Assistance on Medicare services and senior health care options by expert Medicare advisors at Americas Trusted Benefits

Medicare is a federal health insurance program primarily for individuals aged 65 and older, as well as some younger individuals with disabilities. It consists of different parts that cover specific services:

• Part A: Hospital Insurance
• Part B: Medical Insurance
• Part C: Medicare Advantage Plans (an alternative to Original Medicare)
• Part D: Prescription Drug Coverage

Medicare helps cover various healthcare services, but it doesn't cover all medical expenses or the cost of most long-term care. Beneficiaries may need supplemental insurance to cover additional costs.

Yes, Medicare is a form of health insurance provided by the federal government. It offers coverage for hospital and medical expenses for eligible individuals. However, it differs from private health insurance plans and may require additional coverage to meet all healthcare needs.

No, Medicaid and Medicare are distinct programs.

• Medicare: A federal program providing health insurance primarily for individuals aged 65 and older, regardless of income.
• Medicaid: A joint federal and state program assisting with medical costs for individuals with limited income and resources. Eligibility and benefits vary by state.

Some individuals may qualify for both programs, known as “dual eligibility.”

Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance). Medicare Advantage (Part C) plans are offered by private companies and provide all Part A and Part B benefits, often including additional services like vision, dental, and prescription drug coverage. Medicare Advantage plans may have network restrictions, while Original Medicare allows beneficiaries to see any doctor or hospital that accepts Medicare.

Original Medicare (Part A and Part B) does not cover most prescription drugs. To obtain prescription drug coverage, beneficiaries can enroll in a standalone Medicare Part D plan or choose a Medicare Advantage plan that includes prescription drug coverage.

Medigap, or Medicare Supplement Insurance, is a policy sold by private companies to help pay some of the healthcare costs that Original Medicare doesn't cover, such as copayments, coinsurance, and deductibles. Medigap policies do not include prescription drug coverage; for that, you would need a separate Part D plan.

Yes, if you are still working and have health insurance through your employer, you can have both Medicare and employer coverage. The coordination of benefits depends on the size of your employer:

• Employers with 20 or more employees: Your employer's plan is the primary payer, and Medicare is secondary.
• Employers with fewer than 20 employees: Medicare is the primary payer, and your employer's plan is secondary.

It's important to understand how your employer's insurance works with Medicare to make informed decisions about your coverage.

If you don't sign up for Medicare Part B when you're first eligible and don't qualify for a Special Enrollment Period, you may have to pay a late enrollment penalty. This penalty is an additional 10% for each full 12-month period you could have had Part B but didn't enroll. The penalty is added to your monthly Part B premium for as long as you have Part B.

Original Medicare does not cover most dental care, vision exams related to prescribing glasses, or hearing aids. However, some Medicare Advantage plans offer additional benefits that may include dental, vision, and hearing coverage. It's important to review the specific benefits of each plan.

Yes, Medicare covers a range of preventive services to help you stay healthy, including screenings, shots, and yearly wellness visits. Many of these services are provided at no cost if you meet the eligibility requirements and the services are delivered by a provider who accepts assignment.

Even if you haven't worked, you may still qualify for Medicare:

• Through a spouse: If your spouse is eligible for Social Security benefits, you may qualify based on their work record.

SSBCI stands for Special Supplemental Benefits for the Chronically Ill. These are benefits that can be offered to Medicare Advantage members with one or more complex chronic conditions, who are at high risk for hospitalization or adverse health outcomes, and who require intensive care coordination. Established in 2019 under the 2018 Bipartisan Budget Act, the goal of SSBCI benefits is to support delivery of essential non-clinical services that address social and environmental factors of health for members and caregivers with complex medical and social needs. SSBCI also provides funds to states, the District of Columbia, territories, and Tribal governments to promote American entrepreneurship, support small business ownership, and democratize access to capital across the country, including in underserved communities.