what health questions ask medicare

Typically, some of the questions that Medicare beneficiaries will have are, what are your coverage options? Do you have multiple plans you can choose from? What are some of the additional benefits that you, you know, may cover? A lot of times be, you'll say, well, ‘I doctor so infrequently’ or on the other side, ‘I go to the doctor all the time.

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How to contact Medicare for questions?

How to prepare for a call to Medicare

• Your Medicare card and claim paperwork. When you call Medicare, have information ready that your agent will request. ...
• Pen and paper. Make sure to have a pen and paper handy whenever you call Medicare. ...
• Ask a friend or family member to listen in. Remember that you can always request to have information sent to you in writing at the end of your call.

Where to get answeres to your Medicare questions.?

Medicare Eligibility, Applications and Appeals

• What help is available? ...
• Am I eligible? ...
• How do I apply? ...
• How do I check the status of my application? ...
• How do I complain or appeal a Medicare decision? ...
• Who do I contact for extra help? ...
• Is there anything else I need to know? ...

Who can answer Medicare questions?

GRAND RAPIDS, Mich., Oct. 20, 2021 /PRNewswire/ -- West Michigan Seniors who are aging into Medicare or want to review their options for 2022 can attend a comprehensive virtual seminar from the comfort of their own home.

Who do I call for Medicare billing questions?

• Home & Community Based Services Authorities
• HCBS Training
• Guidance
• Statewide Transition Plans
• Technical Assistance

How do I get answers to Medicare questions?

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.

How does Medicare decide what is medically necessary?

According to Medicare.gov, health-care services or supplies are “medically necessary” if they: Are needed to diagnose or treat an illness or injury, condition, disease (or its symptoms). Meet accepted medical standards.

What diagnosis qualifies for Medicare?

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).

What does Medicare consider a pre existing condition?

See Plans. Medicare defines a pre-existing condition as any health problem that you had prior to the coverage start date for a new insurance plan. If you have Original Medicare or a Medicare Advantage plan, you are generally covered for all Medicare benefits even if you have a pre-existing condition.

What are the four factors of medical necessity?

The determination of medical necessity is made on the basis of the individual case and takes into account: Type, frequency, extent, body site and duration of treatment with scientifically based guidelines of national medical or health care coverage organizations or governmental agencies.

How do you prove medical necessity?

Proving Medical NecessityStandard Medical Practices. ... The Food and Drug Administration (FDA) ... The Physician's Recommendation. ... The Physician's Preferences. ... The Insurance Policy. ... Health-Related Claim Denials.

What is considered to be a disability?

The legal definition of “disability” states that a person can be considered disabled if they are unable to perform any substantial gainful activity due to a medical or physical impairment or impairments which can be expected to result in death or which has lasted or can be expected to last for a continuous period of ...

Can I lose my Medicare benefits?

Summary: In most cases, you won't lose your Medicare eligibility. But if you move out of the country, or if you qualify for Medicare by disability or health problem, you could lose your Medicare eligibility.

Do I automatically get Medicare when I turn 65?

You automatically get Medicare when you turn 65 Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

What pre-existing conditions are not covered?

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

Is High Blood Pressure a pre-existing condition for health insurance?

High blood pressure (also called hypertension) is a common pre-existing medical condition, and can be covered by your policy - but you need to meet the conditions below.

Can you be denied Medicare coverage?

Generally, if you're eligible for Original Medicare (Part A and Part B), you can't be denied enrollment into a Medicare Advantage plan. If a Medicare Advantage plan gave you prior approval for a medical service, it can't deny you coverage later due to lack of medical necessity.

What is a welcome to Medicare visit?

A: When you or a loved one first enrolls in Medicare, the Welcome to Medicare visit is an optional, one-time appointment. It serves as a reference point or baseline for planning personalized medical care going forward.

Why is it important to plan ahead for Medicare?

Today, the medical community realizes that planning ahead can help manage Medicare patients’ potential concerns, including hearing and vision loss, depression and progression of chronic disease. This can make a key difference in staying healthy longer.

What is a medical visit?

Both visits are conversations between the patient and clinician to discuss health history and any health concerns, and to review medications and immunizations. These visits are meant to help determine what health issues may become a concern in the future based on family history and risk factors, and help patients work to prevent issues and stay healthy for as long as possible.

What does a doctor do to review health history?

A: The doctor reviews health history and current health by measuring blood pressure, height and weight, testing vision and cognitive function, assessing depression risk, level of safety and evaluating medications.

Can you call for an appointment with Medicare?

