As you age, you’ll start to face new health problems, and old ones become harder to treat. Thankfully, according to the Center for Disease Control and Prevention (CDC), seniors today can expect to live longer and healthier than ever before. That doesn’t mean you don’t have to be careful with your health though. Taking steps like quitting smoking, losing weight, and eating healthier can help you avoid the most common health issues that seniors face.
Heart Disease
Heart disease is one of the most common health problems that seniors have to deal with. There are a range of conditions that fall into the heart disease category:
Blood vessel diseases
Arrhythmias (irregular heartbeat)
Congenital heart defects
Heart muscle disease
Heart valve disease
Heart diseases are also called “silent killers” because they don’t always have obvious outward signs. You have a higher risk of heart disease if you have diabetes, high blood pressure, or high cholesterol.
Heart Disease Symptoms
Heart disease symptoms vary depending on what types of disease it is:
Blood Vessel Disease Symptoms
Coronary artery disease is a common heart problem that affects the main blood vessels that bring blood to the heart muscle. Most of the time, coronary artery disease is caused by cholesterol buildup (plaque) in the heart’s vessels. This plaque build up can lead to the heart and other parts of your body getting less blood. Which can lead to heart attacks, angina, or stroke. Men and women can have different signs of coronary artery disease. For example, men more commonly experience chest pain while women are more likely to have nausea, fatigue, and shortness of breath. Other symptoms include:
Chest tightness
Chest pressure
Pain in the neck, jaw, throat, upper abdomen, or back
Numbness, pain, weakness in your legs or arms
Coronary artery disease might not be found until you have a heart attack or stroke. It’s important to keep an eye out for any of these symptoms and talk to your doctor about them. If you mention it early enough the disease can be found and treated early.
Arrhythmia Symptoms
Arrhythmia is when your heart is beating too fast or slow in an abnormal way. In general, heart arrhythmias can lead to problems like stroke, sudden death, and heart failure. Blood clots are more likely to happen in people with heart problems. If a clot breaks free, it can move from your heart to your brain and cause a stroke. Some signs of arrhythmia are:
Chest pain or discomfort
Dizziness
Fainting
Chest flutters
Lightheadedness
Racing heartbeat
Shortness of breath
Slow heartbeat
Congenital Heart Defect Symptoms
Adult congenital heart disease (ACHD) is a group of disorders that affect the structure of your heart and are present at birth. “Congenital” means that the problem was there when the baby was born. It happened while the baby was still in the womb. These diseases can change how your heart pumps blood. They are also called birth defects of the heart.
Heart problems that are present at birth can be mild or very dangerous. Depending on the type of heart disease and how bad it is, signs may not show up until a person is an adult. Some people never feel anything at all. And some people were treated for these conditions when they were kids, only to have long-term effects as adults. Symptoms include:
Blue tints to fingernails, lips, and skin
Dizziness
Fatigue
Heart murmur
Heart palpitations
Irregular heartbeat
Shortness of breath
Swelling in your ankles, feet, or hands
Heart Muscle Disease Symptoms
Heart muscle disease, or cardiomyopathy, makes it harder for senior’s heart to pump blood to the rest of your body. Cardiomyopathy can cause the heart to stop working. There are 3 types of cardiomyopathy: dilated, hypertrophic, and restrictive. Depending on the type of cardiomyopathy and how bad it is, treatment might include medicines, device implants, surgery or in the worst case heart transplant. Symptoms include:
Breathlessness
Swelling in your legs, ankles, and feet
Bloating
Coughing
Difficulty lying down
Fatigue
Chest discomfort
Dizziness
Fainting
Heart Valve Condition Symptoms
The aorta, mitral, pulmonary, and tricuspid valves are the four valves in the heart. They open and close to help the heart pump blood. Many things can hurt the valves in the heart. A heart valve can become narrowed (stenosis), leaky (regurgitation or weakness), or not close properly (prolapse).
Heart valve disease is another name for valve heart disease. Depending on which valve isn’t working right, the signs of heart valve disease are usually:
Chest pain
Fainting (syncope)
Fatigue
Irregular heartbeat
Shortness of breath
Swollen feet or ankles
Medicare And Heart Disease
Medicare Part B pays for heart disease blood tests every 5 years if your doctor orders them. You don’t necessarily have to have any signs of heart disease to get these tests done, you can have them just as a precaution if you’d like. Original Medicare pays 100% of the Medicare-approved amount for screening blood tests for heart disease. This means you don’t have to pay anything. Medicare Advantage plans have to cover heart disease screenings without deductibles, copayments, or coinsurance if you see a provider in their network.
During your heart disease check, your doctor may find something new or old that needs to be looked into or fixed. This extra care is diagnostic, which means that your doctor is treating you because of some signs or risk factors. During a preventive visit, Medicare may charge you for any medical care you get.
Obesity
As the number of seniors in the U.S grows, so does the obesity rate. According to the National Health and Nutrition Examination Survey, more than one-third of seniors were considered obese. Research has shown that obesity puts older people at risk for a wide range of health problems. When a person is overweight, their organs are put under extra stress, which makes it hard for them to work properly. If you are obese as a senior, you are more likely to have health problems like:
Diabetes
Hypertension
Respiratory problems
Arthritis
Osteoarthritis
Cardiovascular disease
Cancer
Mobility issues
Body pain
Gallbladder disease
Additionally, obesity has been shown to cause depression and a low quality of life. Depression in old age can put you at a higher risk for heart disease and other serious health complications.
Medicare and Obesity
Recent changes to Medicare Part B are a big step toward getting doctors and patients alike to see obesity as a serious health problem. So, beneficiaries with a BMI (body mass index) of 30 or more can get free obesity screenings and behavioral therapy through the Intensive Behavioral Therapy for Obesity program. Their services must be given by a doctor, nurse practitioner, physician’s assistant, or clinical nurse specialist. Covered services include:
Initial BMI assessment
Nutritional evaluation
Ongoing weight loss and dietary counseling
Medicare only pays for visits that take place in a primary care setting as part of the Intensive Behavioral Therapy program. If your doctor tells you to see someone else, like a chef, you’ll have to pay for those services yourself. Some Medicare Advantage (Part C) plans give you more benefits, which can help you lose weight. These plans may cover gym memberships and subscriptions to exercise programs like SilverSneakers, an app for older people that helps them stay fit. For a short time, some Medicare Advantage plans may also cover the delivery of healthy meals to your home.
