If you have questions about Medicare rules, coverage and claims, call Medicare’s help line at 800-633-4227 or use the Live Chat function, which is generally available 24/7 except for some federal holidays. Information is available in about two dozen languages, including English and Spanish.
Full Answer
Who do I call if I Have Questions about Medicare?
Do you have questions about your Medicare coverage? 1-800-MEDICARE (1-800-633-4227) can help. TTY users should call 1-877-486-2048. What should I have ready when I call 1-800-MEDICARE?
Where can I get answers to my health care questions?
For fast answers to your health care questions — whether they’re about managing your health insurance coverage, finding forms and documents, or understanding costs and savings — visit our Get Answers page. How can I get health coverage now that Open Enrollment is over?
How do I Find my Medicare plan for medications?
If you have medications that need coverage, use the Medicare plan finder tool to identify the policy that will cover your medications. Does Medicare cover a home health aide? Medicare will cover intermittent or part-time skilled nursing care.
Are there more Medicare questions than beneficiaries?
And there may be as many different questions about Medicare as there are beneficiaries—maybe more. But certain questions seem to come up more often than others. Here are some of the most common Medicare questions and answers. How Do I Know What Medicare Coverage Is Right For Me? The answer to this may be easy to say but maybe not as easy to do.
How do I confirm my Medicare coverage?
Checking the BasicsYou can use the enrollment check at Medicare.gov.You can call Medicare at 1-800-633-4227.Members can visit a local office to review the coverage in person.
What three types of coverage are provided by Medicare?
The different parts of Medicare help cover specific services:Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.Medicare Part B (Medical Insurance) ... Medicare Part D (prescription drug coverage)
Is Medicare primary or secondary insurance?
Medicare is always primary if it's your only form of coverage. When you introduce another form of coverage into the picture, there's predetermined coordination of benefits. The coordination of benefits will determine what form of coverage is primary and what form of coverage is secondary.
Can you have Medicare and employer insurance at the same time?
Can I have Medicare and employer coverage at the same time? Yes, you can have both Medicare and employer-provided health insurance. In most cases, you will become eligible for Medicare coverage when you turn 65, even if you are still working and enrolled in your employer's health plan.
Is it necessary to have supplemental insurance with Medicare?
For many low-income Medicare beneficiaries, there's no need for private supplemental coverage. Only 19% of Original Medicare beneficiaries have no supplemental coverage. Supplemental coverage can help prevent major expenses.
Does Medicare Part A cover 100 percent?
Most medically necessary inpatient care is covered by Medicare Part A. If you have a covered hospital stay, hospice stay, or short-term stay in a skilled nursing facility, Medicare Part A pays 100% of allowable charges for the first 60 days after you meet your Part A deductible.
How do you determine which health insurance is primary?
If you have Medicare and other health insurance or coverage, each type of coverage is called a "payer." When there is more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" to pay.
Does Medicare cover copay as secondary?
Medicare will normally act as a primary payer and cover most of your costs once you're enrolled in benefits. Your other health insurance plan will then act as a secondary payer and cover any remaining costs, such as coinsurance or copayments.
What will Medicare not pay for?
In general, Original Medicare does not cover: Long-term care (such as extended nursing home stays or custodial care) Hearing aids. Most vision care, notably eyeglasses and contacts. Most dental care, notably dentures.
What happens to my Medicare if I go back to work?
If you're going back to work and can get employer health coverage that is considered acceptable as primary coverage, you are allowed to drop Medicare and re-enroll again without penalties. If you drop Medicare and don't have creditable employer coverage, you'll face penalties when getting Medicare back.
What happens if you don't have health insurance and you go to the hospital?
However, if you don't have health insurance, you will be billed for all medical services, which may include doctor fees, hospital and medical costs, and specialists' payments. Without an insurer to absorb some or even most of those costs, the bills can increase exponentially.
What are Medicare Secondary Payer rules?
Generally the Medicare Secondary Payer rules prohibit employers with 20 or more employees from in any way incentivizing an active employee age 65 or older to elect Medicare instead of the group health plan, which includes offering a financial incentive.
When do I get my Medicare card?
You'll receive a Medicare card two or three months before your birthday , and coverage starts on the first day of your birthday month. 1.
How long do you have to sign up for Medigap?
To buy a Medigap policy, you must be enrolled in both Parts A and B. To guarantee availability, you must sign up within six months of enrolling in Part B.
Does Medicare cover copays?
A: Original Medicare (Parts A and B) won’t cover copays, coinsurance or deductibles, nor will it cover medical care when you travel outside the United States. Some services, such as long-term care, acupuncture and cosmetic surgery, also aren’t covered.
Can you miss your enrollment date for Medicare?
For instance, missing your enrollment date may mean penalties or even higher premiums for the rest of your life. At the same time, you don’t want to pay for additional coverage you don’t need, especially if you’re still working.