If you’re of Medicare age, don’t hesitate to call for your appointment, which can be conducted in-person. Similarly, if you have parents or loved ones on Medicare, it is important to encourage them to schedule their appointment.

When will Medicare show up in mailbox?

It will just show up in your mailbox one day about 3 months before your 65th birthday. If that situation applies to you, there’s nothing else you need to do with Medicare itself – your next step is to pick a Medigap plan and Part D plan (if you are going to get those).

How long does it take to get Medicare if you don't have Social Security?

If you are not receiving Social Security and need to sign up for Medicare, you should do it 2-3 months before the month that you turn 65. You can do it online or at a local Social Security office. It can take Social Security up to a month or more to process a new enrollment into Medicare.

What color is Medicare card?

When you go to the doctor, you present your red, white and blue Medicare card in addition to your Medigap card. The provider files the claims to Medicare, which pays its portion and coordinates the payment from the supplemental (Medigap) company.

How long before you turn 65 can you get Medicare?

If this is your situation, there is nothing else you need to do. Medicare will send you a card in the mail about 3 months in advance of the month in which you turn 65. Your Medicare will start on the 1st day of the month you turn 65 UNLESS your birthday is on the 1st day of the month, in which case it will start on the 1st day of the previous month.

Is Medigap a Medicare Advantage plan?

Medigap plans are NOT Medicare Advantage plans and vice versa. The two could not be any different in how they work. At a fundamental level, the biggest difference is that Medigap plans work WITH Medicare and supplement Medicare’s coverage, while Advantage plans work IN PLACE OF Medicare.

Does Medicare cover prescriptions?

Medicare itself (Parts A and B) and the Medigap plans provide NO coverage for prescription medications. Part D national average premiums are around $34/month currently (2021). But there are plans for as low as $7-15/month in most geographic locations – rates vary by state.

Does Medigap have the same coverage?

Additionally, the plan’s coverage is Federally-standardized, so a Plan G, for example, has the exact same benefits with one company as it does with another. Lastly, all Medigap plans can be used at the same doctors/hospitals (anywhere that takes Medicare), so there are no variations there either.

What are some examples of Medicare Advantage plans?

Another scenario we see is an individual that's working past age 65, and their employer's group health plan is ending. In these circumstances, you have a 63-day window to choose a plan. YouTube. Medicare Allies.

What does "denial of claim" mean on Medicare?

That means if they determine your answers on the application were incorrect or untrue, they can deny your benefits or rescind coverage. Don't lie on an application! The insurance company will find out about it eventually.

What is medical underwriting?

In short, medical underwriting is a process used by insurance companies to verify your health status. For the most part, insurance companies use medical underwriting to determine whether they should offer you coverage, and if so, at what price. To qualify for a Medicare Supplement, also called Medigap plan, you typically have to go ...

How long does open enrollment last?

Open Enrollment allows you to purchase any plan without having to pass any medical underwriting for six months. This only happens once in your life – when you're signing up for Medicare Part B for the first time. For most people, this is when they're turning 65.

What happens if you choose an expensive company during your open enrollment?

If you choose an expensive company during your Open Enrollment, you're stuck there unless you decide to switch carriers. And to switch carriers, you have to go through medical underwriting. Here's a common scenario: a woman turning 65 soon gets a Medicare Supplement mailer from a well-known company.

Is Medigap a Plan G?

The government has standardized Medigap plan benefits across the board, so a Plan G is a Plan G, no matter which company you choose. If you have any kind of health condition, we'll prequalify you for coverage. And if we run into any hurdles, we'll walk you through all of the available options.

Is Medigap the same as underwriting?

Not all Medigap carriers are the same when it comes to medical underwriting. Since plan benefits are standardized, the two main differences between Medigap carriers are pricing and underwriting. You may find one company will accept your health condition, while most others won't.

How often is a wellness visit covered by Medicare?

Your Annual Wellness Visit is covered under Medicare Part B, under two conditions: You only complete this visit once every 12 months. Your doctor or healthcare provider sticks to the checklist above. As long as both of these things are true, you won’t pay anything and your Medicare Part B deductible doesn’t apply.

What is covered visit?

These covered visits are designed to help you develop or update a personalized prevention plan which can help prevent disease and disability. During your visit, your doctor will assess your current health and risk factors.

Do you have to pay coinsurance for annual wellness visit?

However, you may have to pay coinsurance or the Medicare Part B deductible if your doctor or provider performs services outside of what is covered under the Annual Wellness Visit and those services aren’t a part of preventive and screening services. Here’s what isn’t covered as part of your AWV:

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.

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.