Medicare will pay for bariatric surgery if your doctor says you need it because you are very overweight (BMI of 35 or higher). In most cases, you’ll need a certain BMI and at least one health problem connected to your weight, like diabetes or heart disease, in order to get coverage. You must also show that you have tried and failed to lose weight in the past by dieting or working out.
Diabetes
Diabetes affects about 33% of adults ages 65 and up. People in this age group are more likely than younger people with diabetes to get problems like hypoglycemia (low blood sugar), kidney failure, and heart disease. There is new knowledge that can help us better understand and treat diabetes in older people. Special things should be taken into account to help people’s general health and quality of life. Many older people have more than one condition at the same time, such as cognitive impairment, heart disease, and others that affect how they learn about and take care of their diabetes.
Diabetes Symptoms
Diabetes can cause you to feel tired, hungry, or thirsty more often, to lose weight without trying, to urinate a lot, or to have trouble seeing clearly. You could also get skin diseases or take a long time to recover from cuts and bruises. Some people with diabetes may not know they have it because the signs usually come on slowly and are easy to miss. Seniors sometimes brush off these signs as “getting old,” but they could be signs of a major problem. If you have any of these signs, you should talk to your doctor.
Medicare And Diabetes
If you have been diagnosed with diabetes or have certain risk factors, you can rest easy knowing that Medicare Part B covers free diabetes screenings, prevention programs, supplies and nutrition therapy. So you won’t have to pay your deductible or the copayment for Part B, which is usually 20% of the cost of services paid by Medicare. Part B also pays for lessons on how to take care of your diabetes on your own, but you may have to pay the Part B deductible and copay.
Screenings
You can get up to two diabetes checks a year for free if your doctor thinks you might get diabetes and you have any of the following risk factors:
High blood pressure
Abnormal cholesterol history
High blood sugar
Obesity
Or if you have 2 of more of these:
Are 65 or older
Had gestational diabetes during a pregnancy
BMI of 25-29.9
Parents or siblings with diabetes
Prevention
One Medicare-covered diabetes prevention program can help you avoid type 2 diabetes, which often happens to people because of what they eat, how little they exercise, or how they live their lives. The program includes weekly group meetings for six months to help you change your diet, move more, and keep your weight in check, as well as six monthly follow-up meetings.
To be eligible, you must have certain amounts of glucose in your blood or plasma, a BMI of 25 or more, and no history of type 1 or type 2 diabetes. Part B needs you to go to a program put on by a Medicare Diabetes Prevention Program provider that has been approved.
Nutritional Therapy
If you have diabetes or kidney disease and your doctor tells you to go to nutrition therapy, you don’t have to worry. This service may include an initial nutrition and lifestyle exam, individual and group nutritional therapy, help with managing lifestyle factors that affect your diabetes, and follow-up visits. The nutrition therapy services must be given by a registered dietitian or another qualified nutrition worker.
Diabetes Supplies
Medicare covers a lot of products for seniors with diabetes, like blood sugar monitors, glucose test strips, glucose solutions, and lancets used to draw blood. It also pays for constant glucose monitors for seniors who take insulin or who have had trouble with low blood sugar in the past. Part B says that these items are covered as long-lasting medical tools. After you’ve paid your Part B payment for the year, you’ll pay 20% of Medicare-approved costs.
You must buy the equipment from a Medicare-enrolled supplier or order it through Medicare’s mail-order program using a Medicare national contract provider. A Part D prescription plan pays for things like alcohol swabs, bandages, inhaled insulin devices, needles, and syringes that are used to give insulin.
Dementia
Dementia isn’t just one illness. It’s actually a general term for a group of signs that people with different diseases, like Alzheimer’s, may have. Diseases that are called “dementia” are caused by changes in your brain that make it not work properly. The symptoms of dementia cause a decline in cognitive abilities that is serious enough to make it hard to live on your own or do daily tasks. Dementia also changes how you act, feel, and relate to others.
60-80% of dementia cases are caused by Alzheimer’s disease. Vascular dementia is the second most common cause. It is caused by tiny blood clots and blocked blood vessels in your brain. People with mixed dementia have brain changes that stem from more than one type of dementia at the same time. Most people call dementia “senility” which is wrong because that term comes from the belief that mental decline is a normal part of aging, which it’s not.
Medicare And Dementia
Medicare covers dementia care, providing much-needed assistance throughout the condition. Alzheimer’s, vascular dementia, and other dementias require comprehensive care across multiple healthcare providers. However, Medicare addresses many of these needs, thankfully.
First, Medicare Part B covers cognitive tests. These are essential for senior dementia tracking. Doctors can adapt treatment plans based on cognitive changes in you or your loved one through regular cognitive exams. They can also identify the patient’s dementia stage. Medicare Part B provides cognitive and home safety tests. These examinations can detect household hazards that could injure or complicate dementia patients. The evaluations suggest ways to make living safer and dementia-friendly. Medicare Part B also covers care planning. The advancement of dementia requires care modifications. Medicare care planning helps address medical, social, and mental needs as dementia progresses.
Medicare Part A covers hospital stays for complications or severe dementia progression. Inpatient care at general or mental hospitals is included. Dementia care requires pharmaceutical management, which Medicare Part D provides. This prescription drug coverage covers doctor-prescribed dementia drugs. This coverage can greatly minimize senior drug expenditures, which can add up. While Medicare provides extensive coverage, it’s crucial to understand your plan’s deductibles, copayments, and other out-of-pocket charges. Remember that knowing what to expect might make dementia care easier.
How EZ Can Help
EZ can help you enroll in Medicare, buy a Medicare Supplement Plan, or compare options. Our representatives deal with top insurance companies. They can compare all local plans for free. We will assess your medical and financial needs and recommend a plan. Simply call one of our qualified agents at 877-670-3602 or enter your zip code in the bar below to begin.
Medicare enrollees are generally more likely to experience mental health issues. In fact, about 1 in 5 elderly citizens suffer from some form of mental disorder. Thankfully, Medicare provides coverage for counseling which can make support more accessible. Mental health programs and services exist to diagnose and treat mental health needs. As a Medicare beneficiary, you have access to screenings for depression, counseling sessions, medications, and partial hospitalizations. The amount you pay for these services all depends on where you receive care, your doctor’s fees, and any supplemental insurance you might have. Below we’ll look at all of the ways Medicare provides coverage for treatments and what is and isn’t covered.
Medicare Plans with Mental Health Services
Medicare is made up of a few parts. Original Medicare includes Part A (hospital coverage) and Part B (medical coverage), both of which are offered by the federal government. Whereas private insurance companies’ contract with Medicare to provide Part C (Medicare Advantage) and Part D (prescription drug coverage). The government mandates that all of these plans cover certain mental health services for enrollees.
