FAQ About Medicare
Biggers Family Medicine, which is located in Brandon, FL, offers a full range of healthcare services for the entire family. Dr. Joel Biggers and Dr. Elizabeth Biggers are some of the top primary care physicians in Brandon, FL. We accept Medicare. Keep reading to find answers to your most frequently asked questions about Medicare.
How does Medicare work?
Medicare is a national program administered by the Federal Government of the United States. You are eligible for Medicare benefits if you are age 65 or older or disabled. You are also eligible for Medicare benefits if you have been diagnosed with amyotrophic lateral sclerosis or kidney failure.
What Services Does Medicare Cover?
Medicare Part A covers hospice care, home health care, hospital inpatient care, surgery, skilled nursing facility care, and lab tests. Medicare Part B covers doctor visits, lab tests and X-rays, preventive services, mental health services, and durable medical equipment. Medicare coverage for many items, tests, and services depends on your location.
How do I Choose a Medicare Plan?
Visit Medicare.gov and use the Medicare Plan Finder to compare plans and find out the benefits, coverage, and estimated costs for each plan. You can use the Medicare Plan Finder to enroll in a Medicare Supplement Insurance (Medigap) policy, Medicare Advantage Plan, or Medicare Prescription Drug Plan.
Six things to know about Open Enrollment
Fall Open Enrollment is the time of year when you can change your Medicare coverage. You can:
Join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D) plan
Switch between Original Medicare with or without a Part D plan and Medicare Advantage
Listed below are six things to keep in mind while you are choosing your Medicare coverage.
1. Fall Open Enrollment occurs each year from October 15 through December 7.
Any change you make during Fall Open Enrollment will take effect January 1.
In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Part D plan.
If you have Medicare Advantage, you can also switch to Original Medicare. To get drug coverage, you should also join a Part D plan.
Depending on where you live, you may be able to buy a Medigap policy, which helps pay Original Medicare costs. Limitations apply as to who can buy a Medigap and when.
2. Review your current Medicare health and drug coverage. If you are dissatisfied with your coverage for next year, make changes during Fall Open Enrollment.
If you have Original Medicare, take a look at next year’s Medicare & You handbook to know your Medicare costs and benefits for the upcoming year.
If you have a Medicare Advantage Plan or a Part D plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and/or rules for the upcoming year.
Even if you are satisfied with your current Medicare coverage, look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Part D could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices.
3. Help is out there.
Use Medicare’s Plan Finder tool if you need help finding Part D plans. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs.
If you want to join a Medicare Advantage Plan, call 1-800-MEDICARE to find out which plans are in your area. When you receive the list of plans, check the plans’ websites or call them to see which best fits your needs.
If you research a plan online, also call the plan itself to confirm what you have learned. Make sure the plan includes your doctors and hospitals in its network. Confirm that the plan covers all your drugs, and that your pharmacies are in the preferred network. Write down everything about your conversation, including the date, the representative you spoke to, and any outcomes or next steps. This information may help protect you in case a plan representative gives you misinformation.
Call or visit the website of your State Health Insurance Assistance Program (SHIP). Your local SHIP can help you understand your Medicare coverage options and navigate any changes.
4. The best way to enroll in a new plan is to call 1-800-MEDICARE.
Enrolling in a new plan directly through Medicare is the best way to protect yourself if there are problems with enrollment. Write down everything about the conversation when you enroll through Medicare, including the date, the representative you spoke to, and any outcomes or next steps.
Before you enroll in a new plan, remember to confirm all the details about your new plan with the plan itself.
5. If you are dissatisfied with a Medicare Advantage Plan you choose during Fall Open Enrollment, you can change your plan during the Medicare Advantage Open Enrollment Period (MA OEP).
The MA OEP occurs each year from January 1 through March 31, with changes taking effect on the first of the month following the month you enroll. During this time, you can switch from one Medicare Advantage Plan to another, or switch from a Medicare Advantage Plan to Original Medicare with or without a Part D prescription drug plan.
6. Understand the difference between Fall Open Enrollment and Open Enrollment for the state or federal Marketplaces.
The federal Marketplaces (also known as Exchanges) offer annual open enrollment periods for uninsured and underinsured Americans. This enrollment period may overlap with Fall Open Enrollment. The Marketplaces are typically not meant for people with or eligible for Medicare.
If you have or are eligible for Medicare, you should only use the Fall Open Enrollment Period (October 15 through December 7) to make changes to your Medicare coverage.
Are Prescription Drugs Covered?
You may add drug coverage by joining a Medicare prescription drug plan (Part D). Some individuals with limited income and resources may be able to get Extra Help. This Extra Help will help pay for the costs, such as monthly premiums, prescription copayments, and annual deductibles.
How Much Does Medicare Cost?
A premium is the monthly amount you pay to Medicare for your health care coverage. The standard Medicare Part B premium for medical insurance in 2018 is $134.00. Premium amounts may change each year. New Medicare premium rates are announced each fall and become effective in January.
How do I Sign up for Medicare?
Generally, we advise people to file for Medicare benefits 3 months before age 65. Remember, if you don’t sign up for Medicare benefits when you’re first eligible, you may have to pay a penalty for as long as you have the coverage. You automatically get Medicare benefits after you get disability benefits from Social Security for 24 months.
If visits to the doctor haven't been one of your top priorities for the last few years, they should be. Going to the doctor is important at any age. Call Biggers Family Medicine at (813) 655-4646 today to schedule an appointment in Brandon, FL. Seeing a doctor regularly is among the best ways you can help protect your health and well-being.