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Medicare is a health insurance program for people age 65 or older. Some younger people are eligible for Medicare including people with disabilities, permanent kidney failure and amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS). Medicare helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).
Medigap is a supplemental insurance policy sold by private companies that can be used along with Medicare Parts A and B to fill the gaps in their coverage. It can help you cover costs related to deductibles, copayments, coinsurance, and more.
Is Medicare Advantage or Medigap Coverage Your Best Choice? If you are in good health with few medical expenses, Medicare Advantage can be a suitable and money-saving choice. But if you have serious medical conditions with expensive treatment and care costs, Medigap is generally better
Medicare Supplement Plan G is the best overall plan that provides the most coverage for seniors and Medicare enrollees. Plan G will cover almost everything except the Medicare Part B deductible, which is only $226 for 2023
Medicare Advantage plans are offered by private insurance companies contracted through Medicare as alternatives for Original Medicare. These plans combine all of the benefits of Medicare Part A (hospital) and Part B (medical), and may also include prescription drug coverage, dental or vision coverage all for an affordable and sometimes $0 monthly plan premium.
Medicare Part D plans add prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. A prescription drug plan may help you save money on existing prescriptions or on medication needs in the future.
If you are receiving Social Security or Railroad Retirement or disability benefits, you will be automatically enrolled in Medicare Part A and Part B. About 3 months prior to your 65th birthday or 24th month of disability, you will be sent an Initial Enrollment Package that will contain information about Medicare, a questionnaire and your red, white and blue Medicare card. If you want both Medicare Part A (hospital insurance) and Part B (medical insurance), you should sign your Medicare card and keep it in your wallet. If you don't want Part B coverage, you must put an X in the refusal box on the back of the Medicare card form; sign the form and return it with the card to Social Security at the address shown. You will then be sent a new Medicare card showing that you only have Part A.
Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extraction or dentures. There are rare cases in which Medicare Part B will pay for certain dental services. In addition, there are some situations in which Medicare Part A will pay for certain dental services delivered on an inpatient basis. You should contact your local Carrier for more information. Check the Important Phone Numbers of this web site for the phone.
Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. You should call your Durable Medical Equipment Regional Carrier for more information. Check the Important Phone Numbers section of this web site for the phone number. There are some Medicare Health Plans that cover prescription drugs. You can also check into getting a Medigap or supplemental insurance policy for prescription drug coverage. Medicaid may also help pay for prescription drugs for people who are eligible.
You qualify to enroll in Medicare during a Special Enrollment Period if you delayed enrolling in Part B because you were working and had group health insurance through your employer or your spouse's employer. If you sign up during the Special Enrollment Period, you do not have to pay the Part B premium surcharge. Signing up for Medicare Part B will begin your 6 month open enrollment period for buying a Medigap policy. You can enroll in Part B:
You should contact the Social Security Administration to file an application. The phone number for the Social Security office in your area can be found in the Important Phone Numbers section of this site.