New to Medicare? Here are the Answers to Your Medicare Coverage Questions

We understand that Medicare can be a complex and confusing topic, especially for those who are new to the system.

In this article, we aim to provide comprehensive information and answer all your questions regarding Medicare coverage as well as offer you a opportunity to connect with our team of licensed agents. Our goal is to help you make informed decisions about your health care and ensure that you have the coverage you need.

What is Medicare and Where Should I Go To Ask Questions?

Medicare is a federal health insurance program for people who are 65 years or older, certain younger people with disabilities, and those with end-stage renal disease.

Four Parts of Medicare

• Part A: Hospital insurance that covers inpatient hospital care, hospice care, and skilled nursing facility care.
• Part B: Medical insurance that covers doctor services, outpatient care, medical supplies, and preventive services.
• Part C: Medicare Advantage plan, which is a combination of Part A, Part B, and sometimes Part D coverage offered by private health care providers.
• Part D: Prescription drug coverage that helps pay for the cost of medications through Medicare drug plans.

Medicare is a federally regulated health insurance and requires licensed agents to answer your questions about benefits and options.  Our team of licensed agents at Plan Medicare in New York City and Long Island have helped nearly 50,000 with Medicare.

New to Medicare Questions You Should Ask

Here are some of the most common questions that people have when they are new to Medicare:

When can I enroll in Medicare?

You can enroll in Medicare during your Initial Enrollment Period, which is a seven-month period that starts three months before the month you turn 65 and ends three months after your birthday month. If you miss your IEP, you can enroll during the General Enrollment Period that runs from January 1 to March 31 each year.

Do I have to enroll in all parts of Medicare?

No, you can choose which parts of Medicare to enroll in based on your health care services needs. However, it is recommended that you enroll in both Part A and Part B to ensure that you have comprehensive coverage.

Our team has helped nearly 50,000 people figure out how to navigate Medicare enrollment scenarios.  For example, if you’re spouse is retired and you’re still working with employer health coverage and you’re over the age of 65.  Or, you are retiring early and losing your coverage and need to figure out what to do until your Medicare is active.

How much does Medicare cost?

The cost of Medicare depends on the parts you enroll in and is based on annual earned your income.

Part A is usually free for most people who worked most of their life, while you will have to pay a monthly premium for Part B. Part C and Part D are offered by private insurance companies, and the cost varies depending on the health plan you choose.

There are various plan scenarios and ways to shift costs around to fit your budget.  Our team can walk you through that process.

Will Medicare cover all my healthcare needs?

Medicare does not cover all health care services, so it may not cover all of your needs. For example, Medicare does not cover long-term care, dental care, hearing aids, or vision care. However, Medicare does provide coverage for a wide range of medical services, such as hospital stays, doctor visits, and prescription drugs. Additionally, some Medicare Advantage plans may offer extra benefits that are not covered under Original Medicare, such as dental, vision, or hearing care. It’s important to carefully review your plan’s benefits and coverage options to determine what services are covered and which are not.

How do I choose a Medicare plan?

You can compare Medicare coverage with the help of a licensed insurance agent. Consider factors such as the cost, coverage, and providers when choosing a plan that works for you.

We often here Medicare is a bit puzzling, but don’t let that worry you.  Our team is here to help.

Additional Medicare Questions You Should Ask

To make sure you’re fully informed, here are more important questions:

• What is Medigap?
  Medigap is also called a Medicare supplement and helps pay out-of-pocket costs like deductibles, coinsurance, and copays under Original Medicare. Medicare covers 80% and Medigap covers the other 20% you’re responsible for.
• What is the difference between Medicare and Medicaid?
  Medicare is federal health insurance, while Medicaid is a state and federal program that helps with medical costs for people with limited income.
• What are Medicare Savings Programs and Extra Help?
  These programs assist with Medicare premiums and prescription drug coverage for those who qualify.
• What happens if I delay enrollment?
  You may face penalties unless you qualify for a Special Enrollment Period.

Tips for Choosing a Health Plan

When comparing health plans like HMO, PPO options and Medicare Supplements, consider the following:

• Part B premium and other Medicare costs.  This is particularly important for those of you with pensions and retirement accounts.  There is a formula we use to help you calculate your income related adjustment so you know exactly what your costs for Medicare will be and if you have any options to appeal.
• Prescription drug coverage under a Part D plan.  These plans are separate if you purchase a Medicare supplement and often included if you enroll in a Medicare Advantage plan.
• Network of health care providers.  This is important for HMO and PPO plans provided by Medicare Advantage plans only. For example, if you live in New York City, you would want to confirm if NYU Langone Health is in your network.  Medicare Supplements historically can be used with any provider that accepts Medicare, regardless of their network. For 
• Extra benefits like dental or vision.  This is important because original Medicare doesn’t cover dental.

Conclusion

Understanding Medicare coverage can be overwhelming, but we hope this article has helped answer your questions. Remember that Medicare is a personal decision, and what works for someone else may not work for you. Take the time to research your coverage options and choose a plan that meets your unique health care needs.

Contact us today or schedule an appointment with one of our advisors.