Frequently Asked Questions
Can I negotiate my medical bills?
Yes, in many cases you can. The first step is to ask for a detailed, itemized bill and check it for errors. If the charges are correct but unaffordable, call the hospital or clinic’s billing department. You can ask if they offer a discount for paying the bill in full immediately or if they can set you up with a no-interest payment plan. Many providers would rather receive a smaller amount or get paid over time than have to send the bill to a collection agency.
How does my income affect my Medicare premiums?
Higher-income beneficiaries pay higher premiums for Medicare Part B and Part D. This is called the Income-Related Monthly Adjustment Amount (IRMAA). The Social Security Administration determines if you owe an IRMAA based on the modified adjusted gross income you reported on your IRS tax return from two years ago. For example, to determine your 2024 premiums, they would look at your 2022 tax return. If your income as an individual was above $103,000 in 2022, you would pay more than the standard Part B premium in 2024.
What’s the difference between an HMO and a PPO Medicare Advantage plan?
An HMO (Health Maintenance Organization) plan generally requires you to use doctors, hospitals, and specialists within its network of providers. To see a specialist, you typically need a referral from your primary care physician. A PPO (Preferred Provider Organization) plan offers more flexibility. You can see both in-network and out-of-network providers, but your out-of-pocket costs will be lower if you stay in-network. You usually do not need a referral to see a specialist in a PPO plan.
Does dental and vision care get covered by Original Medicare?
No, Original Medicare (Parts A and B) does not cover most routine dental care, such as cleanings, fillings, or dentures. It also does not cover routine eye exams or eyeglasses. Coverage for these services is a common extra benefit found in many Medicare Advantage (Part C) plans. Alternatively, you can purchase separate, standalone dental and vision insurance policies from private companies.
What if I’m still working past 65 and have employer health insurance?
The rules depend on the size of your employer. If you work for a company with 20 or more employees, your employer’s group health plan is the “primary payer,” and Medicare is the “secondary payer.” In this case, you may be able to delay enrolling in Medicare Part B without incurring a late enrollment penalty. If your employer has fewer than 20 employees, Medicare is generally the primary payer, and you will likely need to enroll in Part A and Part B when you first become eligible to avoid gaps in coverage. It is critical to talk to your company’s HR department to understand how their plan works with Medicare.
