What do I need to do? If you received a notice from your insurance company that the plan you are enrolled in is not being offered next year, you will be given options to switch to a new plan. If you are enrolled in a Medicare Advantage or Part D plan that is being eliminated, you will receive a notice from the insurance company. You will be given a Special Enrollment Period (SEP) during which you can select and enroll in a new plan. The SEP’s length will be determined by the unique situation that led to your plan being eliminated and will be provided in your notice. If you are enrolled in a Medicare Supplement (Medigap) plan and receive a notice that your Medicare Supplement plan is not being offered next year, you will qualify for a Special Enrollment Period that will give you limited Guarantee Issue rights. You will have 63 calendar days from the date your coverage ends to find a new Medicare Supplement plan. However, you may be limited to a subset of available Medicare Supplement plans available in your area under this scenario. Let the experts at Kevin Leinum Medicare Agent help you understand the many parts of Medicare and determine the right fit for you. Give us a call to discuss the options available to you.
Those that are new immigrants to the United States are not eligible for Medicare. Only residents of the United States (citizens, permanent residents) are eligible for Medicare. If an immigrant is a permanent resident for five years and has continuously resided in the United States for that entire time, they can purchase coverage once they turn 65. In most cases, you will have to pay a premium for Medicare Part B. If you or your spouse worked and paid Medicare taxes for at least ten years (40 quarters), you will not have to pay a premium for Medicare Part A. These rules also apply to Medicare Advantage plans as well as Part D prescription drug plans and Medicare Supplement plans.
If an immigrant is eligible for Medicare coverage, they should also consider the other coverage options available, including Part D Prescription Drug plans, Medicare Supplement Plans, or Medicare Advantage plans. These plans supplement their Original Medicare benefits and may be required to avoid paying any late enrollment penalties. You can find many of the materials available from Medicare and other insurance companies in languages other than English. However, not all materials are always available in all languages, but translation services are available if you call the toll-free Medicare number or any insurance companies customer service phone number.
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If you didn’t enroll in Medicare during your initial open enrollment period when you first turn 65 or become eligible for Medicare, there is an annual General Enrollment Period. The General Enrollment Period runs from January 1st through March 31st every year. During this time, you can sign up for Part A and/or Part B if you didn’t sign up when you were first eligible, if you aren’t eligible for a Special Enrollment Period.
If you don’t enroll in Part B when you’re first eligible, you may pay a penalty of 10% for each 12-month period you could’ve had Part B but didn’t sign up. In most cases, you’ll have to pay this penalty each time you pay your premiums for as long as you have Part B. The penalty increases the longer you go without Part B coverage, so it is crucial to enroll in Part B when you are eligible to avoid any late enrollment penalties.
If you are still working and covered under an employer group health plan when you turn 65, don’t worry, you can defer your enrollment in Medicare with no penalty. You will be given an 8-month Special Enrollment Period (SEP) to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):
– The month after the employment ends.
– The month after group health plan insurance based on current employment ends.
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The short answer is no. If you like Original Medicare, you don’t have to make any changes. However, it would be wise to talk to an independent agent who is an expert in Medicare to ensure that original Medicare is the most appropriate choice for your specific situation. At a minimum, you should also consider enrolling in a Part D Prescription Drug plan since prescription drugs are not covered under Original Medicare. You could also be assessed a penalty if you don’t enroll in a Part D plan when initially eligible for Medicare.
There are several factors that may impact which Medicare plan is right for you. They include things like your health, financial situation, travel plans, and more. Enrolling in a Medicare Advantage plan can be very affordable, and often Medicare Advantage plans include significant additional benefits not covered under Original Medicare. These include things like transportation to doctors’ visits, dental, vision, hearing, over-the-counter drug benefits, and more. Medicare Supplements (Medigap) plans can also reduce the amount of out-of-pocket costs associated with Original Medicare.
Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call to discuss the options available to you.
You are not required to enroll in a Part D prescription drug plan; however, you will not have coverage for most prescription drugs if you don’t. If you don’t enroll in a Part D plan when you first become Medicare eligible, you will also incur a late enrollment penalty if you enroll later. You will have to pay a late enrollment penalty for any period of 63 or more days in a row when you don’t have Medicare drug coverage or other creditable prescription drug coverage after your initial enrollment period. In most cases, you will have to pay the penalty for as long as you have Medicare drug coverage. The amount of the late enrollment penalty is dependent on how long you did not have Part D or creditable prescription drug coverage. The penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($33.37 in 2022) times the number of full, uncovered months you didn’t have Part D or other creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium. Call Kevin Leinum Medicare Agent – your local Medicare Expert about what Medicare covers or how enrolling in a Medicare Advantage or Medicare Supplement plan can improve your coverage and reduce your out-of-pocket costs.
The answer to this question depends on the type of Medicare plan you are enrolled in. There are three different scenarios based on the type of Medicare plan you select. Original Medicare Part A & Part B Outside of your initial open enrollment period, when you first turn 65 or become eligible for Medicare, there is an annual General Enrollment Period. The General Enrollment Period runs from January 1st through March 31st every year. During this time, you can sign up for Part A and/or Part B if you didn’t sign up when you were first eligible, and you aren’t eligible for a Special Enrollment Period. Medicare Supplemental (Medigap) You can change Medicare Supplement plans anytime during the year. However, if you make a change outside your 6-month Medicare Supplement Open Enrollment Period, in most cases, you will have to go through medical underwriting. Depending on your health conditions, this could mean higher rates or being declined altogether. Medicare Advantage & Part D In general, if you are enrolled in a Medicare Advantage or Part D plan, you can only change plans once a year during the Annual Election Period (AEP), which runs from October 15th through December 7th. You may be able to change plans outside this enrollment period if you qualify for a Special Enrollment Period. You can also make one change during Open Enrollment, which runs from January 1st through March 31st if a plan change did not occur during the Annual Enrollment Period.
Medicare Part B covers medically necessary durable medical equipment (DME) if your doctor prescribes it for use in your home.
DME that Medicare covers includes, but isn’t limited to:
-Blood sugar monitors
-Blood sugar test strips
-Canes
-Commode chairs
-Crutches
-Hospital beds
-Infusion pumps & supplies
-Nebulizers & nebulizer medications
-Oxygen equipment & accessories
-Patient lifts
-Walkers
-Wheelchairs & scooters
Only your doctor can prescribe durable medical equipment that meets these criteria:
-Durable (can withstand repeated use)
-Used for a medical reason
-Not usually useful to someone who isn’t sick or injured
-Used in your home
-Generally has an expected lifetime of at least three years.
If your DME supplier accepts Medicare assignment, you will pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways, depending on if you need to rent or buy the equipment. If your DME doctors or suppliers aren’t enrolled in Medicare, Medicare won’t pay the claims submitted by them.
If you are enrolled in a Medicare Supplement or Medicare Advantage, your deductible, copay, or coinsurance may be different or less depending on the plan you have chosen. Medicare Advantage plans may also offer additional DME services.
Please check your Medicare Advantage Summary of Benefits.
Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give me a call to discuss the options available to you.
Generally, Medicare Part B covers the services that may affect people who have diabetes. Part B also covers some preventive services for people who are at risk for diabetes. Part B covers services like the following:
-Diabetes Screenings
-Prevention Programs
-Self-management training
-Equipment and supplies
-Foot Exams and Treatment
-Glaucoma Tests
Part D plans cover diabetes supplies used for injecting or inhaling insulin. Part D plans cover things like the following:
-Anti-diabetic drugs for maintaining blood sugar
-Certain medical supplies to administer insulin
-Insulin that isn’t administered with an insulin pump
If you are enrolled in a Medicare Supplement or Medicare Advantage, your deductible, copay, or coinsurance may be different or less depending on the plan you have chosen. Medicare Advantage plans may also offer additional services related to diabetes. Please check your Medicare Advantage Summary of Benefits to see if your plan provides any supplemental benefits. For more detailed information, read the following document: Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs.
Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call to discuss the options available to you.
Yes, a home health agency may decline you if it doesn’t have the ability or resources to meet your medical needs as long as it is consistent and does not accept other patients with the same needs. They are not required to accept you as a patient because your doctor has prescribed, and you qualify for care home health covered by Medicare. A home health agency can also decline to take you as a patient if they do not believe that they can ensure your safety in your current living situation. If you are enrolled in a Medicare Advantage plan, your plan may require you to get care from home health agencies in the plan’s network. Check with your Medicare Advantage carrier to determine if a specific home health agency is in their network. Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call to discuss the options available to you. Medicare’s Annual Enrollment Period (AEP) takes place every year from October 15th through December 7th.
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We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This is a proprietary website and is not associated, endorsed, or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program, please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.