Medicare Part A covers mental health services for patients that are admitted to the hospital, regardless of whether they are in a general or psychiatric hospital. The coverage and cost-sharing are typically the same as any other type of hospitalization. For each benefit period you’ll pay the Part A hospital deductible which in 2023 is currently $1,600. As well as $400 a day for hospital coinsurance for days 61-90 of your hospital stay. If you stay longer than 90 days you can use your lifetime reserve days, which come with an $800 per day coinsurance. Keep in mind you only get 60 reserve days in your lifetime; they will not regenerate. Your benefit period begins the day you are admitted as an inpatient to the hospital or skilled nursing facility. It ends after you have been out of the hospital for 60 consecutive days.
Medicare Part A does treat billing for mental health in one way. It will only cover 190 days in a psychiatric hospital that specializes in mental health treatment during your lifetime. However, if you are admitted to a general hospital, even if it’s for a mental health condition, the days spent in the general hospital will not count toward that 190 day limit.
While Part A has the hospital side covered, Medicare Part B covers mental health services you get outside of a hospital. Such as in a doctor’s office, therapist’s office, hospital outpatient department, or community health center. Medicare Part B covers mental health services and visits to psychiatrists, clinical psychologists, clinical social workers, nurse practitioners, and physician assistants. As long as the provider accepts Medicare assignment, which means they agree to provide the services for the price that Medicare approves. Be aware that not every mental health professional will accept Medicare.
After you’ve met your Part B deductible ($226 in 2023), you will pay 20% of the Medicare-approved amount for the service. However, Part B does fully cover preventative services such as depression screenings for free. That is as long as they are provided by a primary care provider, physician assistant, or nurse practitioner who accepts Medicare Assignment. The screening must also be done in a primary care setting such as a doctor’s office where you’re able to receive follow up treatment and referrals. However, aside from the preventative screening, follow up treatment and referrals to see other specialists are not free.
Medicare Part B will also cover partial hospitalizations if you need more intensive care than your doctor or therapist can provide. Typically this partial hospitalization will happen in an outpatient hospital department or a mental health center, where patients do not stay overnight. Part B pays for these services, but you have to meet certain requirements, including having your doctor certify that without these services you would need to be hospitalized.
For partial hospitalizations you will be responsible for 20% of each service you receive. You may also have to pay for coinsurance for each day of outpatient hospital or mental health center treatment.
Medicare Advantage is an alternative option to Original Medicare (Parts A and B), and as such, it generally covers all the same benefits combined into one plan. These plans may also offer additional coverages for telehealth care, grief counseling, and conflict resolution. However, Medicare Advantage plans may have smaller limited provider networks for mental health providers. So, before enrolling make sure your plan covers what you need and the doctors you prefer.
So far we have hospitalization and outpatient mental health services covered in Parts A, B, and C, so all that’s left is your prescriptions. That’s where Part D prescriptions coverage comes in. You can either buy a separate Medicare Part D or enroll in a private Medicare Advantage plan that includes prescription drug coverage. Both types of plans will list covered medications on their drug formularies. Part D plans have to cover, with limited exceptions, all anticonvulsant, antidepressant, and antipsychotic medications. During Open Enrollment, when you’re selecting a Part D or Medicare Advantage plan, make sure the plan will cover your medications and find out exactly how much you would pay in copayments or coinsurance. Since these plans are offered by private insurance companies your out-of-pocket costs can vary from one plan to another. So, comparing is key.
Coverage For Other Types of Mental Health Counseling
Medicare isn’t limited to only helping you with depression and anxiety. Plans also cover substance use disorders and other mental illnesses as well. However, Medicare will only cover counseling services that directly address your mental health condition. We’ve detailed these services below.
Substance Use Disorders
Substance use disorder is considered a chronic mental illness. Medicare plans treat substance use disorders just like they would diabetes or cardiovascular disease. Medicare Part B covers the following substance use disorder treatments:
Monthly care management
Drug testing
Tobacco counseling
Opioid use disorder treatments
Alcohol use disorder screenings
Individual therapy
Group therapy
Medications
Drug withdrawal treatment
Opioid Treatment
Original Medicare covers the total costs of opioid use disorder treatment as long as it’s administered by a Medicare-enrolled program. You may have to pay an additional copayment or coinsurance for any opioid treatment services you receive in an outpatient hospital setting.
Alcohol Use Disorder
Medicare provides screening and therapy for alcohol use disorder to people who drink but are not dependent on alcohol. Medicare may cover up to 4 counseling sessions per year for alcohol abusers. It also pays for:
Detox
Rehab
Advance care planning
Behavioral health integration into primary care for monitoring
As long as your healthcare provider accepts Medicare assignment, you pay nothing for these services.
Marriage and Family
Medicare Part B plans will also help cover family counseling. However, the family counseling services must be medically necessary for your mental health treatment. Medicare typically will not cover marriage counseling or couple counseling though.
Specific Mental Health Services
Medicare provides access to specific mental health care in a variety of ways. Here we will go more into detail about each of these services.
Inpatient Care
Medicare will cover inpatient care if you need intensive care that can only be provided in an inpatient setting. These plans will help with treatment costs and inpatient psychiatric facilities, critical access hospitals, and hospital psychiatric units. Medicare Part A covers up to 190 days of hospitalization in a psychiatric facility. Part B helps cover a portion of doctor or specialist fees that come with mental health inpatient care.
Outpatient Care
If your doctor accepts Medicare assignment, your yearly depression screening is free. However, for any doctor visits to diagnose and treat your mental illness you’ll have to pay the Part B deductible and 20% of the Medicare-approved amount. Medicare covers the costs of the outpatient psychiatric hospital services and supplies as long as they are:
Medically necessary for diagnostic studies
You are expected to improve with treatment
The service is given under a care plan, which is a written plan that your provider writes and includes a list of the types of services you need, how long you need them, and how much they’re predicted to cost.
The prescribing doctor supervises and monitors the services.
Partial Hospitalization Programs (PHPs)
PHPs are structured outpatient mental health treatment programs. Medicare will cover these programs for patients who receive care from hospital outpatient centers and community mental health centers. PHPs give less than 24 hours of mental health care a day to people who have been recently discharged from an inpatient hospital program but need continued support, or people who are at risk of being hospitalized due to their mental illness. If your providers accept Medicare assignment, you may be responsible for a portion of the Medicare-approved amount for each service. You may also have to pay coinsurance for each day you receive PHP services.
