Medicare Blog

what questions do i ask medicare

by Mrs. Jackeline Braun Jr. Published 1 year ago Updated 1 year ago
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Before choosing a Medicare Advantage Plan, you may want to compare several plans by asking them these questions:

  • What's my share of the costs for services and supplies?
  • Does the plan have a network The facilities, providers, and suppliers your health insurer or plan has contracted with to...
  • Does the plan offer benefits The health care items or services covered under a...

Use this guide to consider your options when preparing to enroll in Medicare or after you have already enrolled.
  • What are the basics? ...
  • What are your coverage options? ...
  • Should you enroll in Part D? ...
  • Are you eligible for programs that help lower Medicare costs? ...
  • What resources exist to help you navigate Medicare?

Full Answer

What do you need to know before starting Medicare?

  • Generally, Medicare doesn’t work with your insurance.
  • Once you sign up, Medicare pays first.
  • Some private insurance has rules that lower what they pay (or don’t pay at all) for services you get if you’re eligible for other coverage, like Medicare.
  • Ask your health insurance company if you need to sign up for Part A and Part B when you turn 65.

What are good health insurance questions to ask?

Insurance companies cannot:

  • Prevent you from donating all or part of an organ as a condition to buy or continue to keep a policy.
  • Discriminate against you when offering or issuing, or cancelling a policy solely based on your status as a living organ donor.
  • Charge you more for your policy or change the amount of your coverage due to your status as living organ donor.

How can you tell if someone has Medicare?

  • individual was no longer serving as a volunteer outside of the United States;
  • organization no longer has tax-exempt status; or
  • individual no longer has health insurance that provides coverage outside of the United States.

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? ...

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Do you 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 are the 3 requirements for Medicare?

Be age 65 or older; Be a U.S. resident; AND. Be either a U.S. citizen, OR. Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare.

How do I know which Medicare plan is right for me?

To compare Medicare plans, use the Medicare Plan Finder at www.medicare.gov/find-a-plan, on the official U.S. government site for people with Medicare, which allows you to compare plans by cost, by quality and by other features that may be of importance to you.

Who do you call with questions about Medicare?

1-800-633-4227Call 1-800-MEDICARE For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

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.

Is Medicare free at age 65?

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

What will Medicare not pay for?

Generally, Original Medicare does not cover dental work and routine vision or hearing care. Original Medicare won't pay for routine dental care, visits, cleanings, fillings dentures or most tooth extractions. The same holds true for routine vision checks. Eyeglasses and contact lenses aren't generally covered.

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Who has the best Medicare coverage?

Best Medicare Advantage Providers RatingsProviderForbes Health RatingsCoverage areaBlue Cross Blue Shield5.0Offers plans in 48 statesCigna4.5Offers plans in 26 states and Washington, D.C.United Healthcare4.0Offers plans in all 50 statesAetna3.5Offers plans in 44 states1 more row•Jun 8, 2022

What are the 4 types of Medicare?

There are four parts of Medicare: Part A, Part B, Part C, and Part D.Part A provides inpatient/hospital coverage.Part B provides outpatient/medical coverage.Part C offers an alternate way to receive your Medicare benefits (see below for more information).Part D provides prescription drug coverage.

When should I contact Medicare?

Generally, we advise people to file for Medicare benefits 3 months before age 65.

What is Part B of Medicare?

Part B helps pay for covered medical services and items when they are medically necessary. Part B also covers some preventive services like exams, lab tests, and screening shots to help prevent, find, or manage a medical problem. Cost: If you have Part B, you pay a Part B premium each month.

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.

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.

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 ...

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

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.

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).

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.

Is Medicare mandatory?

Answer: No. Medicare is not mandatory. But even though you're not required to get Medicare, if you do decide to enroll after your Initial Enrollment Period and don't qualify for a Special Enrollment Period, you could face late enrollment penalties for Medicare Part A, Part B, Part C or Part D.

When is the Medicare enrollment period for 2019?

July 17, 2019. Every year, the Annual Enrollment Period for Medicare is from October 15 – December 7 and this is the only time to select the right plan for you. This is also when seniors and other Medicare beneficiaries can switch from Original Medicare administered by the government.

Does Medicare Advantage cover supplemental insurance?

Be sure to ask about Medicare Advantage plans, which are offered by private insurance companies and supplemental insurance that does cover these services and the ones that are right for you. Since this is the one time a year you can sign up or make changes to your policies, you want to make sure you know all of your costs.

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:

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