Medicare and all that it entails can be confusing, even for the savviest health insurance consumer. With the Annual Enrollment Period rapidly approaching, we figured this would be a good time to answer some of the most frequently asked questions about Medicare.
If you need help with your Medicare healthcare options, feel free to reach out to us at VIPcare. If you do not have an agent, we can connect you with a trusted one. The agent can provide you with information and assistance. This will help ensure you receive the necessary care and insurance coverage.
What Is Medicare?
Medicare is a federal health insurance program primarily for people who are age 65 and older, as well as for some younger individuals who receive Social Security disability benefits, including for permanent kidney failure.
When and How Do I Sign Up for Medicare?
You’re first eligible for Medicare three months before you turn 65. They consider that the Initial Enrollment Period.
The Annual Enrollment Period (AEP) runs from October 15 to December 7.
The Medicare Advantage Open Enrollment Period (OEP) runs from January 1 to March 31.
You may be eligible for a Special Enrollment Period if certain life events occur. These events include moving to a new home or losing your insurance coverage.
Some people are automatically enrolled in Medicare coverage, while others will need to sign up. Eligibility varies from case to case. You can apply for a Medicare plan online, by phone, or in person.
What Are the Different Parts of Medicare?
Medicare is divided into four parts, each offering a different type of coverage:
- Part A (Hospital Insurance): Covers inpatient hospital stays, inpatient skilled nursing facility care, hospice care, and some home health services.
- Part B (Medical Insurance): Covers physician services, outpatient care, durable medical equipment, home health services, and many preventive services.
- Part C (Medicare Advantage): Medicare-approved private insurance companies provide all Part A and Part B services, and may also include prescription drug coverage and other supplemental benefits.
- Part D (Prescription Drug Benefit): Medicare-approved private insurance companies provide outpatient prescription drug coverage.
What Is Original Medicare?
Original Medicare is a fee-for-service health program. This means you can choose any doctor or hospital that accepts Medicare anywhere in the United States, and Medicare will pay its share of the bill. Original Medicare health plans include benefits from Part A and Part B.
What Is Medicare Advantage?
Also referred to as Part C, Medicare Advantage provides an alternative way of receiving Medicare benefits. The program consists of many different health plans, typically Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Medicare regulates these plans, but private insurance companies run them. They include Part A and Part B benefits and usually include some form of Part D prescription drug coverage.
Some plans may also include additional preventative benefits, such as routine hearing, vision, and dental care, and fitness programs. To save money, Medicare Advantage plans often require you to see doctors and go to hospitals that are part of your network.
Are There Any Limitations Or Restrictions On Who Can Enroll In Medicare Advantage?
To enroll in a Medicare Advantage plan, individuals must be eligible for both Medicare Part A and Part B, live in the plan’s service area, and not have end-stage renal disease (ESRD) in most cases. Special Needs Plans (SNPs) may have additional eligibility criteria.
How Much Does Medicare Cost?
Costs for Medicare and specific plans, such as Medicare Advantage plans, will vary. The federal program sets a standard monthly premium for Part A and Part B each year, but your specific premium may differ based on your income. Additionally, you may be eligible for premium-free Part A if you’re 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.
How Can I Find And Compare Medicare Advantage Plans?
The Medicare Plan Finder tool on the official Medicare website allows individuals to search for and compare available Medicare Advantage plans based on location, coverage options, and costs. Additionally, private insurance brokers can assist in comparing plans tailored to individual needs.