Community Mental Health Centers
In addition to the services that you get from PHPs, community mental health centers offer hospitalization alternatives. These facilities offer 24-hour emergency care with follow-ups, and screenings for admission to a state mental health facility. They also provide day treatment, partial hospitalization, or rehab that line up with your mental health needs.
Telehealth visits, consultations, and psychotherapy are all covered by Medicare Part B. You will have to pay both the Part B deductible and 20% of the Medicare-approved amount for these services though. In most cases, telehealth costs are generally the same as costs for in-person visits.
The Bottom Line
Medicare plans cover an extensive array of outpatient services, such as individual and group therapy, prescription medications, and diagnostic testing for depression, substance abuse, and other psychiatric disorders. In-person and virtual meetings are also covered.
Help is available if you experience an emotional crisis requiring medical attention. Medicare can also cover a significant portion of inpatient care costs. If you require assistance with Medicare in general, EZ is also available to assist you. EZ can help you enroll in Medicare, purchase a Medicare Supplement Plan, or evaluate your options. Our agents work with the nation’s top insurance providers. They can provide you with a complimentary comparison of all local plans. We will assess your medical and financial needs and assist you in locating a plan that meets them. Simply call one of our licensed agents at 877-670-3602 to get started.
The National Cancer Institute defines gynecology as a field of medicine that focuses on diagnosing and treating diseases of the female reproductive organs. It is often grouped with obstetrics. Gynecology also focuses on other issues related to women’s health, like menopause, hormone problems, birth control, and infertility. Gynecology is not just for younger women, you still need it as you age. That’s why a number of important gynecology treatments are covered by Medicare.
As long as you have an OB/GYN who takes Medicare, you can get preventive women’s health care through Medicare Part B.There are no exceptions; all women who have Medicare Part B have benefits for gynecology. You should make use of these advantages! Remember that Medicare isn’t just meant to help you when you’re sick or hurt; it’s also meant to keep you from getting sick in the first place.
Preventative Screenings
Medicare pays for Pap smears, pelvic checks, STI testing, and HPV screenings. Your medical history and any risk factors will determine how often you can get these preventive treatments. For women with no symptoms and low risk pap smears and pelvic exams are recommended once every 2 years. While women with a higher risk of cervical cancer, or women with a history of abnormal pelvic exams should go annually. Johns Hopkins University says that cervical cancer is more likely to be cured if it is found and treated early. Screening tests, like Pap smears and pelvic checks, can help find cells that aren’t working right and could lead to cancer.
Pelvic Exams
During a pelvic exam, the reproductive systems, including the vagina, vulva, cervix, ovaries, uterus, rectum, and pelvis, are examined physically. During a pelvic exam, your doctor may look for problems, do a Pap and/or HPV test, and look at your medical history.
Pap smears look for signs of cancer in the cervix. The doctor takes a few cells from your cervix with a small tool that looks like a spatula. The sample is then sent to a lab where it is checked for precancerous cells or other problems. If the doctor can find pre-cancerous cells early, you can get treatment before the cancer gets worse. Medicare Part B pays for Pap tests and pelvic exams once every 2 years to check for vaginal and cervical cancers. If you are at high risk, Medicare will pay for these tests once every 12 months. If you do any of the following, you may be in the high-risk group:
If you have had an abnormal pap smear result in the last 3 years
Were sexually active before your turned 16
Have had more than 5 sexual partners throughout your life
Have a history of or currently have an STD
As long as you meet the standards to get these services and get the annual checks, they are free. All of the tests, including the Pap check, lab work, a pelvic exam, and a breast exam, are free. Only if you go to a doctor who does not accept Medicare assignment will you have to pay for these services.
Mammograms
Mammograms are the best way to detect breast cancer. Original Medicare Part B pays for some preventive services, like mammograms, but there are rules you need to know before you schedule one.
Types of Mammograms Covered By Medicare
First of all, Medicare covers 3 types of mammograms:
Baseline mammogram – The first mammogram you get is called a baseline mammogram. It is used to look for early signs of breast cancer and will be compared to other scans in the future.
Screening mammogram – Mammograms used for screening are preventive tests that look for new signs of breast cancer. They are usually done once a year on women over 40 who have no symptoms or signs of breast cancer and are thought to have an average risk of getting it.
Diagnostic mammogram – A diagnostic mammogram is used to find out more about something wrong with the breast tissue, like a lump or a growth. To check for breast cancer, an x-ray of the breast will be taken. Diagnostic mammograms can also be used to find out more about a possible risk that was found during a screening mammogram.
How Often Medicare Covers Mammograms
The next thing you need to know is how often Medicare will cover a mammogram. Medicare will pay for one baseline mammogram for a woman between the ages of 35 and 39. Women over 40 are covered for a screening mammogram once every 12 months. Medicare will pay for as many screening mammograms as you need if they are deemed medically necessary.
Cost Of Medicare Covered Mammograms
Part B pays 100% of the Medicare-approved amount for baseline and yearly screening mammograms if your doctor or health care provider accepts assignment. That means you pay nothing (no deductible or coinsurance) for one baseline mammogram between the ages of 35 and 39, and you pay nothing for one screening mammogram every year if you are 40 or later.
If you get your mammogram from a participating provider, Medicare will pay 80% of the Medicare-approved amount. After you pay your Part B copay, you pay a 20% coinsurance fee ($164.90 in 2023). What you pay out of pocket can depend on how much your doctor charges and what other insurance you may have.
Do You Need A Pap Smear, Pelvic Exam, Or Mammogram After You Turn 65?
Even for older adults, Pap tests are an important way to check for cervical and vaginal cancers. Even if you are 65 years old, you may still be at risk for cervical cancer or vaginal cancer, so you should keep getting Pap tests until your doctor tells you to stop. Pap tests are no longer necessary after age 65 if:
You’ve have 3 consecutive negative pap results
You’ve have 2 negative pap-HPV tests in a row
On the other hand you definitely need to continue Pap smears if:
You have a medical history of lesions of cervical cancer
You were given DES, a synthetic estrogen hormone, during a pregnancy
If you have a weakened immune system
Even if you don’t need Pap smears anymore, gynecology exams are still a good way to check for health problems, especially if you are still sexually active. Regular pelvic checks in older people can help find more than just vaginal cancer. They can also help find sexually transmitted infections (STIs) and other changes in the vagina, rectum, or abdomen that aren’t normal. Also, the CDC says that most cases of breast cancer are found after the age of 50. Since Medicare covers both a breast exam and a pelvic exam, it is very important that you make sure your doctor gives you regular breast checks after you turn 65.
