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Medicare FAQs – What You Need to Know

Medicare FAQs – What You Need to Know

Medicare and all that it entails, can be confusing, even to 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’re in need of assistance as you begin exploring your Medicare healthcare options, don’t hesitate to contact us at VIPcare. We’ll provide you with the answers and help you need so you can rest assured that you’ll get the care and coverage you need. So, here’s what you need to know about Medicare!

What is Medicare?

Medicare is a federal health insurance program for people who are age 65 and over and for some younger people who receive Social Security disability benefits.

When/how do I sign up?

You’re first eligible to sign up for Medicare three months before you turn 65. Annual Enrollment Period (AEP) runs from October 15 – December 7. Medicare Open Enrollment Period (OEP) runs from January 1 – March 31. Some people are automatically enrolled for Medicare coverage, and others will have to sign up. You may be eligible for a Special Enrollment Period if certain life-event occur, such as you have a new residence or lose your insurance coverage. Eligibility varies from case to case. You can apply for Medicare coverage online, by phone, or in person.

What are the different parts of Medicare?

Medicare has four parts, each offering a different type of coverage:

  • Part A (Hospital Insurance) – Inpatient hospital, inpatient skilled nursing facility, hospice, and some home health services
  • Part B (Medical Insurance) – Physician services, outpatient care, durable medical equipment, home health services, and many preventive services
  • Part C (Medicare Advantage) – Medicare-approved private insurance companies that provide all Part A and Part B services and may provide prescription drug coverage and other supplemental benefits
  • Part D (Prescription Drug Benefit) – Medicare-approved private insurance companies that 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. It includes benefits from Part A and Part B.

What is Medicare Advantage?

Also referred to as Part C, Medicare Advantage gives people an alternative way of receiving their Medicare benefits. The program consists of many different health plans, typically HMOs and PPOs. These plans are regulated by Medicare but run by private insurance companies. The plans offer Part A and Part B benefits and usually some form of Part D prescription drug coverage. Some plans may also include additional preventive benefits, such as routine hearing, vision and dental care, and fitness programs. To keep out-of-pocket costs down, Medicare Advantage plans usually require you to go to doctors and hospitals within the plan’s provider network.

How much does Medicare cost?

Costs will vary for Medicare and the specific plan you select if you opt for a Medicare Advantage plan. The federal program sets a standard monthly premium for Part A and Part B each year. However, your specific premium may differ based on your income. In addition, you may be eligible for premium-free Part A if you’re age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.