Lumaktaw sa pangunahing content

Getting Started with Medicare




For anyone who might not know, Medicare is a healthcare plan provider. It has 3 parts, Medicare Plan A, Medicare Plan B, and Plan D or commonly known as Original Medicare, Medicare Advantage Plan, and Prescription Plan. 

Original Medicare is usually applicable for in-patient hospital service, skilled nursing facility care, hospice, and home health care. It is also known as Hospital Insurance. While Medicare Advantage Plan or commonly known as Medical Insurance covers mainly your Outpatient and Physician Services, laboratory tests, wellness, and others.  And lastly, Medicare Plan D  or the Prescription Drug Coverage which covers the cost of your prescription drugs. This plan is usually run by private insurance companies that follow rules set by Medicare.

You have your options as to what Medicare Plan to get. Either you choose Original Medicare, Medicare Advantage, or you'll have Original Medicare and add on it a Medigap or Medicare Supplement Plan.


ORIGINAL MEDICARE ( Doctor and Hospital choice)

You can go to any doctor or hospital that takes Medicare, anywhere in the U.S. In most cases, you don't need a referral to see a specialist.

You usually pay 20% of the Medicare-approved amount after you meet your deductible. If you choose to buy prescription drug coverage, you'll pay that premium separately. 

There is no yearly limit on what you pay out-of-pocket unless you have supplemental coverage or a Medigap policy. This can help you pay your remaining out-of-pocket costs like your 20% coinsurance. 

It covers most medically necessary services and supplies in hospitals, doctors' offices, and other health care settings.

You can join a separate Medicare Prescription Drug Plan to get drug covered.

It doesn't cover care outside the U.S, however, you may be able to buy a Medigap policy that covers care outside the U.S.

MEDICARE ADVANTAGE

It is an "all-in-one" alternative to Original Medicare. This includes Part A, B and usually D. It can also have lower out-of-pocket costs than Original Medicare.

However, in most cases, you'll need to use doctors who are in the plan's network and you may need to get a referral to see a specialist. 

It also offers extra benefits that Original Medicare doesn't cover, like vision, hearing, dental and many more.

It has a yearly limit on what you pay out-of-pocket for Medicare Part A and B covered services. Once you reach your plan's limit, you'll pay nothing for Part A and B covered services for the rest of the year.

You can't buy or use separate supplemental coverage.

Prescription drug coverage is included in most plans.

Plans generally don't cover care outside the U.S. And plan usually doesn't cover non-emergency care you get outside o your plan's network.

Get the most out of Medicare

If you are still having a hard time choosing which Medicare Plan to get, you can get free, personalized counseling from your  State Health Insurance Assistance Program (SHIP). Just click this link for the  - contact numbers.

You can also call 1-800-MEDICARE (1-800-633-4227)
TTY Users can call 1-877-486-2048 or visit the Medicare Plan Finder at Medicare.gov/plan-compare.

Mga etiketa:

Mga Komento

Mag-post ng isang Komento

Mga sikat na post sa blog na ito

Durable Medical Equipment and Medicare

Medicare   Part B  covers the D urable Medical Equipment (DME).   These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home.  There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered. Eligible equipment Medicare’s DME benefit does not cover all medical equipment.  Medicare only covers DME if your  provider  says it is  medically necessary for use in the home . You also must order your DME from suppliers who contract with  Original Medicare  or your  Medicare Advantage  Plan . However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. DME coverage Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment...
Mag-post ng isang Komento
Magbasa nang higit pa

Everything you need to know: Medicare Dental Coverage

ADA, The American Dental Association said that individuals 60 and over face some rather unique dental concerns. Approximately one in four seniors have gone five years or more since their last dental visit and 16 percent in this age range consider their oral health as poor. Also, for instance, there are more than 500 medications that cause dry mouth, some of which were prescribed for high blood pressure, high cholesterol, Parkinsons's and Alzheimer's disease. This is now the common cause of cavities in older adults. Unfortunately, Medicare doesn't always help with this issue. In fact, according to Medicare.gov , this federal health insurance program typically does not cover dental care, procedures, or supplies. They don't provide benefits toward regular cleanings or services designed to treat and/or correct problematic oral issues, such as fillings or tooth extractions and they don't generally offer benefits for dental devices, including dentures and dent...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare Advantage Star Ratings

The Medicare Advantage and Part D star ratings for 2020 shows that more plans have 4 stars or higher star ratings this 2020 as compared to 2019. Also, there are more plans being offered to start on October 15.  According to the Centers for Medicare and Medicaid Services, there are about 1,200 more Medicare Advantage plans operating in 2020 than in 2018. Approximately 52 percent of contracts for Medicare Advantage plans offering Part D coverage earned 4 stars or higher, compared to about 45% in 2019. In the 401 contracts for 2020, 210 are at 4 stars or higher, compared to 172 in 2019 when there were only 376 contracts. Twenty contracts for MA and Part D earned 5 stars, 72 earned 4.5 stars and 118 earned 4 stars. This compares to 14 that earned 5 stars in 2019, 64 that earned 4.5 stars, and 94 that earned 4 stars last year. The comparison between 2020 and 2019 shows 55 contracts rated 3 stars for 2020 as opposed to 66 in 2019. The average star rating for 20...
Mag-post ng isang Komento
Magbasa nang higit pa