Which Parts Of Medicare Cover Gynecology?
Medicare will pay for appointments with an OB-GYN. But that’s not always the case. As is usually the case with Medicare, you have to meet certain requirements for Medicare to pay for your trips to the OB-GYN. We’ll explain what these are below so you know what to expect.
Gynecology exams are covered by Original Medicare, which is made up of Medicare Parts A and B cove. Medicare Part B covers the cost of a visit to an OB-GYN. Medicare Part B pays for OB-GYN treatments like pap smears, pelvic exams, and breast exams. Once every 24 months, Medicare Part B pays for the above-mentioned services,ut Medicare Part B may pay for these tests once a year if you are at high risk of cervical or vaginal cancer or if you are of childbearing age and have had a negative pap smear in the last 3 years. During the tests, if your doctor finds a new or existing problem and has to treat it, that care would is diagnostic care, and Medicare Part B could send you a bill for it.
Medicare Advantage plans (Medicare Part C) also covers OB-GYN visits. By law, they must pay for everything Original Medicare pays for. But these plans also cover a wider range of health care treatments. Different plans will cover different services and charge different amounts for these services and the plan itself.
EZ Can Help
Original Medicare covers most of the health care needs of women, which is good news. But Medicare Advantage and Medicare Supplements can add to the benefits you get from Original Medicare. Our licensed agents can help you find more health benefits through Medicare Advantage or more cash benefits through Medicare Supplements. Talk to an EZ agent who can tell you what you need to do to sign up and explain everything to you.
EZ can help you sign up, buy a Medicare Supplement Plan, or just think about your choices. Our insurance brokers work with the best firms in the country. You can get a free review of all the plans in your area from them. We’ll talk with you about your medical and financial needs and help you find a plan that meets them all. Call one of our agents at 877-670-3602 or enter your zip code in the bar below to start.
Original Medicare does not have an annual limit on out-of-pocket costs, and 4.5 million Medicare recipients are expected to spend more than $5,000 each on out-of-pocket health care costs in 2023. This lack of financial protection, combined with the fact that Original Medicare doesn’t cover all medical costs, has led to a lot of people buying Medicare Supplement Plans. This is because Medicare Supplement Plans fill in those gaps in coverage and financial protection. But how do private health insurance companies determine your premium? Insurance companies who offer Medicare Supplement Plans use three different pricing methods: attained-age, issue-age, and community-rated. Knowing how these prices work, can help you compare Medicare Supplement Plans and find the one that works best for you.
The Pricing Methods
The method a company uses for pricing has a significant impact on the overall cost of a policy. These 3 ratings are each based on different factors. First, we have attained age rating, which is based on the age you are when you sign up for your plan and will increase as you age. Next is issue-age rating, this method also uses your age when you enroll to determine your premium, but it will not increase as you get older. Finally, there is community-rated, which isn’t based on your age but instead is based on where you live. Below we’ve detailed each of these plans and how they work.
Community Rating
The costs of community-rated Medicare Supplement plans depend on where you live. No matter someone’s age, everyone pays the same premium for the same Medicare Supplement plan within their region, which is decided by the insurance company it can be by city or county. So, if you and your neighbor buy the same Medicare Supplement plan, your monthly premium will be the same even if you are 70 and your neighbor is 80.
Only a few states offer Medicare Supplement plans that are rated by the community. Maine, Vermont, Massachusetts, Connecticut, New York, Arkansas, Minnesota, and Washington are some of these states. States that don’t offer community-rated plans may charge you a higher premium based on your age, depending on whether they offer attained-age or issue-age-rated plans at enrollment. Most of the time, community-rated plans have the least expensive premiums, but rates may be different depending on where you live, whether you live in a city or a rural area, among other things.
What States Have Community-Rated Medicare Supplement Plans?
In these eight states, the monthly premiums for Medicare Supplement policies must be based on the community rating:
Arkansas
Connecticut
Massachusetts
Maine
Minnesota
New York
Vermont
Washington
Issue Age Rating
The premiums for issue-age-rated plans are based on how old you are when you sign up for coverage, similarly to attained age but they do not incrementally increase with age. For example, if you sign up for a plan at 65 your initial premiums will be less than if you signed up at 75. Most of the time, issue age plans also raise rates every year, but the rate increases are not based on your age like attained-age premiums are. Instead, they raise based on inflation and other factors that affect health costs.
If you sign up for this type of plan when you first become eligible to buy a Medicare Supplement plan, it costs less in the long run than plans for people who are older. But you should be aware that issue-age-rated plans start with higher premiums than attained-age-rated plans.
The issue-age method is used to rate Medicare Supplement insurance policies in the following states:
In these states, however, carriers may opt to use community ratings instead through an appeals process.
Attained Age Rating
Most of the time, Medicare Supplement insurance companies use attained-age rating models. The age when you sign up for the plan is used to figure out how much your premiums will cost. The younger you are when you enroll the lower your premiums will be. But these premiums are not locked in for life, as you age they will increase. For example, if you’re 65 years old, the premium for a certain Medicare Supplement plan might be $130, but if you’re 75, the same plan might cost $170. Generally, rates go up by a small amount each year or at a designated time. These rate increases are generally decided by state health insurance agencies.
Some states, like Massachusetts, Minnesota, and Wisconsin, have different rules for coverage as well as different Medicare Supplement Plans available. While those states have different plans they do all offer the same benefits they just operate in slightly different ways and have different names. If you live in one of these states, you can look at our state-by-state Medicare Supplement guide to find out exactly how your plans will be priced.
States that Offer Attained-Age Medicare Supplement Plans
No state requires carriers to offer Attained-Age Medicare Supplement plans. However, any state that is not required to specifically use a certain method is allowed to offer attained-age plans. There are many states that offer this pricing method but they can also offer any of the other methods as well. These states are:
Choosing Between Attained Age, Issue Age, and Community Rating
When choosing between attained-age, issue-age, or community-rated plans, there are a few things to think about, such as:
Your medical needs as a whole
Costs and benefits of the plan
Your age
The plan provider’s reputation
Premium cost rate projections
Different states have different levels of protection for Medicare recipients who want a Medicare Supplement plan. One such right to be on the lookout for is ‘guaranteed issue’ protections. With these rights, a Medicare Supplement insurance company can’t turn you down if you meet certain requirements. Such as, you suddenly lost a group health plan that covered your Medicare cost-sharing, You disenrolled from Medicare Advantage within 12 months of enrolling, or if your previous insurer no longer offers your Medicare Supplement Plan or commits fraud. They also promise to cover pre-existing conditions and won’t raise your premiums too much because of your health.
