What does Medicare NOT cover?
It is important to understand what Original Medicare Part A and Part B do not cover. Some of the items and services Medicare doesn’t cover include: – Long-term care (also called custodial care ) – Most dental care – Eye exams related to prescribing glasses – Dentures – Cosmetic surgery – Acupuncture – Hearing aids […]
What does Medicare Part B cover?
Medicare Part B helps cover medically necessary services and preventive care. This includes doctor visits, outpatient care, lab work, X-rays, mental health services, durable medical equipment, and some home health and rehab services like physical therapy. Part B also covers preventive services to help catch health issues early. Screenings like mammograms, flu shots, and yearly […]
What does Medicare Part A cover? Is there a premium I have to pay?
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice services, and some home health care. This includes your semi-private room, meals, nursing care, medications during your stay, and necessary hospital supplies. Most people don’t pay a monthly premium for Part A because they or their spouse worked and paid Medicare taxes for […]
What are the four parts of Medicare?
There are four main parts of Medicare are: Original Medicare Part A – Medicare Part A (hospital insurance) covers Medicare inpatient care that is care received while in a hospital, skilled nursing facility, and, in certain circumstances, at-home treatment. Original Medicare Part B – Medicare Part B (medical insurance) covers medical services provided by doctors, […]
What is the Medicare Modernization Act?
On December 8, 2003, the President signed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which became effective on January 1, 2006. Two significant changes occurred with this legislation; a prescription drug benefit was made available for seniors and people with disabilities who are covered by Medicare. The managed care program, formerly […]
What is a Medicare PFFS plan?
Medicare Advantage Private Fee For Service (PFFS) plans are a type of Medicare Advantage Plan that is generally only available in rural areas where there are not many plan options available. PFFS plans do not require you to choose a primary care physician (PCP) or need a referral to see a specialist like HMO plans […]
What is a Medicare HMO plan?
Several types of Medicare Advantage plans are available, and a Health Maintenance Organization (HMO) is one of them. If you join an HMO Plan, you will need to go to your Primary Care Physician (PCP) within the HMO’s network of doctors to get most of the routine care you will need. If you do need […]
I’m disabled. When can I start getting Medicare?
If you’re disabled, you can qualify for Medicare before age 65 through Social Security Disability Insurance benefits, but timing varies by condition. Most disabilities require a 24-month waiting period after SSDI approval before Medicare coverage begins. However, two conditions have special rules. If you have ALS, you receive Medicare immediately upon SSDI approval with no […]
How do I decide what Medicare plan is best for me?
Choosing the right Medicare plan for you can be intimidating, especially for those new to Medicare. There are many options, including Original Medicare Part A and Part B, Medicare Advantage, Part-D, and Medicare Supplemental plans (Medigap). On top of that, deciding which insurance carrier to choose, understanding all the rules and enrollment periods so you […]
What is the initial Medicare (IEP) enrollment period?
The Medicare Initial Enrollment Period (IEP) is a seven-month window that begins three months before you turn 65, includes your birthday month, and extends three months after. During this period, you can enroll in Medicare Part A and Part B. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled […]