FAQ

How Does Medicare Work?
Medicare is a federal health insurance program that provides benefits to American citizens and permanent legal residents (of at least five continuous years) aged 65 and older, or who have a qualifying disability or illness. Most people are automatically enrolled into Original Medicare, Part A and Part B, when they become eligible; however, some people need to manually enroll in the insurance program. Part A is hospital insurance; Part B is medical insurance.

What does part C cover?
Medicare Advantage (Medicare Part C) gives you a way to get your Original Medicare coverage through a private, Medicare-approved insurance company instead of directly through the government. Advantage plans provide all you’re Part A and Part B benefits other than hospice care, which Part A still covers. But many Advantage plans include extra benefits, such as routine dental and vision services. And most Advantage plans include prescription drug coverage, letting you get all your benefits through a single plan.

Can I have Original Medicare? With no Health Plan?
If you stay with Original Medicare, be aware that prescription drugs aren’t covered in most situations.

What does my part D cover?
Medicare Part D offers prescription drug coverage through private, Medicare-approved insurance companies. You may want to consider adding a stand-alone Prescription Drug Plan.

What is a Medicare supplement?
If you decide to stay with Original Medicare, another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of- pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles

What is my Medicare effective Date?
For Original Medicare, Part A and Part B a simple way to determine your exact effective date is to refer to the lower right corner of your Medicare card or to refer to your letter from either the Social Security Administration or the Railroad Retirement Board.

If I retire at age 62, will I be eligible for Medicare?
No, but in some cases, when one spouse turns 62, the other spouse may qualify for premium-free Part A even if he or she hasn’t worked. Benefits start once you reach the age of 65 (unless you qualify by disability). You’re automatically enrolled at age 65 if you’re already receiving Social Security or Railroad Retirement Board benefits. If you’ve worked at least 10 years (40 quarters) while paying Medicare taxes, there is no monthly premium for your Part A (hospital insurance) benefits. But if you haven’t worked, or worked less than 10 years, you may qualify for premium-free Part A when your spouse turns 62, if she or he has worked at least 10 years while paying Medicare taxes. However, to be eligible, you need to be 65 years old. You also need to be an American citizen or legal permanent resident of at least five continuous years.

What is the monthly premium for Part B?
The standard Part B premium for medical insurance in 2016 is $121.80.

How can I get help with my Part B premiums?
States must help pay some of the costs for beneficiaries who have limited income and resources. Under these programs, states help pay for Part A and Part B premiums, deductibles and copayments. Some of these programs also pay additional expenses for elderly and disabled people.

Since Medicare doesn’t cover all my health care cost, how can I supplement Medicare?
Most people supplement Medicare with some other form of coverage, such as a Medigap plan, retiree plan, Medi-Cal (if they have low income and assets), or Veterans Affairs (VA) benefits (if they qualify). Others receive Medicare through private health plans called Medicare Advantage (MA) plans.

 

You may also go to Medicare.gov

Licensed sales agents at MP Insurance Solutions can help you find a health plan that matches your life style and needs. We can help you to understand the benefits entitled to you and how to utilize these added services.

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This is a solicitation of insurance. By providing this information, you agree that an authorized representative or licensed insurance agent/producer may contact you by phone, e-mail, or mail to answer your questions or provide additional information about Medicare Insurance plans.

Types of Plans

  • Managed Care Plans, also known as Health Maintenance Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Private Fee-For-Service (PFFS) Plans

Medicare is a Health Insurance Program for

  • People age 65 or older.
  • People under age 65 with certain disabilities.
  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).

Medicare Basics

  • Part A – Covers inpatient care in hospitals, skilled nursing facility, hospice care services, home health care services, and Religious Nonmedical Health Care Institution.
  • Part B – Covers medical services provided by doctors, outpatient care, and home health services.
  • Part C – Medicare Advantage Plans are offered by private insurance companies approved by Medicare.
  • Part D – Medicare Prescription Drug Plans (PDP) needs to be purchased separately, if not included in a Medicare Advantage Plan. Premium can vary by plan.
  • Medicare Supplement Insurance (Medigap) – Medigap helps pay Part A and Part B coinsurance, copayments, and/or deductibles and may have added benefits not covered by Original Medicare. These plans are sold by private insurance companies

Do I qualify? – You are eligible if you or your spouse paid Medicare taxes for at least 10 years, Disabled individuals who have been receiving social security benefits for a minimum of two years and Individuals who purchase their Medicare Benefits are also eligible.

Enrollment Periods

  • Initial Coverage Election Period: Begins 3 months before your 65th birthday, the month of your birth and then three months following the birth month for a total of 7 months.
  • Annual Enrollment Period: October 15 ~ December 7
  • Annual Disenrollment Period: January 1 ~ February 14
  • Special Enrollment Period: Timeframes for SEPs can vary. Most begin on the first day of the month in which the qualifying event occurs and last for a total of three months.

2017 Medicare Supplement Plans / Benefits

Basic Benefits

  • Part A Hospital
    – 61-90 days: $329/day
    – 91-150 days: $658/day (lifetime reserve days)
    – Beyond 150 days: 100% for 365 days
    • Parts A and B Blood Deductible (first three pints)
    • Part B Coinsurance: 20% of Medicare approved charges
    • Part A Hospice Care Coinsurance or Copayment
    * F Prime has the same benefits but does not pay until you have met the $2,200 deductible

Part A Deductible for 2017 is $1,316
Part B Deductible for 2017 is $183

Important Contact Info:

Medi-Cal: 877-597-4777  |  Medicare: 800-633-4227

Low Income Subsidy: 866-922-4368

You may also go to Medicare.gov

Have a question? We can help.

Call today to speak with an agent! (855) 731-8888

By calling this number, I understand I will be directed to a licensed insurance sales agent or broker.