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FAQ's
We Specialize in Medicare
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How do I enroll in Medicare? Is it automatic when I turn 65?Apply in person at a Social Security Administration office or apply online at www.SocialSecurity.gov/benefits/retirement If you are already collecting some form of Social Security (either retirement benefits or disability benefits) when you become eligible for Medicare, you will be automatically enrolled in both Part A and Part B.
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I’m I Eligible for Medicare?Medicare is available to people who are: · Age 65 or older · Younger than 65 with a qualifying disability · Diagnosed with end-stage kidney disease At age 65 or older you are eligible for Medicare if you worked and paid Medicare taxes for at least 10 years. If you have not worked for at least 10 years but your spouse (living, deceased or divorced) has worked and paid Medicare taxes for at least 10 years than you are eligible to enroll in Medicare Part A and Part B. If you (or your spouse) did not pay Medicare taxes while you worked or worked less than 10 years, you may be able to pay a monthly premium for Medicare Part A. If you get disability benefits from Social Security for 24 months you will receive Medicare Part A and Part B in your 25th month.
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When is my Initial Enrollment Period?Your Initial Enrollment Period (IEP) is 7 months long. It includes your birthday month plus the 3 months before and the 3 months after. Your IEP begins and ends one month earlier if your birthday is on the first of the month.
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What does Medicare cost – is it free?Part A does not have a monthly premium, for most people, however Part A does have a $1408 deductible for each benefit period. And days 61+ of a hospital stay have coinsurance. Part B has a standard premium of $144.60 per month and after a $198 deductible you pay 20% of the Medicare approved amount for doctor services.
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Should I enroll at 65 if I am still working and have employee coverage or coverage through a spouse?You can enroll in Part A as Part A has no monthly premium. Because Part B has a $144.60 monthly premium it is often best not to enroll in Part B while you have employee health coverage.
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Do I have to pay for Part B if I am still working and have employee coverage?No. Because Part B has a $144.60 monthly premium it is often best not to enroll in Part B while you have coverage. If Medicare automatically enrolls you in Part B when you turn 65, you can decline Part B.
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If I am 65 and not working but covered on my spouse’s plan do I need to sign up for Medicare?No
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If I’m newly eligible for Medicare because I have a disability, what can I do ?"You can sign up for a Medicare Advantage Plan or a Medicare Prescription Drug Plan. Your Medicare coverage begins 24 months after you get Social Security or Railroad Retirement Board (RRB) disability benefits. When? During the 7-month period that: · Starts 3 months before your 25th month of getting Social Security or RRB disability benefits · Includes your 25th month of getting disability benefits · Ends 3 months after your 25th month of getting disability benefits
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Do both my spouse and I have to be on the same Medicare plan?No
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Are there penalties for not signing up for Part D?If you are 65 or older and do not have coverage then Yes there are penalties for not signing up for Medicare Part D.
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What care is covered by Medicare, and what isn’t covered?"Does Medicare cover dental? No Does Medicare cover vision? No Does Medicare cover cataract surgery? Yes, Part B with a 20% copay. Does Medicare cover long-term care? No In home care? No Hospice? Yes Does Medicare cover hearing aids? No
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I am working past my 65th birthday, do I have to sign up for Medicare? "If you are working past your 65th birthday month and have credible employee health coverage or coverage through a spouse you do not have to enroll in Medicare. There will be no late enrollment fees. You can enroll in Part A as Part A has no monthly premium. Because Part B has a $144.60 monthly premium, it is often best not to enroll in Part B while you have employee health coverage.
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Does Medicare cover inpatient rehabilitation care?Yes, Inpatient rehabilitation can help if you’re recovering from a serious surgery, illness, or injury and need an intensive rehabilitation therapy program, physician supervision, and your doctors and therapists working together to give you coordinated care. After you have been in a hospital for at least 3 days, Medicare will pay for inpatient rehab for up to 100 days in a benefit period. Rehabilitation services, including physical therapy, occupational therapy, and speech-language pathology are covered.
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What is the difference in Medicare Advantage and Medicare Supplement Insurance?Medicare Advantage plans combine Part A and Part B benefits into one plan. Most include prescription drug coverage and offer additional benefits as well, often with no additional premium. Medicare Supplement Insurance helps pay for some of the out-of-pocket costs not paid by Original Medicare.
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Do I have to answer medical questions to get a Medigap plan? Are Medigap Plans guaranteed issued?If you apply for a Medigap policy during your Initial Enrollment Period then you do not have to go through medical underwriting.
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Can I change my mind after choosing a plan?Yes, Annual Enrollment Period runs from October 15th till December 7th each year, during this time you can make changes to your plan. Also, from January 1st and March 31st each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to Original Medicare, and buy a Part D prescription drug plan to supplement your Original Medicare. You also have the option to switch to a different Medicare Advantage plan during this time.
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I am going on an overseas trip. Will Medicare cover me if I need emergency care when I’m out the US?No
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What are the basic plan choices ?· Original Medicare and a Part D plan -- Part A + Part B + Part D · Original Medicare and a Part D plan and a Medicare Supplement plan · Original Medicare and a Medicare Advantage plan – Part A + Part B + Part C
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