If you are eligible for Medicare, you have the option of receiving benefits from your original Medicare or Medicare Advantage plan. If you sign up for the Extra Help program, which helps older low-income adults pay out Medicare’s pocket money, you don’t have to pay a penalty. Keep this letter with you so you can show Medicare that you have access to all Medicare Part G benefits and the additional help you will need when the time comes to sign up for Part D. You don’t pay penalties when you sign up, but you can pay penalties in other ways, such as deductibles and co-payments.
The type of Medicare coverage you choose depends on where you live, which doctors accept your insurance, and whether your plan includes benefits beyond Medicare coverage. You can see which providers accept Medicare and which don’t, if you travel frequently, but you still keep your Medicare coverage.
Some private insurance companies offer standardized coverage plans, such as A & N, to make it easier to compare costs, while others do not.
Although you may not need to renew your Medicare coverage, it is always a good idea to review your coverage annually. Original Medicare Part A and B are sold by private insurance companies, but Medicare has rules that your insurance company must follow. Medicare and your insurance company pay a fixed amount into your plan each month to ensure coverage for your care.
This can change from year to year and affect how much you pay out-of-pocket, but the annual comparison of plans is one way to ensure that your coverage continues to meet your health needs and budget.
Medicare Part B covers all other medical services, including dental, visual, mental and other health services, as well as prescription drugs.
Optional coverage of prescription drugs is available to everyone in Medicare for an additional fee. Private companies offer plans to cover things that traditional Medicare does not, such as dental, vision, mental health and other health services. Original Medicare covers all other medical services as well as prescription drugs and dental and mental health care.
To help pay for things that are not covered by Medicare, you can opt to purchase supplemental insurance, known as Medigap (Medicare Supplement Insurance). These policies are offered by private insurers and cover things such as dental, visual, mental and other health services, as well as travel costs when you travel abroad. Medigap Type F offers the most comprehensive coverage, covering all co-pays and deductibles. Medigap policies vary, but most offer coverage for dental and visual care, and some policies cover other medical services such as physical and dental care when traveling abroad, according to the Centers for Medicare and Medicaid Services.
You are responsible for paying your monthly premium, whether you want Medicare Part B or not, according to the Centers for Medicare and Medicaid Services.
Medicare Advantage is perhaps better known as Medicare Part C, which is offered to seniors over 65 by Medicare – approved private insurance companies. Much like private health insurance, most Medicare Advantage plans require you to use approved medical providers, doctors and hospitals. This includes healthcare providers such as doctors, hospitals, pharmacies and nursing homes, as well as hospitals and other medical facilities.
Some people opt for a Medigap policy to see doctors who do not accept Medicaid, such as doctors in nursing homes, hospitals and other facilities.
If you have a Medigap policy and have joined a Medicare Advantage Plan (Part C), you may want to cancel it. You can’t use it to pay copies, deductibles or premiums for a Medicare Advantage plan.
You can switch from the original Medicare to Medicare Advantage at any time, but you must have all of your rights for the first 12 months you participate in a Medicare Advantage plan.
There are also some circumstances in which you have special enrollment rights that allow you to switch from the original Medicare to Medicare Advantage. For example, if you are already enrolled in the Medicare Advantage plan, you can opt out of the Medicare Advantage plan and sign up for original Medicaid or Medicare supplemental insurance (Medigap) for the first 12 months of your Medicare Part D plan. If and when you leave Medicare Advantage after switching from Medicare (there are a few exceptions), you will have the same rights that you would have been guaranteed under the original Part G plan in your first year of Medicare, but without the benefits.
The good news is that when you enroll in Medicare Part A on December 31, 2019, you can keep your original Medicaid or Medicare supplemental insurance (Medigap) for the first 12 months of your first Medicare year, as long as you have at least $1,000 in annual premiums and $2,500 in deductibles and the like. They do not receive the same benefits as everyone who is not eligible for Medicare on or after January 1, 2020, but can keep all benefits such as Medicare Advantage, Medicaid and Medigap.
Some Changes Due to COVID-19
According to the Journal of Accountancy, some of the major changes made to Medicare in response to COVID-19 include “testing for COVID-19 ordered after Feb. 4, 2020, is covered under traditional Part B when ordered by a physician or other health care provider. Beneficiaries are not required to pay the Part B deductible or any related co-insurance. If a Medicare patient is required to be quarantined in the hospital even if they no longer require acute care, they will not be required to pay an additional deductible for the cost of the quarantine. Part B is required to fully cover a COVID-19 vaccine if one becomes available.” For more information see www.cms.gov.