Frequently asked questions

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How can I get dental and vision coverage with Medicare?

Original Medicare, comprising Part A and Part B, does not include coverage for routine dental or vision care. However, Medicare Advantage plans (Part C) often provide these benefits, along with additional services not offered by Original Medicare, such as prescription drug coverage. For more details about Medicare Advantage plans, please refer to page 10 of your Medicare resource material.

What will I pay for prescription drugs if I enter the Part D donut hole?

The Medicare Part D donut hole, also known as the coverage gap, occurs after your initial coverage period. You enter the donut hole when your total drug costs, including both your expenses and what your plan has paid for your drugs, reach a specific limit. These limits may vary from year to year.

How do I know if I’ll be able to see my same doctor when I’m on Medicare?

Numerous doctors accept Medicare, but it’s always wise to confirm with your specific healthcare provider. If you’re contemplating a Medicare Advantage plan (Part C) with a provider network, it’s crucial to check if your doctor is included. Review the provider list for each plan you’re considering to ensure your preferred healthcare professionals are within the network.

Who is eligible for Medicare program?

Medicare is available for people who are aged 65 or over, or if you are a person suffering from a disability or certain conditions such as end stage renal disease. You do not have to pay Medicare premiums if you are over 65 and are currently receiving benefits.

What does Medicare Part D include?

Indeed, that’s accurate. Medicare Part D is a prescription drug plan available to all Medicare beneficiaries. It covers a variety of prescription drugs, including at least two drugs in each category. Medicare Part D encompasses both formulary and generic prescription drugs. The plan is structured into three tiers, which impact the co-payment amount and the drugs covered under the plan.

What happens to my spouse’s health coverage when I retire and go on Medicare?

If your spouse is younger than you and there’s a gap between their coverage under your employer plan and Medicare eligibility, they might need to seek alternative coverage options. Your employer might provide COBRA for your spouse’s continued coverage; it’s best to discuss this with your employer plan administrator.

Alternatively, your spouse can purchase individual coverage through the Marketplace or directly from an insurance company until becoming eligible for Medicare. When eligible, they may qualify for premium-free Part A based on either your work record or their own.

What happens if I move? Can I keep the same Medicare Advantage plan?

Medicare Advantage plans operate within specific geographic service areas. If you move within the same service area, you can keep your plan. It’s advisable to contact your plan’s customer service number to confirm if your new address falls within your current plan’s service area.

However, if you relocate outside your plan’s service area, you’ll need to either choose a different Medicare Advantage plan or revert to Original Medicare. In the latter case, you might consider adding a standalone prescription drug plan and Medicare supplement insurance for comprehensive coverage.

When can I join, switch, or drop a Medicare Advantage Plan?

You have the option to join, switch, or drop a Medicare Advantage Plan during the annual open enrollment period, which spans from October 15 to December 7. Any changes made during this period will take effect on January 1 of the following year.

Is Medicare Part C the same as supplemental insurance?

Yes, that’s correct. Medicare Part C, also known as Medicare Advantage, provides supplemental insurance coverage designed to bridge the gap in payments between what Medicare Parts A and B cover and the actual cost of your medical treatments. These plans are offered by companies approved by Medicare.

I can’t afford to pay for Medicare — not even the Part B premium. Where can I get help?

Certainly, if you qualify, there is assistance available to help cover Medicare premiums and other associated costs. For more details and a list of resources.

973-221-3451

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Orange, NJ 07052, EE. UU.

Our agency focuses on Medicare-related insurance solutions, offering expertise in Medicare Supplement (Medigap), Medicare Advantage, Medicaid, Stand-Alone Part D Prescription, dental, final expense, individual, and long-term care plans. We specialize in guiding individuals towards suitable healthcare options tailored to their needs.

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We assist Medicare-eligible individuals in understanding the fundamental aspects of Medicare and guide them through their Medicare journey. Our goal is to help them make informed decisions, choosing the option that aligns best with their specific needs and requirements.