Medicare Questions Answered

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By Tina Fader

Did you know there are 10,000 Baby Boomers turning 65 every day right now? You are probably one of them, or know someone who is. I would like to go over some basic facts about Medicare that you may already know, or, perhaps, there’s a few things that are new.

Tina Fader

Who is Covered

If you are turning 65 you may apply for Medicare Part A and Part B  3 months before or after your 65th birthday. You qualify for Medicare Part A and Part B even if you choose not to take your Full Retirement Benefits (i.e. Social Security). Signing up late can affect costs. You may have to pay a penalty if you sign up late for Part B or Part D (Prescription Drug coverage). Even if you don’t take any prescription drugs now, you should still sign up for Part D because you will pay a late penalty fee if you wait to sign up. In many cases, there are no premiums for Part D coverage.

What is Covered

Medicare Part A is hospital insurance that helps cover hospital, skilled nursing, home health and hospice care. Medicare Part B is medical insurance that helps cover doctor visits, outpatient care and preventative services. It also helps to pay for services Part A does not cover, like occupational and physical therapy.

Part A and Part B covers much of your medical care, but not all, and you typically pay a deductible and coinsurance when you use it. That is why many people buy coverage with benefits beyond those included in Medicare.

Medicare Part C is a Medicare Advantage Plan that covers everything that Parts A and B cover and often includes services at no additional cost and may include Prescription Drug coverage. You must have both Medicare Part A and B to join a Medicare Advantage Plan. Medicare Advantage Plans usually include extra benefits and services like fitness programs and gym memberships, mail delivery pharmacy access, health education programs, and a 24-hour nurse advice line, and may lower your out-of-pocket costs. You may also be able to customize

your plan to meet your needs with optional supplemental benefits such as dental and vision coverage, for an added cost.

Frequently Asked questions:

Medicare Advantage Plan Types

Health Maintenance Organization (HMO). A primary care physician arranges your healthcare in the plan’s network.

Preferred Provider Organization (PPO). You can choose any provider, although you may pay more for out-of-network providers.

Private Fee-For-Service (PFFS). More freedom to choose providers may be available, however, a network arrangement may still apply. Medicare Supplement Insurance Plans. Medicare Supplement plans can be purchased to go

with Original Medicare to help with some costs Part A and B don’t pay, like coinsurance and deductibles.

Special Needs Plans (SNPs). Medicare Special Needs Plans are available only to people with specific diseases or circumstances. These plans include tailored benefits, providers and Drug Lists to meet the needs of members.

How My Plan Choices Affect Costs

Whether you choose Original Medicare or Medicare Advantage, you must pay your Part A and B premiums, if you have one. Medicare Advantage, Medicare Part D prescription drug coverage and Medicare Supplemental Insurance may have additional premiums. Your cost depends on the coverage you choose. The cost for a Medicare Advantage plan depends on whether the plan charges a monthly premium and pays any of your monthly Part B premium. Original Medicare and Medicare Advantage plans both cover routine services. Medicare

Advantage Plans are required to cover everything that Original Medicare covers, including coverage for services that Medicare considers medically necessary.

If you choose a Medicare Advantage plan, you still have Medicare coverage. You simply choose to receive your Medicare benefits through a private insurance company. You may pay an additional premium for the extra services and benefits of a Medicare Advantage plan.

Annual Enrollment Period Begins Oct. 1

This is a special election period when Medicare Beneficiaries can change plans for the following calendar year, between October 15th and December 7th, to become effective January 1, 2019. There are exceptions that may allow you to enroll outside of this period. Call me for any questions you may have. The best time make change to your existing plan is coming soon o October 1,2018.

Tina Fader is a Licensed Health and Life Insurance Professional offering Medicare Advantage Plans, Medicare Supplemental Plans, Vision and Dental Plans for all ages, and Life Insurance. Tina Fader has been a local resident for 20 years serving the community and looks forward to helping anyone needing personal service or has questions needing answers. You can reach Tina Fader for a confidential assessment at 850-368-8007 or e-mail at tinafader@yahoo.com.

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