What is Medicare and how does it work?
Answer:
Medicare is a federal health insurance program primarily for people age 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. Medicare is divided into four parts:
• Part A covers hospital stays
• Part B covers doctor visits and outpatient care
• Part C, also called Medicare Advantage, is offered by private insurance companies
• Part D covers prescription drugs
Most people receive Part A automatically at age 65 if they have worked and paid Medicare taxes for at least 10 years. Medicare does not cover 100 percent of medical costs, which is why many beneficiaries consider additional coverage options.
What is the difference between Medicare and Medicaid?
Answer:
Medicare is a federal health insurance program mainly for people age 65 and older or those with certain disabilities. Medicaid is a joint federal and state program that provides health coverage to individuals with limited income and resources.
A person can qualify for both Medicare and Medicaid at the same time. This is called being dual eligible. Eligibility rules and benefits vary by state for Medicaid.
When can I enroll in Medicare?
Answer:
Your Initial Enrollment Period begins three months before the month you turn 65, includes your birth month, and continues for three months after. This is a seven month window to enroll in Medicare.
There is also an Annual Enrollment Period from October 15 to December 7 each year, when beneficiaries can review and change plans. Certain individuals may qualify for Special Enrollment Periods based on specific circumstances.
What is the difference between Original Medicare and Medicare Advantage?
Answer:
Original Medicare includes Part A and Part B and allows beneficiaries to see any provider that accepts Medicare nationwide. Medicare Advantage plans are offered by private companies and often require members to use a provider network.
Medicare Advantage plans may include extra benefits, but costs and access to providers vary.
Do I need a Medicare Supplement plan?
Answer:
A Medicare Supplement plan, also called Medigap, helps pay some of the out of pocket costs not covered by Original Medicare, such as deductibles, copayments, and coinsurance.
Medigap policies are offered by private insurance companies and work alongside Original Medicare. They cannot be used with Medicare Advantage plans.