Medicare Basics: Answers to Common Questions - Physicians Mutual on Home & Family

Medicare Basics: Answers to Common Questions Hallmark Channel's Home & Family asked Physicians Mutual Vice President Bob Gunia back to the show to answer some of the most common questions people have about Medicare. What's the difference between Medicare and Medicaid? Medicare and Medicaid (in California, Medi­cal) are two separate programs with distinct differences. Medicare is a federally-run insurance program that serves people primarily over the age of 65, regardless of income. Most people become eligible for Medicare at age 65. The first time you can sign up is during your Initial Enrollment Period, which includes the month you turn 65, and the three months before and after. For the most part, Medicare is the same throughout the United States. Medicaid is a joint federal and state program that helps pay medical costs for families and individuals - regardless of age - who have limited income and resources. To be eligible for Medicaid, you must meet certain requirements. Some people qualify for both Medicare and Medicaid. What are my options for Medicare coverage? There are two ways to get your Medicare coverage. You can go with Medicare, which is Part A and Part B. Or, you can opt out of Medicare and go with Part C, also called Medicare Advantage. • Medicare (Parts A and B) - Part A is your hospital insurance. It provides benefits for hospitalization, skilled nursing, hospice and home health care. Most people don't pay for Part A since it's usually covered by the taxes you paid when you worked. Part Bis your medical coverage. It helps pay for things like doctor visits, outpatient procedures and emergency room services. There's a monthly premium for Part B, and that amount can change each year. • Part C (Medicare Advantage) - Medicare Advantage replaces Medicare. That means you opt out of Medicare, so you won't have Parts A and B. Medicare Advantage plans are offered by Medicare-approved private insurance companies. They normally cover Parts A and B, and sometimes include a prescription drug plan. Medicare Advantage plans - and their networks and providers - can change each year. It's also possible that a Medicare Advantage plan can be discontinued. What is Medicare Part D? Part Dis Medicare's prescription drug coverage and is available for a monthly premium. It, too, is provided by private insurance companies that work with Medicare. Generally, you'll want to sign up for Part D at the same time you sign up for Medicare - even if you're not on medications when you retire. That way, if you need medications down the road, you'll avoid a late enrollment penalty by having your coverage already in place. If I have Medicare and Part D, is that all I need? Medicare is a great program, but it was never intended to pay all of your medical expenses. There are deductibles and co-pays, and those can go up each year. To help cover these costs, many people get Medicare Supplement insurance - also called Medigap. This type of coverage is available through private insurance companies. There are several standardized Medicare Supplement insurance options, and the benefits you get depend on the option you choose. With Medicare Supplement insurance, you have a six-month Open Enrollment Period when you're guaranteed coverage, no matter what. That period lasts six months and begins the first day of the month in which you are 65 or older and enrolled in Medicare Part B. It's important to know when your Open Enrollment Period is. If you miss it and want to get coverage later on, you may have to answer health questions. You can only get Medicare Supplement insurance if you have Medicare, Parts A and B. What is Medicare Open Enrollment? Medicare Open Enrollment is the time each year when people already enrolled in Medicare can make changes to their coverage. It runs October 15 - December 7. People are often unsure about what to do during Medicare's Open Enrollment. Here are a few tips to help you better understand Open Enrollment: • If you have Medicare along with a Medicare Supplement insurance policy, and you're happy with your coverage, you don't need to do anything. • If you have a Medicare Advantage plan (Part C), Open Enrollment is the time to review your plan for the coming year since plan benefits can change each year. If your Medicare Advantage plan no longer fits your needs, you can change plans - or switch back to Medicare (Parts A and B) -during Open Enrollment. • If you have Part D, Medicare's prescription drug plan, Open Enrollment is also the time to review your coverage since plan benefits can change each year. If your current prescription drug plan no longer meets your needs, you can change plans.