Frequently Asked Questions About Medicare Terminology
Does Medigap cover the Part B deductible?
No modern Medigap plan covers the Part B deductible for beneficiaries newly eligible after January 1, 2020. You must pay the $283 deductible in 2026 yourself.
Popular plans like Plan G pay your 20% Part B coinsurance in full once you meet that deductible.
Existing enrollees who held Plan C or Plan F prior to 2020 can keep their coverage and deductible protections indefinitely.
What happens if I miss my Initial Enrollment Period?
If you lack creditable employer coverage, you must wait for the General Enrollment Period from January 1 through March 31.
You may also face a lifetime 10% Part B premium penalty for each full 12-month period you delayed enrollment.
Part D drug coverage carries a separate penalty equal to 1% of the national base beneficiary premium per month delayed.
How do I appeal an IRMAA surcharge if my income dropped?
You can appeal an IRMAA surcharge by submitting Form SSA-44 to the Social Security Administration after life-changing events like retirement.
Include documentation of your reduced income so the agency recalculates your premium using current earnings instead of your tax return from two years prior.
Can my Medicare Advantage plan change its copays mid-year?
Medicare Advantage plans cannot alter their copays, coinsurance, or benefit coverage in the middle of a calendar year.
Plans must keep their cost-sharing structures consistent from January 1 through December 31. Review your Annual Notice of Change each September for upcoming adjustments.
HealthyHabits.care is an independent publication and is not connected with or endorsed by the U.S. government or the federal Medicare program. This article is general information, not insurance or legal advice. For free, unbiased help with your coverage, contact your State Health Insurance Assistance Program (SHIP) or call 1-800-MEDICARE.
