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.
Medicare In-Depth FAQ’s
Medicare generally does not cover medical care that you receive while travelling outside the U.S. and its territories. However, Original Medicare and Medicare Advantage Plans must cover care you receive outside the U.S. in certain circumstances:Medicare...read more
Medicare Advantage and Part D plans must work to maintain access to health care services and prescription drugs during emergencies for plan members living in affected areas. Plans must meet certain requirements following the declaration of a disaster,...read more
If I Delayed Enrollment in Part B Because I Had Insurance Through Current Employment, When Can I Enroll in Part B?
If you declined Medicare Part B or delayed enrolling in it because you were covered by insurance through the current employment of yourself or your spouse (or, in some cases, certain family members if you are eligible for Medicare due to disability), you...read more
If you missed enrollment in Medicare during your IEP and you cannot use the Part B SEP to email, you likely need to enroll using the General Enrollment Period (GEP). The GEP takes place January 1 through March 31 of each year. During this period, you can...read more
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...read more
There are times when you may be able to change your Medicare health or drug coverage. The length of the Special Enrollment Period (SEP) and the effective date of the new SEP vary depending on the circumstances that trigger your SEP. The plan and, in some...read more
Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. It is important to...read more
If you qualify for the hospice benefit, Medicare covers the following: Skilled nursing services, which are services performed by or under the supervision of a licensed or certified nurse to treat your injury or illness. Services you may receive include...read more
Hospice care is always covered under Original Medicare, even if you have a Medicare Advantage Plan. After electing hospice, care related to your terminal illness will follow Original Medicare’s cost and coverage rules. While you cannot receive curative...read more
Medicare’s hospice benefit should cover any prescription drugs you need for pain and symptom management related to your terminal condition. You pay a $5 copayment for outpatient pain and symptom management drugs. You pay nothing for drugs you receive as an...read more
Medicare covers hospice at a skilled nursing facility (SNF) only if the SNF has a contract with a Medicare-certified hospice that can provide your care. The hospice benefit will not pay for room and board at the SNF, so you will be responsible for that...read more
Medicare covers hospice care for two initial 90-day benefit periods, or a total of six months. After this, it will cover an unlimited amount of 60-day (two-month) benefit periods. At the start of each benefit period, your hospice doctor or a related...read more
If you decide you want curative treatment (instead of just palliative treatment), you have the right to stop hospice at any time. Speak with your hospice doctor if you are interested in stopping. If you end your hospice care, you will be asked to sign a...read more
As a Medicare beneficiary, you should look out for suspicious behavior from health care providers that might indicate Medicare fraud or abuse. For example, providers should not be providing or billing for hospice services for patients who are not...read more
An appeal is a formal request for review of a decision made by your Original Medicare, Medicare Advantage, or Part D plan. If you were denied coverage for a health service or item, you may appeal the decision. Before you start any appeal, make sure you...read more