Medicare Insurance Experts

To be eligible for Original Medicare, you must be a permanent legal resident (green card holder) or an American citizen who has lived in the United States for at least five years AND one of the following: 

• Age 65 or older 
• Under age 65 and receiving Social Security Disability Income for 24 months 
• Diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis 

Medicare Supplement plans and Medicare Advantage plans are not the same things. While both Medicare Supplement and Medicare Advantage plans bring additional benefits to Original Medicare, they work very differently. Medicare Supplement plans, also known as Medigap plans, work as a secondary to Original Medicare (Medicare Part A and Part B). The plan will only pay after Original Medicare has paid its portion. These plans have no networks, no restrictions, and no referrals to see specialists. 

Medicare Advantage plans, also known as Medicare Part C, on the other hand, become your primary coverage over Original Medicare. They often require you to follow a strict network of doctors and have higher out-of-pocket costs. However, they often provide additional benefits. 

These additional benefits provided by Medicare Advantage plans often include dental, vision, hearing, and prescription drug coverage, as well as transportation assistance and gym memberships. However, not every plan or every carrier is required to offer these additional benefits.

For most, the Medicare Part A premium is $0 per month. However, if you do not qualify for zero-premium Part A, the premium can be as high as $506. To qualify for zero premium, you must have worked at least 40 quarters or ten years paying Medicare taxes. If you did not meet this qualification, you would be required to pay the Medicare part A premium. 

The standard Medicare Part B premium in 2023 is $164.90. This can increase based on income. This difference in premium reflects your Income Related Monthly Adjustment Amount (IRMAA).