Medicare
What is Medicare?
Medicare is a federal health insurance program for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (called End-Stage Renal Disease or ESRD).
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Who Qualifies for Medicare?
In order to qualify for Medicare you must be a United States citizen or permanent resident age 65 or older and receive or are eligible to receive Social Security benefits. Or, you receive or are eligible to receive railroad retirement benefits; or you or your spouse (living or deceased, including divorced spouses) worked long enough in government employment where Medicare taxes were paid; or you are the dependent parent of someone who worked long enough in government employment where Medicare taxes were paid. Also, certain people younger than age 65 can qualify for Medicare, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig's disease).
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What is Medicare Part A?
Medicare Part A can be categorized as hospitalization insurance. It covers inpatient care in hospitals, skilled nursing facilities and qualified home health and hospice care.
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What is Medicare Part B?
Medicare Part B can be categorized as medical insurance. It covers doctor's services and outpatient care, and certain other Medicare services that Part A does not cover (like physical and occupational therapists) and some home health care.
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What is Medicare Part C?
Medicare Part C, formerly known as "Medicare+Choice," is now known as "Medicare Advantage". Private insurers manage Medicare Advantage plans, like HMOs and PPOs. In order to join a Medicare Advantage Plan, you must qualify for Medicare Part A and Part B before you can apply for Part C.
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What is Medicare Part D?
Medicare Part D is prescription drug coverage, also offered through private insurers, and covers only Medicare approved prescription drugs.
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When can I apply for Medicare Part B?
You may apply for Medicare Part B when you turn age 65. If you still have group coverage through an employer, you do not have to sign up for Part B until that coverage ends. Individuals have the 3 months prior to turning 65 and 3 months following to apply.
After the year you turn 65, a 10% increase in premium penalty applies for each year of delay applying for Part B benefits.
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Medicare Supplement
What is a Medicare Supplement?
Medicare Supplement insurance is a supplemental insurance product designed to help pay for medical expenses not covered by Medicare. Medicare Supplement insurance plans are standardized by most states so that all insurance companies will have the same basic benefits for each category of plans.
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How old do I have to be to purchase Medicare Supplement?
Like Medicare insurance, you must be age 65 or older to purchase a Medicare Supplement plan, and persons with disabilities who qualify for Medicare may also purchase Medicare Supplement insurance.
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Are there different types of Medicare Supplement plans?
Yes, there are twelve standardized plans (A through L) and each plan comes with different rates and benefits.
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Are there advantages to selecting a Medicare Supplement plan versus a Medicare Advantage plan?
While the answer to this question may reflect your particular preferences, there are certain key features to a Medicare Supplement that should be considered. For example, because Medicare Supplement plans are open plans, you can visit the physician of your choice and are not limited to a particular network. Also, with a Medicare Supplement, you have the freedom to travel the country and receive the same benefits from state to state. For more information and Medicare Supplement plans, see your insurance professional.
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When can I qualify for Open Enrollment for a Medicare Supplement policy?
Once you have received both Medicare Part A and Part B you have a 6 month qualification period following your enrollment in Medicare Part B.
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What is "guaranteed issue"?
"Guaranteed Issue" is when you are not required to provide evidence of insurability to obtain coverage. If your health coverage terminates under certain circumstances you may be able to enroll in a Medicare Supplement policy regardless of your health status.
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What is an example of someone who would qualify for guaranteed issue for Medicare Supplement?
Someone whose group coverage is ending would qualify as guaranteed issue for Medicare Supplement.
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How long is the qualification period for guaranteed issue?
You must enroll within 63 days after your health insurance ends.
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Supplemental Health Plans
What are supplemental health plans?
Supplemental health insurance policies are purchased in addition to your primary health insurance. They are designed to help alleviate the burden of unforeseen out-of-pocket medical and non-medical expenses not covered by your primary insurance. They pay a cash benefit to the insured or to the person designated by the insured.
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Are there different types of supplemental health plans?
Yes. Some supplemental health insurance policies provide coverage for specific events or diseases such as cancer, accidental death, dismemberment, or confinement to a hospital.
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Why should I consider purchasing an Accidental Death and Dismemberment plan?
The very nature of an "accident" is the reason for purchasing accidental death and dismemberment insurance. No one expects to lose eyesight or a limb or lose their life through accidental means. Many accident related expenses such as advanced rehabilitative and physical therapies, and non-medical costs such as normal living expenses, or deductibles and copays may not be covered under your primary medical insurance. In the event of accidental death or a dismemberment situation, would you or your family be forced to dip into savings or liquidate assets? If so, you might want to consider purchasing this type of plan to prepare for the unexpected.
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What type of underwriting is used for an Accidental Death and Dismemberment Plan?
Accidental Death and Dismemberment plans are guaranteed issue so no one can be turned down.
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Why should I purchase a Supplemental Cancer plan?
Unfortunately, many primary health insurance policies do not cover cancer related treatment and expenses. While some plans may help to cover the major aspects of cancer treatment, there are generally many incidental day-today expenses that are not included in the plan.
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What is covered by a Supplemental Cancer plan?
Supplemental Cancer plans can be used to help cover coinsurance and deductibles of major health coverage, off-set some of the expense of drugs and medicine, provide benefits to help off-set the cost of certain experimental treatment programs and provide benefits for radiation and chemotheraphy, hospital confinement, surgery and anesthesia, ambulance service and hospice stays for cancer treatment.
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What else is covered by a Supplemental Cancer plan?
Transportation and lodging is an often overlooked expense that can quickly add up for cancer patients and their families. Some supplemental cancer plans offer benefits for ground and air transportation, and lodging necessary for treatment outside your home city.
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I have hospitalization covered under my primary health plan on my job. Why should I consider purchasing a Hospital Indemnity plan?
If you have ever seen an itemized hospital bill you know how expensive hospital stays can be. From the fees of the doctors and specialists to the charges for individual aspirin, the cost of any item not covered by your insurance becomes a rapidly mounting financial responsibility. In some cases, hospital bills can take years to pay off. Hospital Indemnity coverage pays a daily benefit for each day you are confined that can be used to cover these costs.
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What is covered by a Hospital Indemnity plan?
Hospital indemnity insurance is designed to assist with certain medical expenses and supplement many of the out-of-pocket expenses not covered by your primary health insurance such as coinsurance, deductibles, private room charges, in-room TV, expenses for travel and lodging, childcare, cell phones and other incidental expenses.
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