Frequently Asked Questions

Medicare is a health insurance program for people age 65 and older, people under 65 with certain disabilities, and people of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant). Medicare is run by the government and is divided into four parts: Part A, Part B, Part C, and Part D.

• Part A covers hospital stays, including inpatient care and some home health care services.

• Part B covers medical services and supplies, such as doctor visits and preventive care.

• Part C, also known as Medicare Advantage, is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies and are approved by Medicare.

• Part D covers prescription drugs.

Together, these four parts of Medicare help cover a wide range of healthcare services and supplies.

Open enrollment is the period of time each year when individuals who are enrolled in Medicare or Medicare Advantage can make changes to their coverage. During open enrollment, individuals can switch from Original Medicare to a Medicare Advantage plan, or vice versa, and they can also switch between different Medicare Advantage plans or prescription drug plans.

Special Enrollment Periods (SEP), also know as Special circumstances, is a specific time frame during which individuals who are eligible for Medicare can enroll in or make changes to their coverage outside of the regular enrollment period. SEPs are typically triggered by certain life events, such as moving to a new area, losing employer coverage, or qualifying for Medicaid. Individuals who qualify for a SEP have a limited amount of time to enroll in or make changes to their coverage, so it's important to be aware of the specific guidelines and deadlines for each SEP.

Medicare Advantage, also known as Medicare Part C, is a type of Medicare health plan offered by private insurance companies. It provides the same coverage as Original Medicare (Part A and Part B) and often includes additional benefits such as prescription drug coverage, routine dental and vision care, and even fitness memberships.

With Medicare Advantage, you have the flexibility to choose from a variety of plan options to find the one that best fits your needs and budget. And with the added benefits, you can save money on out-of-pocket costs and have peace of mind knowing you have comprehensive coverage.

Medicare Part A covers a variety of inpatient medical services, including:

• Inpatient hospital stays

• Inpatient care in a skilled nursing facility (not custodial or long-term care)

• Hospice care

• Home health care (if medically necessary and ordered by a doctor)

Part A is primarily designed to cover the cost of medical treatment and care that requires a person to be admitted to a hospital or other inpatient facility. It helps to pay for things like a private room, meals, nursing care, and other hospital services and supplies.

It's important to note that Part A has a deductible that must be met before coverage begins, and beneficiaries are generally responsible for paying a portion of the cost of the covered services and supplies, known as the coinsurance or copayment.

Part A is premium-free for most people, meaning that most people do not have to pay a monthly premium to have this coverage. However, if you do not qualify for premium-free Part A, you may be required to pay a premium for this coverage.

One important part of Medicare is Medicare Part B, which covers a wide range of medical services and supplies that are deemed medically necessary. Some of the things that Medicare Part B covers include:

• Doctor's visits

• Laboratory services

• Durable medical equipment (like wheelchairs and walkers)

• Mental health services

• Outpatient hospital care

So if you need to visit the doctor or need medical equipment to help you get around, Medicare Part B can help you. And with Medicare Solutions on your side, you can feel confident that you're getting the best coverage for your needs.

So don't stress about navigating the complicated world of healthcare - let Medicare Solutions take the wheel and steer you towards the coverage you deserve!

Medicare Advantage plans (also known as Medicare Part C) are private insurance plans that are approved by Medicare and are an alternative way to receive your Medicare benefits. These plans provide all the same hospital and medical coverage as Original Medicare (Medicare Part A and Part B), but they may also offer additional benefits such as:

- Prescription drugs

- Vision

- Hearing

- Deental services. Some Medicare Advantage plans may also offer home health care, transportation to medical appointments, and wellness programs.

Each Medicare Advantage plan is different, so it's important to review the specific coverage and benefits offered by the plan you're considering. You can use the Medicare Plan Finder tool on the Medicare website to compare different Medicare Advantage plans available in your area and see which ones might be a good fit for you.

A Medicare Advantage Dual plan is a type of Medicare Advantage plan that is specifically designed for people who are eligible for both Medicare and Medicaid. These plans are also known as "dual eligible special needs plans" or "SNPs".

Medicare Advantage Dual plans are required to provide the same level of hospital and medical coverage as Original Medicare (Medicare Part A and Part B), but they may also offer additional benefits such as coverage for prescription drugs, vision, hearing, and dental services. These plans are typically offered by private insurance companies that contract with Medicare to provide these benefits to eligible beneficiaries.

Medicare Advantage Dual plans are available to people who are eligible for both Medicare and Medicaid due to a disability, being aged 65 or older, or having end-stage renal disease (ESRD). These plans are designed to provide coordinated care and additional benefits to help meet the needs of dual eligible beneficiaries.