#1 Medicare vs. Medicaid
Medicare and Medicaid are both government health insurance programs, but they have different eligibility rules for who can join. Medicare is for people who are 65 or older or have certain health conditions. Medicaid is for adults with low incomes and is run by both the federal government and each state. To get Medicaid, your state will check that you don't have too much money saved up in the bank. If you have Medicaid, you can see doctors, get X-rays, go to the hospital, get nursing care, and have tests like X-rays. Some states may also give you more help, like paying for prescriptions, physical therapy, dental care, and even rides to the doctor.
#2 At What Age you can get Medicare?
You can get Medicare if you're 65 and get Social Security. If you've been getting Social Security Disability Insurance (SSDI) for 24 months, you can also get Medicare, no matter how old you are. If you have certain serious health problems like ALS (Lou Gehrig's disease) or permanent kidney failure, you can join too.
#3 Is Medicare Free?
Most people don't have to pay for Medicare Part A because they already paid taxes for it when they worked. Some people can also get Part A for free through their spouse's work history. But for other parts of Medicare, like Part B, you might have to pay a monthly fee.
#4 Is Medicare Like Regular Insurance?
Medicare helps pay for medical costs just like regular insurance. But it's not as extensive as some private insurance plans. Regular insurance often covers family members like a spouse and kids, but with Medicare, you have to meet certain age or disability requirements to qualify.
#5 What Doesn't Medicare Cover?
Medicare doesn't pay for some important healthcare things. It won't cover long-term care, like help at home or in a nursing home. Medicaid helps with these costs, but not Medicare. Other things not covered by Medicare include eye exams, glasses, dentures, most dental work, medical care outside the U.S., cosmetic surgery, and massages. Medicare does not cover: Long-term care, Hearing aids, Routine dental care, Routine vision care, Medical care outside of the U.S, Dentures, Plastic and/or cosmetic surgery, Massage therapy,
#6 How Much Does Medicare Cost?
For most people who paid taxes while working, there's no cost ($0) for Medicare Part A. But Medicare Part B has a monthly fee. In 2023, the standard monthly fee is $164.90down from $170.10 in 2022-19, automatically deducted from your Social Security checks.
#7 Can you stick with your doctor if you're on Medicare?
If you have Medicare Part B (which is for medical insurance), you can go to any doctor who accepts Medicare and is open to seeing new Medicare patients. It's a good idea to ask your doctor if they can take you as a new Medicare patient. However, not all doctors take Medicare as full payment. Medicare sorts doctors into 3 groups: 1)Participating Doctors: They accept Medicare and the payment that Medicare approves for their services. 2)Nonparticipating Doctors: They do accept Medicare, but they might charge more than what Medicare approves for their services. 3)Opt-out Doctors: These doctors don't take Medicare at all, and patients have to pay for all the costs of their care when they see them.
#8 Where can I find out more?
The official website for Medicare is Medicare.gov. Here, you can explore the website, engage in live chats with Medicare representatives, or reach out by phone at 800-MEDICARE (800-633-4227, TTY 877-486-2048). Additionally, you can enter your state to locate nearby organizations that offer assistance with Medicare-related matters. If you still can't get clarity about Medicare, our team of experts can guide you through the process for further assistance.
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#9 What is Medicare Advantage?
Medicare Advantage, often referred to as Medicare Part C, is a comprehensive alternative to traditional Medicare for receiving healthcare benefits. It combines Medicare Part A and Part B coverage and typically includes Medicare Part D for prescription drug coverage.
#10 Is there any insurance beyond the original Medicare?
If you're seeking prescription drug coverage, it's necessary to consider buying either Part D coverage or a Medicare Advantage plan (Part C) that includes drug benefits. These options are administered by private companies that collaborate with Medicare. Enrollment in these plans may entail a monthly premium, and eligibility hinges on your enrollment in Original Medicare. Medicare Advantage plans often provide additional perks, such as vision and dental coverage. However, they come with the requirement that you utilize healthcare providers within your plan's network and adhere to the plan's guidelines.
#11 What are Medicare Supplements Plans?
Medicare Supplement plans (Medigap) are private insurance policies that complement Original Medicare, covering expenses like copayments and deductibles. Standardized by the government, they come in various plan types (e.g., Plan F, Plan G) offering consistent benefits across insurers. Beneficiaries pay monthly premiums in addition to Medicare Part B. Medigap allows freedom in choosing healthcare providers, and coverage is renewable. These plans do not include prescription drug coverage (Part D). Understanding enrollment periods and guaranteed issue rights is crucial for timely enrollment and cost management.