The easiest time to join a Medicare Supplement plan is during your six-month Medicare Supplement Open Enrollment Period, which starts when you sign up for Medicare Part B. After this initial enrollment period, Medicare Supplement plan providers can turn you down for coverage if you already have a health problem.
For example, if you drop your Medicare Supplement attained-age-rated coverage because it’s too expensive, you might not be able to buy another Medicare Supplement plan unless your state has continuous guaranteed issue rights or you meet other requirements. The states that have continuous guaranteed issue rights are Connecticut, Maine, Massachusetts, and New York. Continuous guaranteed issue rights mean that all Medicare Supplement providers must sell policies at least once a month or all year long.
Before you sign up for a Medicare Supplement plan, it’s important to know the rating category so you can figure out how much your long-term premiums will cost.
What Else Affects Medicare Supplement Plan Costs?
Medicare Supplement premium prices can be affected by a number of other things. Rates can be affected by things such as the rate of inflation, the state you live in, the cost of health care, and your lifestyle. Lifestyle factors can include choices like smoking or drinking.
The plan benefits that you want to include will also affect the price of your plan. The cost of the plan will be higher if it has more benefits. Your premiums will be less if you choose a plan with a higher deductible. In order to choose the best plan, you should carefully look at your health care needs and how much each plan will cost in the long run.
How To Lower Medicare Supplement Plan Costs
There are other ways to lower your Medicare Supplement premiums besides researching your options and comparing different insurance companies, such as:
High deductible plans – This could be a good choice if you are in good health and think you could pay more for the few claims you make.
Getting a plan for your partner – Some companies give a Medicare Supplement Household Discount to couples who both buy Medicare Supplement policies from them.
Bundling – Companies may lower the cost of your Medicare Supplement premiums if you buy another type of insurance from them, like life insurance.
It’s important to understand your pricing plan, whether you’re signing up for Medicare Supplement for the first time or you already have a policy. As a customer, if you know how companies charge for their services, you can make better decisions about what to buy. Be sure to do your research, and you might be surprised by how much you can save.
Working With EZ
If you are in the market for a Medicare Supplement Plan, one of the most important things you can do is compare the various plans’ premiums and benefits. This can require a significant amount of research, which can take a notable amount of time because you will need to call a number of different insurance companies in order to get quotes.
However, if you collaborate with an EZ agent, you can reduce the amount of time it takes to compare prices by 50%. When you work with a licensed agent, you gain access to a centralized resource where you can compare the Medicare Supplement Plan offerings of multiple insurance companies.
In addition to providing you with price comparisons, your agent can also explain the distinctions between the various plans. Your insurance agent will be able to assist you in comparing the out-of-pocket costs to the monthly premiums so that you can select the strategy that will save you the most money in the long run. Give us a call at 877-670-3602 to get started with your search for a Medicare Supplement Plan.
Medicare tax is a federal payroll tax that contributes to Medicare funding. All U.S.-based workers are required to pay Medicare tax on their wages. In accordance with the Federal Insurance Contributions Act (FICA), the tax is grouped together. When reviewing your paycheck, the Medicare tax and Social Security tax may appear as a single deduction for FICA.
The Medicare tax was established in 1966 to solve a health care problem: after retirement, the income of many seniors declines while their health care needs increase. Before Medicare, however, the cost of insurance became unmanageable, and some retirees’ policies were terminated due to their age. There are numerous components to the Medicare program, but at the time, the working population was required to pay a new Medicare tax to support Medicare hospital insurance. Below we’ll take a look at how Medicare taxes work.
How Medicare Tax Works
Medicare tax is a two-part tax: a portion is automatically deducted from your paycheck, and the other portion is paid by your employer. The tax is based on “Medicare taxable wages,” which is calculated by subtracting pretax health care deductions such as medical insurance, dental, vision, and health savings accounts from your gross pay.
Your employer is required to collect tax, and it electronically deposits both the employee and employer versions to the IRS on a regular basis. Self-employed individuals pay a Medicare tax as part of their self-employment tax. Instead of being deducted from a paycheck, the money is paid quarterly through estimated tax payments.
Medicare Tax Rate
When the Medicare tax was first introduced in 1966, the tax rate was 0.7% of an employee’s wages, with the employer and employee each paying 0.35%. The rate has since gone up considerably. In 2023, the Medicare tax rate is 2.9% which is still shared equally between the employer and employee. W-2 employees pay 1.45% towards the Medicare tax and their employer covers the remaining 1.45%. Self-employed individuals must pay the full 2.9% in full because they are both the employee and the employer.
Medicare Surtaxes
To fund the Medicare expansion, the Affordable Care Act imposed 2 Medicare surtaxes in 2013: The additional Medicare tax and the net investment income tax. Both surtaxes apply to high-income earners and are specific to distinct income types. It is possible to be subject to both of these surtaxes.
Additional Medicare Tax
The additional Medicare tax only applies to income above $200,000 ($250,000 for joint tax filing and $125,000 for married taxpayers filing separately). The additional Medicare tax rate is 0.9%. For example, if you earn $225,000 per year, the first $200,000 is subject to the standard 1.45% Medicare tax, while the remaining $25,000 is subject to the 0.9% additional Medicare tax. Similar to the initial Medicare tax, the surtax is withheld from an employee’s paycheck or paid through self-employment taxes.
Net Investment Income Tax
The net investment income tax, also known as the “unearned income Medicare contribution surtax”, imposes an additional 3.8% tax on net investment income as of 2023. As with the additional Medicare tax, no employer contribution is required. Net investment income can include taxable interest, dividends, nonqualified annuities, capital gains, and rental income. It excludes income that is already excluded for income tax purposes, such as interest on tax-exempt municipal bonds.
Net investment income tax is applied to your net investment income or the excess modified adjusted gross income (MAGI) over certain thresholds, whichever is less. Suppose, for example, that a married couple joint filing earned $225,000 in pay. The couple received an additional $50,000 in investment income during the same year, bringing their MAGI to $275,000. The tax threshold on net investment income for married couples filing together is $250,000. The couple would pay the 3.8% tax on the lesser income which would be the excess MAGI at $25,000 and not the total investment income which was $50,000. In this situation the couple would owe $950 in net investment income tax (3.8% x $25,000).
