General Medicare Questions
What is Medicare, and who is eligible?
Medicare is a federal health insurance program for individuals aged 65 and older or those under 65 with certain disabilities or conditions. You are eligible for Medicare if you are 65 or older, or if you’ve received Social Security Disability Insurance (SSDI) for at least 24 months.
What are the different parts of Medicare?
Medicare is divided into four parts:
- Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing care, hospice, and some home health services.
- Part B (Medical Insurance) covers doctor visits, outpatient care, preventive services, and some medical supplies.
- Part C (Medicare Advantage) is an alternative to Original Medicare, offered by private insurers, combining Parts A and B, often with additional benefits.
- Part D (Prescription Drug Coverage) helps cover the cost of prescription medications.
When should I enroll in Medicare?
You should enroll during your Initial Enrollment Period, which starts three months before your 65th birthday, includes your birthday month, and ends three months after. If you miss this window, you may face late enrollment penalties for Part B and Part D.
Can I keep my employer’s health insurance when I enroll in Medicare?
Yes, if you’re still working and have employer-sponsored health insurance, you can delay enrolling in Medicare Part B without penalty. However, once you stop working, you’ll need to enroll during a Special Enrollment Period to avoid penalties.
Plan-Specific FAQs
What is Medicare Advantage (Part C)?
Medicare Advantage plans are an alternative to Original Medicare offered by private insurers. These plans bundle Medicare Parts A and B and may offer additional benefits like vision, dental, and prescription drug coverage. ACBS helps you compare plans to find the best option for your needs.
What are Medicare Supplement (Medigap) plans?
Medicare Supplement plans (Medigap) help cover out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. These plans are sold by private companies and provide more financial security.
What is the difference between Medicare Advantage and Medigap?
Medicare Advantage plans are an all-in-one alternative to Original Medicare, often with added benefits. Medigap, on the other hand, supplements Original Medicare by covering out-of-pocket costs like deductibles and copayments.
How do I choose between Medicare Advantage and Medigap?
It depends on your healthcare needs. Medicare Advantage plans offer additional benefits at a lower upfront cost but may require copayments for services. Medigap plans have higher premiums but help cover out-of-pocket costs, offering more predictable expenses. ACBS can help you compare the two and decide which is right for you.
What is Medicare Part D, and do I need it?
Medicare Part D provides prescription drug coverage. If you don’t have creditable drug coverage through another source, it’s important to enroll in Part D to avoid late penalties and ensure access to affordable medications.
Enrollment and Costs FAQs
How much does Medicare cost?
- Part A: Most people don’t pay a premium for Part A if they have worked and paid Medicare taxes for at least 10 years.
- Part B: The standard premium is $170.10 in 2024, but it may be higher based on income.
- Part C and Part D: Costs vary by plan, and you’ll also need to factor in copayments, deductibles, and premiums for specific plans.
What happens if I miss my Medicare enrollment period?
If you miss your Initial Enrollment Period, you may face a late enrollment penalty, which can increase your Medicare premiums. You’ll also have to wait until the General Enrollment Period (January 1 – March 31) to enroll, with coverage starting on July 1.
Can I change my Medicare plan later?
Yes, you can change your Medicare plan during the Annual Enrollment Period (October 15 – December 7). During this time, you can switch between Medicare Advantage, Original Medicare, or enroll in a new Part D plan.
Veterans and Disability Medicare FAQs
How does Medicare work with Tricare for Life and VA Benefits?
If you have Tricare for Life, Medicare acts as your primary payer, and Tricare covers any out-of-pocket expenses. VA benefits cover care at VA facilities, while Medicare covers non-VA providers. Enrolling in both ensures comprehensive coverage for all healthcare settings.
What if I qualify for Medicare due to a disability?
If you qualify for Medicare due to a disability, you’ll be automatically enrolled in Medicare Part A and Part B after receiving Social Security Disability Insurance (SSDI) for 24 months. You may also enroll in a Medicare Advantage or Prescription Drug Plan to enhance your coverage.
Medicare with Medicaid FAQs
What is dual eligibility?
Dual eligibility means you qualify for both Medicare and Medicaid. Medicare will cover most healthcare costs, and Medicaid will help with premiums, copayments, and other out-of-pocket expenses. ACBS can help you navigate the complexities of dual eligibility to maximize your benefits.
What are Dual-Eligible Special Needs Plans (D-SNPs)?
D-SNPs are Medicare Advantage plans specifically designed for individuals who qualify for both Medicare and Medicaid. These plans often offer extra benefits like dental, vision, and transportation services.
ACBS-Specific FAQs
How does ACBS help with Medicare enrollment?
At ACBS, we provide personalized guidance to help you understand your Medicare options and select the best plan for your needs. Our expert team will walk you through the entire process, handle the paperwork, and provide ongoing support to ensure your plan continues to meet your needs.
Is there a fee for ACBS’s services?
No, our services are provided at no cost to you. We receive compensation from insurance companies when we help you enroll in a plan, allowing us to offer personalized advice without any fees.
How do I schedule a consultation with ACBS?
You can schedule a consultation by calling our toll-free number, attending one of our webinars, or filling out a form on our website. One of our Medicare specialists will reach out to you to set up a convenient time for your consultation.
Have Questions?
If you have any additional questions or need personalized advice, feel free to contact our team today.