How long do you have to be on Medicare after receiving Social Security?
In general, you are eligible for Medicare after receiving Social Security disability benefits for 24 months. There are exceptions for people with certain medical conditions. Get your enrollment dates and learn more about Medicare and disability.
What is Medicare Made Clear?
Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.
What is the difference between Medicare Advantage and PPO?
A Medicare Advantage HMO plan usually helps pay only for care you receive from providers in the plan network. A PPO plan will generally help pay for care received outside the plan network, but it may pay less than for the same care received within the network.
When does Medicare Annual Enrollment Period start?
It’s a good idea to review your Medicare choices every year during the Medicare Annual Enrollment Period each fall, which runs Oct. 15 – Dec. 7.
Does Medicare cover vision?
Original Medicare (Parts A & B) does not cover routine dental or vision care; however, some Medicare Advantage (Part C) plans do. Plans include all the coverage provided by Parts A and B, and often additional benefits like dental, vision, hearing and gym memberships, all in one plan.
Is Medicare a state governed program?
Medicare is generally for people who are 65 or older, or who have a qualified disability. Medicaid is a state-governed program for people with limited income and resources. Some people are eligible for both Medicare and Medicaid. These people are considered “dual eligible” and are often qualified for special Medicare plans.
Is Medicare decision personal?
Medicare decisions are highly personal. And there may be as many different questions about Medicare as there are beneficiaries—maybe more. But certain questions seem to come up more often than others. Here are some of the most common Medicare questions and answers.
Common Medicare Questions: Answers From Medicare Expert Christian Worstell
Our Medicare expert answers questions to some common 2022 Medicare questions, such as what is Medicare, how much are premiums and what are the advantages of Medicare plans.
Learn More About Medicare
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
What happens if you don't pay Medicare?
But, if you don’t pay the premium on a Medicare Advantage or Medigap plan, they can drop you. Also, if you don’t pay your Part D premium, the drug plan can drop you. Usually, they give multiple notices before the plan terminates your policy.
How many classes of drugs does Medicare cover?
There are many drugs covered under Medicare. Plus, every plan must cover the six protected classes. If you have medications that need coverage, use the Medicare plan finder tool to identify the policy that will cover your medications.
What is Medicare Part C?
Medicare Part C is a Medicare Advantage plan. These plans sometimes have a $0 per month premiums, and many of them include Part D drug coverage. However, there are some pitfalls to Medicare Advantage plans that you need to know before signing up.
What is a medicaid supplement?
A Medigap plan is a supplemental option for Medicare. Medigap plans are also Medicare Supplement plans; these policies fill the gaps in Medicare. So, when Medicare would otherwise charge you 20% or a deductible, the Medicare Supplement could instead pick up the bill.
Does Medicare pay less if you have a low income?
The cost of Medicare depends on many things. Those with a low income will likely pay less than the standard amount and may qualify for Medicare and Medicaid. Those with a higher income will likely pay more for Part B; this is called the Part B Income Related Monthly Adjustment Amount.
Is Medicare mandatory?
Of course, Medicare isn’t mandatory, so you can choose whichever option makes the most sense for your situation. You can also always consult your benefits administrator at the office where you work to identify your options.
How long do you have to wait to apply for cancer insurance?
If you’ve had a recent surgery or you are going through any treatments, you’ll want to wait a couple of years before applying.
Is rheumatoid arthritis a problem with life insurance?
For example, minor arthritis isn’t problematic, but more severe rheumatoid arthritis could indicate a decline in coverage. The Body Mass Index isn’t as strict on supplement plans as it is with life insurance. Having those few extra pounds isn’t an issue if you aren’t morbidly obese.
Can you keep your Medicare coverage if you have a chronic illness?
Keep Your Coverage if you have a Chronic, Incurable Condition. There are plenty of health issues that can be treated but are still considered incurable illnesses. When you have an illness that requires treatment forever, you’ll see that there are questions on many Medicare Supplement applications that can exclude you.
Can you change your insurance if you have diabetes?
If you only have diabetes and no related conditions, you should be able to change carriers.
Does Medigap require a supplement policy?
Oregon and California allow beneficiaries to change their supplement policy within the birthday month with no supplement underwriting. This does require that you have a supplement policy currently active to qualify. Talk to your agent; they can get quotes to check if a lower rate exists.
Do you need to answer questions about your health to qualify for new coverage?
In many states, you need to answer questions about your health and get through underwriting to qualify for new coverage. While medical underwriting can cause some stress, many individuals successfully pass under writing and change coverage annually, so don’t worry. Let’s dive into information about the situations typically resulting in approval.
Is Medicare Supplement underwriting required?
Medicare Supplement underwriting questions aren’t always mandatory. Sometimes, like during your Open Enrollment Period, you receive a waiver for health question requirements. If you’re changing a Medigap plan or miss your OEP, underwriting is likely a must.
