Enrolling
When do you have to actively enroll in Medicare?
When you are still working
When you are not receiving Social Security benefits (retirement/disability)
Co-Pay
A fixed payment amount you pay for a health care visit or prescription at the time of service
Covers doctors visits
Part B
A joint federal-state program that helps cover medical costs for some people with limited income and resources.
Medicaid
Original Medicare is different than a Medicare Advantage Plan
TRUE
Medicare covers at 80% while the patient is responsible for 20% and does not offer dental or vision coverage
Medicare Advantage Plans offer hearing, dental and vision coverage. They also require prior authorizations and co-pays/co-insurances.
Who do you call to enroll into Medicare?
The Social Security Administration
Appeal
A process to request your Medicare health plan to reconsider or perhaps change the decision of denying your request for coverage for the medical care coverage you want
Part A
A program that assists individuals with limited income and resources in paying for their prescription drug costs under Part D
Extra Help
Once I pick a drug plan, supplement or Medicare Advantage plan I am stuck with it for life
Each year there is a Open Enrollment Period where you can review updates to next years policy and make a change if needed
Extra Help
Financial assistance from Medicare to help cover Part D drug plan costs
Hospital Admissions
Part A
Pennsylvania state programs that help eligible senior citizens afford prescription medications
PACE/PACENET
If I choose to enroll in a Medicare Advantage Plan, I no longer have Medicare.
FALSE
You still have Medicare coverage but you have chosen it to be administered through a private company.
How old do you have to be to enroll into Medicare?
65
Unless you have been receiving disability benefits for 24 months.
Deductible
The amount of money you must pay for a health care service before an insurance plan starts to pay
Prescription drugs
Part D
It helps adults in Pennsylvania who are 18 years or older with social and life services. They recommend local, state, and national resources based on what each person needs.
The Clearing House
I can only speak with someone at Medicare or a Private Insurance company about changing my Medicare coverage
FALSE
By reaching out to PA MEDI, you can be connected to a counselor that will provide unbiased information about Medicare coverage options so you can make an informed decision.
When are you automatically enrolled in Medicare
When you are receiving Social Security Benefits like retirement or disability (after 24 months)
Medigap
Medicare supplement insurance that helps fill the "gaps" in Original Medicare and is sold by private insurance companies
Injections performed by a medical provider
Part B
A federally funded, state-administered program that help individuals with limited incomes afford Medicare costs
Medicare Savings Program (MSP)
Insurance plans are not a one size-fits all
TRUE
The best coverage for you, will depend on your medications, providers and current healthcare needs. A plan that works great for your neighbor, may not be a good fit for you. It's good to look at all available options.