Frequently Asked Questions
New Yorkers 65 and older may be familiar with Medicare. MetroPlusHealth’s Medicare Plans offer the same coverage as traditional Medicare, plus so much more. You’ll be covered head to toe by an extensive network of providers and services that are tailored to your needs.
Where do you apply for Medicare?
You can apply for Medicare through the Social Security Administration. You’ll need to provide your Social Security number, where you were born, start and end dates for any current group health plans and start and end dates for any group health plans after age 65. If you’re signing up for Medicare Part B, you’ll need a valid email address and your existing Medicare number.
Who is eligible for Medicare?
Medicare is generally for people 65 or older. However, you may be eligible for Medicare earlier if you have certain disabilities, End-Stage Renal Disease, or ALS (Lou Gehrig’s Disease).
What does Medicare provide?
There are four parts of Medicare. When you sign up, you can sign up for Parts A and B, or just Part A.
Part A: Part A is hospital insurance and helps pay for inpatient care at hospitals, skilled nursing facilities, hospice, and some outpatient home health care. If you worked and paid Medicare taxes for at least 10 years, Part A is free.
Part B: Part B is medical insurance and helps cover outpatient care, services from doctors and other providers, home health care, durable medical equipment and some preventative services. The premium for Part B depends on your income.
While Part A and Part B are federally run, private companies run Part C and Part D, though the federal government approves each plan. Costs and coverages vary.
Part C: This part is known as Medicare Advantage and is considered an alternative to Parts A and B. It typically bundles Parts A, B and D. It may also include vision, hearing and dental insurance. You are required to sign up for Part A or Part B before enrolling in Part C.
Part D: Part D helps cover prescription drug costs. You are required to sign up for Part A or Part B before enrolling in Part D.
Does Medicare have premiums?
Medicare Part A is free if you worked and paid Medicare taxes for at least 10 years, but most people pay a monthly premium for Part B based on their income.
Parts C and D are privately run so premiums will vary depending on coverage.
What are key considerations people should make in evaluating different Medicare plans?
While it may be tempting to go with what looks like the most affordable option, it’s important to evaluate your lifestyle, health and needs. This includes your yearly appointments, medications, preferred providers, and any anticipated treatments.
While only enrolling in Part A may seem cheaper, it could end up being a lot more expensive in the long run if you’re paying for your doctors’ appointments and prescriptions out of pocket.
It may also be worth considering the life you want to live as you continue to age. If you love to read or listen to audiobooks, you may want to ensure you have solid vision and hearing coverage with a Medicare Advantage plan.
Do you have a doctor or health network you trust? Make sure you’ll still be covered under your Medicare coverage.
Do you visit your grandchildren in another state regularly? You may want to ensure you’ll have access to doctors who participate in your Medicare Advantage plan there.
How can I maximize my Medicare benefits?
One way to maximize your Medicare benefits is by taking advantage of all the preventative care coverage it provides. This includes more than just a yearly check-up. It covers abdominal aortic aneurysm screening, bone mass measurements, mammograms, heart disease screening, cervical and vaginal cancer screening, diabetes screening, glaucoma tests, vaccinations, HIV screening, and prostate cancer screening. Catching things early will save you money — and stress — in the long run.
In the same vein, adding prescription drug coverage is worth it for many people. Just make sure to check your plan’s list of covered drugs and make sure yours are covered.
There are a lot of plan options, so don’t be afraid to ask for help. Call a Medicare representative or use the Medicare plan finder tool to talk through your options.
What parts of Medicare do I need?
Technically, Medicare isn’t mandatory. But Medicare Part A begins automatically at age 65. If you opt out, you may lose your Social Security or Railroad Retirement Board benefits. Or, if you decline and sign up later, you may have to pay a penalty.
You need to enroll in Medicare Parts A & B before deciding which additional Medicare parts may be right for you.
Medicare
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