Medicare In-Depth

Medicare is broad in scale and complex in nature. It comprises an alphabet soup of parts and plans.

Then there are the many policy combinations, eligibility guidelines, and enrollment periods.

We understand Medicare.

Here, we take on common questions and answer them in detail. Our goal is to remove any confusion or doubts you have about Medicare, so you can move forward with making your decision.

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Medicare In-Depth FAQ’s

What is Fall Open Enrollment?

Open Enrollment is a period when you can change your Medicare coverage, It occurs each year from October 15 to December 7.During this time, you can:Join a new Medicare Advantage Plan or a stand-alone Prescription Drug Plan (Part D).Switch between Original...

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Medicare Eligibility for Those 65+

When you turn 65, you become eligible for Medicare if you:Either receive or qualify for Social Security retirement cash benefitsOr, currently reside in the United States and are either:A U.S. citizenOr, a permanent U.S. resident who has lived in the U.S....

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Medicare Eligibility for Disabled Youths

If you have a child under the age of 20, they can only qualify for Medicare if they have End-Stage Renal Disease (ESRD). Additionally, to qualify for Medicare coverage, the child must:Need dialysis on a regular basis or require a kidney transplantAnd, have...

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Does My Income Affect My Medicare Cost?

If you earn a certain level of income, the law requires an adjustment to your monthly Medicare Part B (medical insurance) and Medicare prescription drug coverage premiums.This is called an income-related monthly adjustment amount.These beneficiaries, who...

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Outpatient Physical, Speech, and Occupational Therapy

Medicare Part B covers medically necessary outpatient therapy services, including:Physical therapySpeech-language pathology servicesOccupational therapyIf you meet Medicare’s eligibility requirements, Medicare covers therapy on a temporary basis to improve...

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Cardiac Rehabilitation Programs

Cardiac rehabilitation programs provide various services if you have a heart condition, including exercise, education, and counseling. These programs are designed to help improve your cardiac health and reduce risk factors. Medicare Part B covers both...

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Outpatient Therapy Costs

Medicare Part B covers outpatient therapy, including physical therapy (PT), speech-language pathology (SLP), and occupational therapy (OT). Previously, there were limits, also known as the therapy cap, how much outpatient therapy Original Medicare covered...

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When Does Medicare Part A and/or Part B Enrollment Start?

The first opportunity you have to enroll in Medicare is called your Initial Enrollment Period. The steps you should take to enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) depend on how you became eligible for Medicare and if you are...

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How Do I Qualify for a Part B Special Enrollment Period?

A Special Enrollment Period (SEP) allows you to enroll in Medicare outside of the standard Medicare enrollment periods. The Part B SEP is available only if you have delayed enrollment in Part B because you have employer group coverage. For example, when...

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Do I Get an Annual Wellness Visit with Medicare?

The Annual Wellness Visit is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan. Medicare Part B covers the Annual Wellness Visit if you have had Part B for over 12 months and you have not received...

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Are Preventive Services Free with Medicare?

 Preventive care is the care you receive to prevent illness, detect medical conditions, and keep you healthy. If you meet the eligibility requirements and guidelines for a preventive service, Part B of Original Medicare or your Medicare Advantage Plan must cover that...

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What Happens During the Welcome to Medicare Visit?

The Welcome to Medicare visit is a one-time appointment you can receive when you are new to Medicare. The goals of the visit are promoting general health and disease prevention.During the course of your preventive visit, your provider should:Review your...

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What Happens During the Annual Wellness Visit?

The Annual Wellness Visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan to help you avoid illness, based on your current health and risk factors.Keep in mind that the Annual Wellness Visit is not...

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What Are Emergency and Urgently Needed Services?

Emergency services these are covered inpatient and outpatient services you receive from a qualified provider. An emergency medical condition has symptoms that are severe enough that someone with an average knowledge of health and medicine could reasonably...

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How Does Medicare Cover Emergency Room Services?

If you have Original Medicare, Part B covers emergency room services anywhere in the U.S. Emergency room services are typically provided when you have a medical condition that requires immediate action, such as an injury or sudden illness. Medicare...

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How Does Medicare Cover Ambulance Transportation?

Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Medicare considers an emergency to be any situation when your health is in serious danger and you cannot be transported safely by other means. If...

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Does Medicare Cover Air Ambulance Transportation?

In limited cases, Medicare Part B covers transportation in an air ambulance. The service must be medically necessary, meaning that you require immediate and rapid ambulance transportation that could not be provided by a ground ambulance. More specifically,...

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