What Is The Medicare Tax Used For?
The Medicare tax funds Medicare Part A, which provides health insurance for those 65 and older, those with disabilities, and those with certain medical conditions. Medicare Part A, also known as hospital insurance, pays for hospital stays, skilled nursing care, hospice care, and certain home health services. The tax collected for Medicare accounts for 88% of Medicare Part A’s total revenue.
What Is The Additional Medicare Tax Used For?
The additional Medicare tax paid by high-income earners is used to offset the costs of the Affordable Care Act, according to the IRS. The funds are used to pay for provisions of the ACA, including the provision of tax credits for health insurance, to make health insurance more affordable for over 9 million individuals.
What Is The Medicare Trust Fund?
Medicare trust funds are what provides the money to fund Medicare beneficiaries. It is primarily made up of 2 funds:
Hospital Insurance Trust Fund (HI) – This fund finances Medicare Part A, which covers hospital stays, skilled nursing facilities, and hospice care for eligible beneficiaries. The fund’s primary sources of revenue are payroll taxes and Social Security benefits taxation. In addition, this fund and the Railroad Retirement account contribute to the annual revenue.
Supplemental Medical Insurance Trust Fund (SMI) – This fund finances Medicare Part B, which covers physician services, essential medical supplies, and a portion of the more recent Medicare Part D prescription drug program. This fund’s primary revenue source is beneficiary premiums, and it does not require a sizable amount of reserves.
Can I Opt Out Of Medicare Tax?
A religious exemption is possibly the most common way to avoid paying FICA tax. Members of recognized religious organizations that oppose accepting Social Security benefits are permitted to opt out. Although the rules and reporting requirements are very strict. The IRS outlines the rules, including the need to submit forms 4631 and 8274. So, don’t get any ideas about starting a religion just to avoid these taxes. The religious organization must have existed since 1950 and be able to demonstrate that its members have a sufficient standard of living during that time.
There are additional, even less likely ways to afford paying FICA. In some cases, these include nonresident aliens and income from student employment. The student exemption only applies to the student’s school-related employment. They must also be enrolled in the school where they work for their income to be exempt from taxation. The IRS has clarified the student-employee exemptions, restricting its eligibility. There may be a few other rare exemptions, such as for the children of family-owned businesses. Some participants in state and local pension plans may also be exempt from Social Security tax. Some of these employees are not covered by Social Security, and therefore do not pay FICA taxes.
What Wages Are Subject To Medicare Tax?
Medicare tax applies to all taxable employment income. This includes a variety of income sources, including salary, overtime, paid time off, tips, and bonuses. There is no limit on the amount that is taxed; all taxable income is subject to Medicare tax. Medicare wages may exclude certain pretax deductions, while others are included. Pre-tax medical insurance premiums and contributions to a health savings account are not taxed. However, Medicare tax is assessed on retirement account contributions and life insurance premiums, despite the fact that these funds are exempt from federal income tax.
Medicare Premiums
If you never paid Medicare taxes it doesn’t mean you can’t sign up for Medicare when the time comes. It just means that you will have to pay a premium for Medicare Part A, which is normally free thanks to those Medicare taxes. As of 2023, if you don’t qualify for free Part A, the premiums can cost up to $506 a month. This also applies if you were unemployed for at least 10 years (40 quarters). Typically, you won’t be eligible for premium-free Part A insurance in this circumstance. However, if your spouse is eligible for free Part A and you meet citizenship and residency requirements you can also be eligible for free Part A.
FAQs
What is a Medicare deduction on my paycheck?
If Medicare is deducted from your paycheck, it indicates that your employer is fulfilling its payroll obligations. This Medicare Hospital Insurance tax is a mandatory payroll deduction that funds health care for seniors and individuals with disabilities.
What if my employer didn’t withhold FICA taxes?
Employers who violate tax laws by failing to withhold FICA taxes for Social Security and Medicare could face criminal and civil penalties. Check with your employer to ensure there was no error or that you did not claim exemption on your W-4 form if you discover that no taxes have been withheld. You may be required to pay a tax penalty at the end of the year if you underpaid.
What is a Medicare benefit tax statement?
This statement confirms that you are enrolled in Medicare Part A and have health insurance that meets the requirements of the Affordable Care Act. This form, also known as a 1095-B, can be used if the IRS requests verification of your health insurance coverage.
Working With EZ
Due to the Social Security and Medicare taxes, your net pay may not be as high as you would like. Nonetheless, these taxes provide you with retirement insurance. You can enroll in Medicare even if you have not paid enough Medicare taxes over your lifetime. Just be prepared to pay the Part A premiums that other seniors will receive for free. Medicare is beneficial, but it can be confusing. However, you will still need to make decisions regarding your healthcare after enrollment. Speak with an EZ representative who can explain everything and tell you how to sign up.
EZ can help you enroll in Medicare, purchase a Medicare Supplement Plan, or simply weigh your options. Our agents work with the nation’s top insurance providers. They can provide you with a complimentary comparison of all local plans. We will discuss your medical and financial needs and assist you in locating a plan that meets all of your specifications. Simply call one of our licensed agents at 877-670-3602 to get started.
If you are a Medicare recipient or are about to become one, you may have noticed that Original Medicare (Parts A and B) does not cover all of your medical costs. Therefore, you will likely need a Medicare Supplement Plan to help cover out-of-pocket expenses. The good news is, you have plenty to choose from, there are 10 different plans available all with different levels of coverage. However, Plan G and Plan N are currently the most popular. Choosing between these two plans can be hard because they do have a lot in common, in fact they have more similarities than differences. It is essential to understand what each plan covers. Being misinformed can leave you with extra unnecessary out-of-pocket costs. So, let’s compare these plans so you can get an idea of which one fits you better.
What Both Plans Cover
Medicare Part A deductible– In 2023, if you are hospitalized for inpatient care, you have to pay the Part A deductible of $1,600 per each 60-day benefit period. The Benefits period restarts after you have been out of the hospital for 60 consecutive days. This is not an annual deductible, you could end up paying this deductible more than once in a single year. Having these plans cover this deductible means it’s not coming out of your pocket.
Part A hospital care and coinsurance – Part A partially covers hospice care leaving you copays or coinsurance. Certain prescription drugs will also have a copayment. However, you will be responsible for all of these copayments without a Medicare Supplement Plan that covers them.
