Frequently Asked Questions

Medicare consists of four main parts:

1. Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most people don't have to pay a premium for Part A if they or their spouse paid Medicare taxes for a sufficient time.
2. Part B (Medical Insurance): Covers certain doctors' services, outpatient care, medical supplies, and preventive services. Most people pay a monthly premium for Part B.
3. Part C (Medicare Advantage): An alternative to Original Medicare (Part A and B) offered by private companies approved by Medicare. These plans include Part A, Part B, and usually Part D coverage, often with additional benefits.
4. Part D (Prescription Drug Coverage): Adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.

When it comes to Medicare, you generally have two main options:

1. Original Medicare (Part A and Part B):
   • You can see any doctor or hospital that takes Medicare, anywhere in the U.S.
   • You can add a separate drug plan (Part D) to your coverage.
   • You can buy supplemental coverage (Medigap) to help pay your out-of-pocket costs.
2. Medicare Advantage (Part C):
   • An "all in one" alternative to Original Medicare, these "bundled" plans include Part A, Part B, and usually Part D.
   • Plans may have lower out-of-pocket costs than Original Medicare.
   • In most cases, you'll need to use doctors who are in the plan's network.
   • Plans may offer extra benefits that Original Medicare doesn't cover - like vision, hearing, and dental services.

The best choice depends on your individual health needs, budget, and preferences.

Getting started with Medicare involves several steps:

1. Check your eligibility: Most people are eligible for Medicare when they turn 65. You may qualify earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS.
2. Understand the enrollment periods:
   • Initial Enrollment Period: Starts 3 months before you turn 65 and ends 3 months after.
   • General Enrollment Period: January 1 to March 31 each year if you missed your Initial Enrollment Period.
   • Special Enrollment Periods: Available under certain circumstances.
3. Decide on your coverage:
   • Choose between Original Medicare or Medicare Advantage.
   • Decide if you need additional drug coverage (Part D) or supplemental coverage (Medigap).
4. Enroll:
   • If you're receiving Social Security benefits, you'll be automatically enrolled in Part A and Part B.
   • Otherwise, you'll need to sign up through the Social Security Administration.
5. Review your coverage annually: Your health needs and plan offerings can change, so it's important to review your coverage during the Open Enrollment Period (October 15 to December 7) each year.

Consider speaking with a Medicare specialist or insurance agent to help navigate your options and ensure you're getting the coverage that best fits your needs.

Protecting yourself from Medicare fraud is crucial. Here are some tips:

1. Guard your Medicare number: Treat it like a credit card number. Don't give it to anyone except your doctor, other healthcare providers, or your Medicare plan.
2. Be wary of free offers: Be suspicious of anyone offering free medical equipment or services in exchange for your Medicare number.
3. Review your Medicare statements: Regularly check your Medicare Summary Notices (MSN) or Explanation of Benefits (EOB) for any services or items you didn't receive.
4. Be cautious of unsolicited calls or visits: Medicare will not call you to sell you anything or visit you at your home.
5. Don't let anyone persuade you to see a doctor for care or services you don't need.
6. Be cautious of providers who say they know how to bill Medicare to get Medicare to pay for a service that isn't usually covered.
7. Report suspicious activity: If you suspect fraud, call 1-800-MEDICARE or report it online through the Office of the Inspector General.
8. Educate yourself: Stay informed about common Medicare scams and fraud schemes.

Remember, being vigilant and informed is your best defense against Medicare fraud.