what medical questions will i be asked when applying for medicare

Each carrier has a minimum of one form of health-related questions included in its Medigap

application. Some of the questions ask if you’ve EVER had a particular condition; however, others inquire about a more recent time. Commonly, questions about the last couple of years of health history.

Full Answer

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

What information do I need when applying for Medicare?

What documents do I need to enroll in Medicare?your Social Security number.your date and place of birth.your citizenship status.the name and Social Security number of your current spouse and any former spouses.the date and place of any marriages or divorces you've had.More items...

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 are the 3 requirements for a member to be eligible for a Medicare?

You're 65 or older.You are a U.S. citizen or a permanent legal resident who has lived in the United States for at least five years and.You are receiving Social Security or railroad retirement benefits or have worked long enough to be eligible for those benefits but are not yet collecting them.More items...•

What are the four factors of medical necessity?

Medicare defines “medically necessary” as health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.

What is an example of a medical necessity?

The most common example is a cosmetic procedure, such as the injection of medications, such as Botox, to decrease facial wrinkles or tummy-tuck surgery. Many health insurance companies also will not cover procedures that they determine to be experimental or not proven to work.

How long before you turn 65 do you apply for Medicare?

3 monthsYour first chance to sign up (Initial Enrollment Period) It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

Do I automatically get Medicare when I turn 65?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

Is Medicare Part A and B free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

What is Medicare Part A?

Medicare Part A coverage includes: 1 A semi-private room 2 Hospital meals 3 Skilled nursing services 4 Care on special units such as intensive care 5 Drugs, medical supplies and medical equipment used during your inpatient stay 6 Lab tests, X-rays and medical equipment when you’re an inpatient 7 Operating room and recovery room services 8 Some blood transfusions (in a hospital or skilled nursing facility) 9 Rehab services such as physical therapy received through home health care 10 Skilled health care in your home if you’re homebound and only need part-time care 11 Hospice care

When do you have to retire to get Medicare?

Answer: If you retire or lose employer coverage before age 65, you’ll need other health coverage until you reach Medicare eligibility age and have your seven-month Initial Enrollment Period. If you are 65 or older when you retire or lose employer coverage, you may qualify for what is called a Special Enrollment Period (SEP).

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 notice of creditable coverage for Medicare?

You’ll need a written notice of “creditable coverage” from the plan to qualify for a SEP and avoid late penalties. The notice certifies that the plan provides coverage at least as good as Medicare.

How long do you have to enroll in Part B?

Answer: When you’re over 65 and retiring soon, getting Part B is fairly simple. If you qualify for a Special Enrollment Period (see question 2 above), you’ll have up to eight months to enroll in Part B without penalty. If you don’t actually quality for an SEP, you will have a Part B late penalty. To get Part B, you will enroll directly with Social Security, which you can do online, in person or on the phone.

How long does Medicare last?

This period lasts seven months total, and includes the three months before the month you turn 65, the month in which you turn 65, and the three months after. If you are receiving Social Security or Railroad Retirement Board benefits when you first become eligible for Medicare, then you’ll be automatically enrolled in Part A and Part B ...

Does Medicare cover hospice care?

Hospice care. Medicare Part A does not cover custodial care such as help with bathing, dressing and eating, but due to new Medicare regulations, some Medicare Advantage plans (Part C) may begin offering some of these services in the home starting in 2019.

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.

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.

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.

What are the parts of Medicare?

Together, parts A and B are known as original Medicare. You’ll need to enroll in original Medicare before you can enroll in any other Medicare parts. Other parts of Medicare include: Medicare Part C, also known as Medicare Advantage. Medicare Part D, which is prescription drug coverage.

How long does it take to sign up for Medicare?

Initial enrollment period. This is a 7-month window around your 65th birthday when you can sign up for Medicare. It begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birth month. During this time, you can enroll in all parts of Medicare without a penalty.

How long do you have to sign up for Medicare if you have delayed enrollment?

If you delayed Medicare enrollment for an approved reason, you can later enroll during a special enrollment period. You have 8 months from the end of your coverage or the end of your employment to sign up without penalty. Medicare Advantage open enrollment (January 1–March 31).

How to get a copy of my naturalization certificate?

You can fill out Form N-565, Application for Replacement Naturalization/Citizenship, either online or by mail, to have a copy of these documents sent to you.

What to do if you don't have birth certificate?

if you don’t have a record of your birth, other documents to prove your age, such as your immunization records, school records, state census records, insurance records, or medical records.

How to replace a permanent resident card?

Citizenship and Immigration Services. You can fill out Form I-90, Application to Replace Permanent Resident Card , either online or by mail.

When is the open enrollment period for Medicare?

Open enrollment period (October 15–December 7). During this time, you can switch from original Medicare (parts A and B) to Part C (Medicare Advantage), or from Part C back to original Medicare. You can also switch Part C plans or add, remove, or change a Part D plan. General enrollment period (January 1–March 31).