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.
Medicare Part B covers manual manipulation of the spine if medically necessary to correct a subluxation when provided by a chiropractor or other qualified provider. Medicare doesn’t cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture. If you only have Original Medicare, you will have to pay 20% of the Medicare-approved amount; the Part B deductible also applies. 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 chiropractic services. Please check your Medicare Advantage Summary of Benefits to see if your plan provides this supplemental benefit. Medicare’s Annual Enrollment Period (AEP) takes place every year from October 15th through December 7th. Kevin Leinum Medicare Agent wishes you a happy holiday season!
Original Medicare does not cover transportation for routine doctor’s office visits. The only transportation covered by Original Medicare is ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services. Transportation in an airplane or helicopter to a hospital if you need immediate and rapid ambulance transportation not available by ground transportation is also provided. There are, however, some Medicare Advantage plans that offer transportation services to doctors’ offices. Some provide unlimited trips, and others have a set number of trips defined by the plan. Please check your Medicare Advantage Summary of Benefits to see if your plan offers this supplemental benefit. 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.
Original Medicare usually doesn’t cover health care while you’re traveling outside the U.S. and its territories. There are some exceptions, including some cases where Medicare Part B (Medical Insurance) may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S. Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in only a few rare cases. Some Medicare Advantage plans offer international travel benefits. If you have Medicare Supplement (Medigap) Plan C, D, E, F, G, H, I, J, M or N, your plan: * Covers foreign travel emergency care if it begins during the first 60 days of your trip and if Medicare doesn’t otherwise cover the care. * Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year. * Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000. Before you travel outside the U.S., talk with your Medicare Advantage, Medigap plan, or insurance agent to get more information about your travel benefits. 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.
There are many benefits that people often think original Medicare will cover, and health club memberships are one of those. Original Medicare, Part A, and Part B do not cover any of the costs associated with gym memberships or fitness programs. However, other Medicare plan options may cover a gym membership cost as a part of their supplemental benefits. Medicare Advantage plans can offer a supplemental fitness benefit like a fitness club membership in their plans if they so choose. It is important to review the Summary of Benefits for each Medicare Advantage plan to understand if there is a fitness membership included and any limitations. Most of the fitness programs available as a part of Medicare Advantage plans limit you to a network of fitness clubs. Be sure you check and see if there are any located near you or if the one you want to go to is a part of the network. There are also very few Medicare Supplement plans that also provide supplemental fitness benefits, but they are rare. Medicare Advantage or Medicare Supplement insurance companies may offer supplemental fitness benefits through companies like SilverSneakers and others. Medicare’s Annual Enrollment Period is from October 15th to December 7th. 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.
SilverSneakers is not a benefit provided under Original Medicare. SilverSneakers is a company that some Medicare Advantage or Medicare Supplement insurance companies use to provide a supplemental fitness benefit to their members. SilverSneakers is a health and fitness program designed for adults 65+. If your Medicare Advantage or Medicare Supplement plan offers SilverSneakers benefits, they can include the following: – Go to thousands of gyms, community centers, and other participating fitness locations across the nation. – Take fun exercise classes designed for seniors of all fitness levels and led by trained instructors. – Access an on-demand video library of classes and workouts. – Download the SilverSneakers G.O. app to get your digital membership card and workouts (free, iOS, and Android). – Find a friendly, supportive community in person and online. Medicare Advantage or Medicare Supplement insurance companies may also offer supplemental fitness benefits through other companies than SilverSneakers. Call Kevin Leinum Medicare Agent at 6198865665- 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.
Under Original Medicare Part A & Part B, the following are NOT covered: Hearing aids or exams for fitting hearing aids. Most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services you get when you’re in a hospital. Medicare doesn’t cover eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B (Medical Insurance) covers eye exams for diabetic retinopathy once each year if you have diabetes. You may be responsible for a copay or deductible. Some Medicare Advantage plans offer dental, vision, and hearing supplemental benefits. Talk to your agent to find a plan that provides these if it is important to you. Medicare’s Annual Enrollment Period (AEP) is from October 15th through December 7th. 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.
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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.