Medicare's Most Asked Questions

1. What is Medicare? Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

2. What are the different parts of Medicare?

• Part A: Hospital Insurance

• Part B: Medical Insurance

• Part C: Medicare Advantage (an alternative to Original Medicare offered by private companies)

• Part D: Prescription Drug Coverage

3. When can I sign up for Medicare?

• Initial Enrollment Period: 3 months before, the month of, and 3 months after your 65th birthday.

• General Enrollment Period: January 1 to March 31 each year.

• Special Enrollment Periods: Various conditions like losing employer coverage.

4. How do I sign up for Medicare? You can sign up online at the Social Security website, by phone, in person at a Social Security office, by mail, or Call me. The simplest way is to call me first. I will walk you through the entire process. Education is the key to informed decisions. Lisa Maas 208-544-5011.

Coverage and Costs

5. What does Medicare Part A cover? Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.

6. What does Medicare Part B cover? Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

7. How much does Medicare cost?

• Part A: Usually premium-free if you or your spouse paid Medicare taxes while working.

• Part B: Standard monthly premium, which may be higher based on your income.

• Part C and Part D: Costs vary by plan and provider.

8. What are the out-of-pocket costs with Medicare? You might have to pay deductibles, co-payments, and co-insurance. Medigap policies can help cover these costs.

9. Does Medicare cover prescription drugs? Medicare Part D covers prescription drugs. You can add Part D to Original Medicare or get it through a Medicare Advantage Plan that includes drug coverage.

Enrollment and Eligibility

10. What happens if I don’t sign up for Medicare when I’m first eligible? You may have to pay a late enrollment penalty for Part B and Part D if you don’t have other credible coverage.

11. Can I still work and have Medicare? Yes, you can have both employer health coverage and Medicare. There are special rules for how the two work together. This is tricky. Call me if you decide to keep working past 65.

12. What is the difference between Original Medicare and Medicare Advantage?

• Original Medicare: Managed by the federal government, includes Part A and Part B.

• Medicare Advantage: Offered by private companies, includes Parts A, B, and often D, plus additional benefits like vision and dental.

Additional Coverage

13. What is Medigap? Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies.

14. How do I choose the right Medicare plan? Consider your health needs, budget, and the coverage options available in your area. I can go over all the options for you on the phone or in person.

15. What is Extra Help for Medicare prescription drug costs? Extra Help is a program to help people with limited income and resources pay for Medicare prescription drug costs. You can apply directly at www.SSA.Gov.

Using Medicare

16. Can I go to any doctor with Medicare? With Original Medicare, you can go to any doctor or hospital that accepts Medicare. With Medicare Advantage, you may need to use network providers.

17. Does Medicare cover long-term care? Medicare doesn’t cover most long-term care services, including custodial care. It only covers short-term stays in a skilled nursing facility or hospice care. We do have policies available that will cover long term care.