay higher premiums or copays than somebody who is in perfect health. That kind of discrimination has never existed in Medicare. A history of smoking, alcohol use or obesity doesn’t increase rates either.

Q: Can I get Medicare if I haven’t worked long enough to qualify?

A: It’s possible. You may qualify on the work record of your current, divorced or deceased spouse. (In states that recognize same-sex marriage, this would include same-sex spouses.) If so, you’ll be entitled to Part A services without paying a monthly premium. Or you can choose to buy into the system by paying premiums for Part A. Regardless of your work record, you can get Part B and Part D services by paying the same premiums as anybody else.

Q: I plan to take my Social Security benefit early. Can I sign up for Medicare at 62?
A: No. Nobody can get Medicare benefits before age 65, except for those who qualify at an earlier age because of disability.

Q: Will Medicare cover my younger spouse or other dependents?

A: No. Family coverage doesn’t exist in Medicare — not for spouses, dependent children or other family members. Also, if you and your spouse are both in Medicare, each of you must pay premiums separately and in full unless you receive government assistance to help pay them. Medicare doesn’t give price breaks to married couples, even in its private Medicare Advantage health plans and Part D drug plans.

Q: Do I have to sign up for Medicare if I continue working after 65?

A: Yes, unless you’re covered by health insurance from an employer for whom you or your spouse is still working (and the employer has 20 or more employees). If so, you can delay Medicare enrollment until you or your spouse stops work, without risking any late penalties. (This rule may be different if you’re in a same-sex marriage or live abroad.)

Next page: Medicare and Obamacare. »

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