Medicare is a health insurance program for people 65 and over and certain younger individuals. Medicare offers its original Medicare coverage, which includes part A and part B and two additional plans:
- Part A Medicare provides inpatient hospital coverage.
- Part B Medicare provides outpatient medical coverage.
- Part C Medicare (Medicare Advantage) provides an alternative way to receive Medicare benefits, including a private healthcare plan.
- Part D covers prescription drugs.
Even though Medicare has many benefits and caters to different needs, newly eligible Medicare beneficiaries may feel confused as they begin their journey with Medicare. Below, we have answered the six most frequently asked questions regarding Medicare assistance, so you get a little help with the entire process.
Commonly Asked Questions Regarding Medicare Assistance
1. How Can I Know What Type of Medicare Plan Is Right for Me?
To choose the right Medicare Plan, you must understand your medical health care needs and requirements. Based on that, select a Medicare plan. For example, if you regularly take prescription drugs, make sure you get Part D Medicare coverage. Or, if you have specific needs, opt for Medicare Advantage so you can easily customize it as per your personal health care needs.
2. What Is the Difference Between Medicare HMO and PPO?
When opting for Medicare Advantage, the type of plan you select determines how much you will be for health care and where you can seek treatment. There are two Medicare Advantage plans: Health Maintenance Organization (HMO) Plan and Preferred Provider Organization (PPO) Plan.
An HMO plan covers medical assistance you receive from a specific network of providers included in the plan. In comparison, a PPO plan allows you to receive care from their preferred providers but pays less than receiving the same care within the network.
3. Do I Have to Pay More for Medicare Part B If I Have a Higher Income?
Most people have to pay the standard premium amount for Medicare Part B. However, you have to pay a higher premium if your annual gross income is above a certain amount. This will be determined through your income reported in your IRS tax returns. Individuals who reported earning more than $85,000 per annum, or couples earning $170,000 per annum, pay an Income Related Monthly Adjustment Amount, also known as IRMAA.
4. Will I Get Medicare Supplement Plan?
You must already be a Medicare beneficiary to avail Medicare supplement insurance plan, also known as Medigap, and have to buy it separately. You can get Medigap during a 6-month open enrollment period. After the open enrollment period passes, Medigap might cost more and can also be denied.
Moreover, if you have Medicare Advantage (Medicare Part C), you are not eligible for Medigap.
5. Will Medicare Cover My Dental Costs?
Original Medicare, which includes Part and Part B coverage, will not cover your dental costs such as routine cleaning, scaling, cavity fillings, or root canals. However, in certain cases, Medicare might cover dental care costs related to other serious health conditions, for instance, a broken jaw.
Medicare Part C will cover dental costs, but it varies depending on the specific coverage plans.
6. What Can We Do to Prevent Medicare Fraud?
Medicare fraud is quite common, with many beneficiaries at risk every year. Here’s what you can do to avoid Medicare fraud:
- Don’t give your personal information to unsolicited and unofficial callers or visitors.
- Thoroughly research any potential providers claiming to provide Medicare services.
- If you notice any suspicious or fraudulent activities, file a claim with Medicare as soon as possible. You can call 1800-Medicare (1800-6334227).
- Don’t give out your Medicare information, such as Medicare card numbers, to anyone other than your health care providers.
- Don’t accept services and care you don’t need. If your providers are pressuring you to get unnecessary tests done, ask for a second opinion from other physicians.
- Join the SMP, also known as Senior Medicare Patrol. It is a great way to educate yourself and take an active role in preventing Medicare fraud and abuse.
If you are looking for a Medicare consultant in Ft. Lauderdale, Golden Guardians are here for you. Call 954-345-1214 today to learn more about us.