Part B coinsurance – Medicare Part B requires a coinsurance payment for each covered service. Meaning Part B will pay 80% of the Medicare-approved amount for each covered service. Leaving you to pay the remaining 20% as your coinsurance payment (after you meet your annual Part B deductible). Plans N and G will both cover 100% of the Part B coinsurance.
Blood – If you need a blood transfusion for any reason, Original Medicare will only start covering the pints of blood after you have already paid for the first 3. Plans G and N will cover those first 3 pints for you so you’ll never have to pay for blood.
Skilled Nursing Facility Care – Medicare Part A will require you to pay a daily coinsurance if you are admitted for more than 20 days. As of 2023, your coinsurance could reach up to $200 a day. Thankfully, Plans G and N cover this coinsurance entirely.
Foreign Travel Emergencies – Typically, Original Medicare does not cover any medical care that you receive outside of the U.S. Plans G and N will both cover 80% of the costs of qualifying emergency medical care if you need it outside of the country.
What Neither of Them Cover
The only benefit that both of these plans will not cover is the Part B deductible. This is because of the Medicare Access and CHIP Reauthorization Act, or MACRA. This law altered Medicare with a modification to regulations that say plans are not allowed to offer any first-dollar coverage. This is also why Plans C and F are no longer available to new Medicare beneficiaries because both plans offered the Part B deductible coverage.
The Coverage Differences
Now that we know what benefits these plans both have in common, let’s look at the differences between them.
Benefits
Doctor Visit Copays – While Plan G will cover 100% of doctor visit copays, Plan N will not. With Plan N you will still have a $20 copay for each doctor’s visit. Therefore, if you visit your doctor fairly often this could really add up over the course of the year.
Emergency Room Copay – First, keep in mind that visiting the emergency room and being admitted are two different things. Just coming to the emergency room and then being released will cost you a $50 copay with Plan N. However, with Plan G there are no additional costs or copays for an emergency room visit.
Medicare Part B excess charges – Doctors and other healthcare providers can sign an agreement to accept “Medicare Assignment”. Which is essentially a fee schedule between Medicare and the provider saying that Medicare believes services should cost a specific amount and the doctor agrees to accept those prices. If the healthcare provider does not sign this agreement then they are allowed to charge up to 15% more than the Medicare-approved amount. That 15% is what is known as the Part B excess charge. Excess charges are one of the most significant coverage differences between Plan N and G as it could leave you with significantly higher medical expenses if it’s not covered. Plan G covers 100% of these excess charges whereas Plan N doesn’t cover them at all.
Costs
Cost is another difference, obviously even though the coverage differences are slight any plan with more benefits will be more expensive even if it’s only by a small margin. The price of Medicare Supplement Plans vary based on your location, age, and smoking status. In areas with higher costs of living, monthly premiums are generally more expensive. In general, Medicare Supplement Plans are priced in three ways: community-rated, issue-age-rated, and attained-age-rated.
Community-rated
Everyone, regardless of age, who has the same Medicare Supplement Plan pays the same monthly premium under this pricing structure. Your premiums may increase due to inflation and other factors but never due to your age.
Issued-age-rated
With this structure, your Medicare Supplement Plan premium is baked on your age at the time you purchase it. The younger you are the lower your premiums will be, and they will not increase with your age. Just like with community-rated, these plans will only ever become more expensive due to inflation and other outside factors but not your age.
Attained-age-rated
This type of pricing will calculate your premium based on your current age and does increase as you get older. Your premiums will be lower when you’re younger, but will steadily rise with your age. Increases can also happen due to inflation and other factors as well as your age.
Having Said that Plan G premiums range between $100 and $300 on average. Now, if you’re interested in a Plan G plan but the premium is a bit too expensive there is an alternative. Plan G also has a high-deductible version that offers all the same benefits with a lower premium. In exchange for the lower monthly cost you have to meet a higher deductible than you would with the standard Plan G. As for Plan N the average premium is between $120 and $180 as of 2023. When you factor in all the variables that can affect your premium Plan N can cost as low as $70 or be as expensive as $400.
So Which One Is Better?
The answer to this all depends on you. But in our opinion Plan G is the most valuable. Compared to Plan N, it provides the most coverage and saves you a significant amount of money. However, if you don’t need to visit your doctor frequently, you may easily be better off with Plan N. Overall if you’re a healthy person on a tight budget Plan N does have fantastic benefits. Although, even if you only visit the doctor a few times a year, Plan G does offer that extra bit of protection for only a little bit more money. With Plan G the only out-of-pocket Medicare cost you have to worry about is the $226(2023) Part B deductible.
How To Enroll
The best time for you to enroll is during your Medicare Supplement Open Enrollment Period. This is because if you enroll during this time you automatically receive guaranteed issue rights. Meaning you can’t be denied coverage or charged more due to your health or any pre-existing conditions. You only get one Medicare Supplement Plan Open Enrollment Period, so it is important to make use of it while you have it. The Medicare Supplement OEP begins once you turn 65 and enroll in both Medicare Part A and Part B; it continues for 6 months.
Need Some Help?
Financial planning and figuring out which benefits you need and don’t need can be time-consuming and frustrating. That’s what EZ.Insure is here for. A Medicare agent can do all of that research and compare plans for you. As well as take the time to get to know your budget and explain everything that will affect you personally. This means you’ll have professional help ensuring you get the best coverage. EZ.Insure provides you with your own personal agent. You’ll never have to worry about bouncing from agent to agent, yours will always be there to answer your questions, compare plans, and enroll you all for no extra cost. They can even help you after you’ve enrolled by reviewing your coverage annually or helping submit claims. To get started with your agent today simply enter your zip code in the bar below or give us a call at 877-670-3602.
When the Medicare tax was first introduced in 1966, the tax rate was 0.7% of an employee’s wages, with the employer and employee each paying 0.35%. The rate has since gone up considerably. In 2023, the Medicare tax rate is 2.9% which is still shared equally between the employer and employee. W-2 employees pay 1.45% towards the Medicare tax and their employer covers the remaining 1.45%. Self-employed individuals must pay the full 2.9% in full because they are both the employee and the employer. 
The answer to this all depends on you. But in our opinion Plan G is the most valuable. Compared to Plan N, it provides the most coverage and saves you a significant amount of money. However, if you don’t need to visit your doctor frequently, you may easily be better off with Plan N. Overall if you’re a healthy person on a tight budget Plan N does have fantastic benefits. Although, even if you only visit the doctor a few times a year, Plan G does offer that extra bit of protection for only a little bit more money. With Plan G the only out-of-pocket Medicare cost you have to worry about is the $226(2023) Part B deductible.