Medicare Beneficiaries: The Top FAQs You Need to Know About

What Do the Medicare Parts Mean?

After covering Medicare Part A and B, we’ll move on to the next part of the alphabet: parts D and C.

  • Part B: Also known as an Advantage Plan or a Part C, Part C combines Parts C and A under a private provider. It typically provides additional services unavailable through Original Medicare (dental, vision, hearing). These plans look like your standard health insurance plan and often have HMOs or PPOs.
  • Part D This section is the most basic. Just remember to use “D” for drugs. Part D covers the prescription portion of your plan. And oddly enough, D is often included with C. This leads me to my next question.

What Prescription Coverage Do I Need?

Yes, that’s the short answer. You will need prescription drug coverage to avoid the late enrollment penalty (Part D). Part C often has Part D included. Only two situations are where you need a separate Part D insurance policy: when you choose to keep Original Medicare (rare), or a Medigap policy, otherwise known as a Supplement.

Medicare Supplement -vs- Medicare Advantage?

It is highly recommended that you speak with a broker to discuss the differences between these policies. Here’s a general overview. A Medicare Supplement Planis a supplement to your Original Medicare Parts B and A. In most cases, you only pay the Part B deductible, and the plans cover the rest of your medical bills. Supplements have a higher monthly cost than Advantage plans and may require a separate drug plan with a deductible.

Medicare Advantage plans include private health insurance plans with copays and coinsurance. These plans usually have a lower monthly cost and no Part D deductible. Advantage plans include additional benefits like hearing, vision, or dental coverage. Many plans include additional benefits such as gym memberships, meal plans, and electronic alerts.

Does Medicare Cover Dental & Vision?

Original Medicare does not provide vision or dental coverage. Many Advantage plans offer additional benefits, as described above. You will need to buy a separate vision and dental plan if you add a Supplement. For more information, see 7 Things to Consider When Choosing Vision and Dental Insurance in Retirement.

What do I have to do to get Medicare?

You don’t have to choose to be a Medicare beneficiary. You can remain with your employer plan as long as you have creditable coverage, which most employers do.

Employers with fewer than 20 employees can no longer offer you a plan after age 65. This option is rarely removed, but it may. Good news: Medicare is generally much cheaper than group coverage. Make sure you have checked your medication before making the switch. Medicare beneficiaries are not eligible for discounts or copay programs.

Does Medicare Cover Hearing Aids?

Original Medicare doesn’t offer any additional benefits beyond medical. Original Medicare will cover testing and doctors for hearing loss, but not hearing aid fitting or replacement. Advantage plans often include additional hearing benefits and aids. The amount they pay will vary from plan to plan, so make sure you talk with your broker about the best plan.

What is the Difference Between Medicare and Medicaid?

This question is much more frequent than I expected. They are even verbally misunderstood daily. Medicare is for people 65 years and older or those with disabilities. Medicaid is available to all people and is intended for those who require more financial assistance. Both are often combined to aid people in both of these situations.

Many people are concerned about their retirement finances. The Medicaid program isn’t used enough by the 65+ population. Medicaid may even cover your entire medical expense, including your premium. For assistance, contact your broker.

Does Medicare Cover Cataract Surgery?

Although it feels a little lacking, it is possible if it is medically required, and the doctor accepts Medicare. Double-check with your provider if you’re interested in something other than the original cataract surgery.

What Vaccines Are Medicare Covered for?

Contrary to popular belief, vaccines are covered by Part D. To be eligible for those immunizations and vaccines. You must have Part D coverage. You must include the vaccine in your plan’s formulary. It will usually cover 100% of the vaccine in most cases if the formulary has been completed after the plan deductible.

Part B covers vaccines such as the Influenza vaccines and pneumococcal vaccinations. It also covers direct contact vaccines such as rabies or tetanus.

Does Medicare Cover Assisted Living?

This question is often asked too late. While assisted living communities can be a great option for people who want to live independently and still have access to a doctor, they can also get costly. Unfortunately, Medicare doesn’t cover assisted living costs. The plan will cover the doctor who visits the facility. However, the medical expenses of the facility will not be covered.

Original Medicare will cover skilled nursing up to 100 percent for the first 20 days and 80 percent for all subsequent days. Your plan may provide a supplement that covers 50 to 100 percent of the cost of skilled nursing.

Medicare Advantage Plans have a stricter policy regarding skilled nursing because a provider manages them. They usually do all they can to get you out of skilled nursing facilities. If you wish to remain in skilled nursing facilities, you’ll be better off getting Original Medicare or Supplemental Medicare.

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