Medicare FAQs
Original Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD). It consists of Part A (Hospital Insurance) and Part B (Medical Insurance).
Medicare Advantage Plans, also known as Part C, are an alternative way to get your Medicare benefits. These plans are offered by private companies approved by Medicare and must provide at least the same benefits as Original Medicare, but may offer additional benefits such as vision, hearing, and dental coverage.
Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps cover the cost of prescription drugs and may help lower your drug costs and protect against higher costs in the future.
Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Medigap policies can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles.
The Medicare Extra Help program, also known as the Low-Income Subsidy (LIS), helps people with limited income and resources pay for their Medicare prescription drug program costs, such as premiums, deductibles, and coinsurance.
You can enroll in Medicare through the Social Security Administration (SSA). Enrollment can be done online at the SSA website, by calling the SSA, or by visiting a local SSA office. You have an initial enrollment period when you first become eligible for Medicare, typically around your 65th birthday.
Yes, you can switch Medicare plans during certain times of the year. The Annual Election Period (October 15 to December 7) allows you to change your Part D or Medicare Advantage Plan. The Medicare Advantage Open Enrollment Period (January 1 to March 31) allows individuals enrolled in a Medicare Advantage Plan to switch to a different Medicare Advantage Plan or return to Original Medicare.
An Advance Directive is a written document that outlines how an individual wants medical decisions to be made if they lose the ability to make these decisions themselves. It can include a living will and a durable power of attorney for healthcare, specifying the individual’s healthcare preferences in advance. This document is crucial because it ensures that an individual’s healthcare wishes are followed if they’re unable to communicate them, and it helps alleviate the burden on family members.
Yes, if you receive care at a Critical Access Hospital (CAH), your Medicare coverage is generally the same as it would be at any other hospital. CAHs are small facilities in rural areas providing 24/7 emergency care and other essential services, with no more than 25 inpatient beds. Medicare covers inpatient and certain outpatient services provided by CAHs.
The Open Enrollment Period (OEP) for Medicare Advantage runs from January 1st to March 31st. During this period, existing Medicare Advantage policyholders can switch to a different Medicare Advantage plan or cancel their enrollment in a Medicare Advantage plan to return to Original Medicare and enroll in a Medicare Part D plan.
Coinsurance is a type of cost-sharing where a Medicare beneficiary pays a percentage of the cost for a covered medical service or supply. It is usually a fixed percentage of the Medicare-approved amount for the service or supply, required in addition to any deductibles or copayments that may be due.
A Comprehensive Outpatient Rehabilitation Facility (CORF) provides a variety of services on an outpatient basis, including physician services, physical therapy, social or psychological services, and rehabilitation. CORFs aim to help individuals recover and improve their functional abilities following a decline in physical, mental, or cognitive functioning due to illness, injury, or disability.
