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FAQ

When can I become eligible for Medicare plans?

 

You have to be 65 years old to become eligible for Medicare plans. However, younger people can also become eligible for these plans if they have some disabilities. Yet, they should first be approved by Social Security. 

After getting social security disability benefits for two years, people belonging to the criteria would become eligible for Medicare. People working for big firms or large employers might defer registering for Medicare as their salary can cover expenses. But, they still are eligible to enroll. Furthermore, patients of end-stage renal diseases are also suitable for Medicare plans.

 

Do I require Medicare plans if I am still working and have a job?

 

The answer to this question is circumstantial. Those working for companies that have around 20 or fewer employees and provide health insurance, such people should go for Medicare. Both Medicare Part A and B should be included for such people.

The other scenario does not consider the size of the company and is straightforward. People getting their health insurance from a company that is not creditable as per the definition of Medicare require enrolling in Medicare. 

Also, to eliminate the chances of penalties later, one should take both Medicare Part A and Medicare Part D that covers the Prescription of drugs.

On the other hand, those working in firms with more than 20 employees, and the coverage is creditable as per Medicare definitions; enrollment is not required.

Yet, a noticeable fact is that comparing what you can get with Medicare plans with what your group health insurance can cover is worth pondering. Choose whatever gives you the most out of your money.

 

What do the different parts of Medicare cover, namely A, B, C, D?

Medicare Part A covers hospital insurance. In simple words, it covers the hospitalization portion of the coverage and more. The expenses like inpatient rehab, in-home care, hospice, and others are all covered by Part A.

Medicare Part B covers medical insurance. In simple words, it covers the outpatient medical needs and provides coverage in that area. The expenses of doctors' services, home health services, tests, outpatient care, medical equipment, and services are covered by Part B.

Medicare Part C is often called a Medicare Advantage Plan. It is a type of health insurance provided by the private insurance companies to add up to the benefits provided by the Medicare Original plan. It covers Part A, Part B, and mostly cover prescribed drugs as well.

However, Medicare Advantage plans and Medicare Supplement Plans (Medigap plans) are different, and one shouldn't get confused between the two.

Medicare Part D is for drug coverage. Private insurance companies provide clients with Medicare Prescription Drug Plans that cover prescription expenses. 

Both generals, as well as brand-name drugs, are protected by it. However, the private companies must follow guidelines laid by Medicare to provide Medicare Part D coverage.

 

Is Medicare Part D optional?

Yes, Medicare Part D, that is drug coverage, is entirely optional. Not all the people required prescription coverage but enrolling in Part D coverage plans is a very crucial opportunity that, once missed, comes with penalties the next time. 

This means that people who do not enroll in the Drugs Plan. At the same time, eligible can enroll later but with a monthly penalty, also known as Part D Late Enrollment Penalty (LEP). This is a penalty for a lifetime. 

You can also enroll only for the Drug Plan later in the Annual Enrollment Period (AEP). It is between October 15th and December 7th every year, and enrollment cannot happen outside this period. Furthermore, the new drug plan would only begin after January 1st of the coming year.

 

Who is eligible for Medicare Supplement plans, and what do they cover?

Medicare Supplement Plans or Medigap Plans fill the gap left by Original Medicare and work as the primary insurance. Private insurance companies provide these plans. Types of Medigap plans are differentiated by the letter they are followed by like Medicare Plan G or N or F. So, they are suitable for tourists.

However, they are standardized by the government. This means that a Medigap plan provided by company A would cover what the Medigap plan offered by company B can cover. However, the monthly premium payment amounts taken by different companies might vary, but the coverage remains the same.

People who are on Medicare can enroll in Medicare Supplement Plans. However, people must take note of the timeframes where they can purchase the Medigap plans. 

They vary from one private company to the other. Also, those who have pre-existing health conditions may not be able to enroll in Medicare Supplement Plans.

 

When can I apply for Medicare Supplement Plans?

 

The primary requirement for enrolling in the Medicare Supplement Plan is to have Medicare Part A and Medicare Part B covered. Then, an individual can apply for Medigap plans anytime in the year. 

The best time to enroll is within the first six months following the 65th birthday. However, the vital thing to note is that pre-existing health conditions are not considered only during a specific period. 

After that, one would have to go through an underwriting procedure and be denied a Supplement Plan due to health conditions.

 

Can I enroll in both the Medicare Supplement as well as Advantage Plan?

 

No, you can either pick Medicare Supplement Plan or Medicare Advantage Plan. It is illegal for the agents to sell both the plans to one individual.

 

What are the ways of getting prescription drugs under Medicare?

 

There are three possible ways of getting drugs prescription coverage:

a)   You can get a Medicare Advantage Plan, and it would cover Part D.

b)   You can get a stand-alone Prescription Drug Plan along with the Medicare Advantage plan that doesn't include Part D, or with a Medigap Plan.