Answering Frequently Asked Questions Seniors Have About Medicare

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Medicare

President Barrack Obama signed into law the Affordable Care Act on March 23, 2010 as a health insurance reform legislation. If you want to know more information and detailed explanation about the Affordable Care Act, you can visit www.medicare.gov or you can get in touch with someone from the Serving Health Insurance Needs of Elders or SHINE through their website, www.FloridaShine.org

With the signing of the new Medicare act, there’s been questions rising to further understand what Medicare is all about as well as some other concerns that need more clarity. Here, we will attempt to answer some of the most frequently asked questions about Florida health care for seniors.

What is Medicare?

It is the federal health insurance program dedicated for people ages 65 years old and up as well as for people with certain disabilities ages 64 years old and below.

How does it work?

There are four parts of the Medicare program that you need to understand:

Medicare Part A refers to hospital insurance. This part of Medicare helps you pay for your hospital bills, home health care, rehabilitative nursing facilities, and hospice. In most cases, you don’t have to pay any premium for Medicare Part A because you’ve been paying it through your payroll tax while you were working.

Medicare Part B refers to medical insurance. This part of Medicare helps you to pay for your doctors’ fees as well as outpatient care. Medicare Part B requires you to pay a monthly premium. There is one thing that you need to understand and keep in mind: if you don’t sign up for Part B the moment you become eligible at age 65 or when you have already been disabled for 2 years but ultimately decides that you need some time in the future, you will may be required to pay a penalty for all those years that you’ve been eligible but didn’t sign up.

Medicare Part C refers to Medicare Advantage Program. This is an option where you can choose to have Medicare Parts A and B be provided by a private institution or a private insurance company if they offer a Medicare Advantage Plan that covers both Medicare Part A and Part B as well as other additional benefits as part of their package.

Medicare Part D refers to the coverage of prescription drugs. The way Medicare Part D works is typically the same as Part B where you will may be required to pay a penalty for the years you have become eligible but didn’t sign up.

What is Medicare Advantage?

This is a type of health insurance plan where you can get your original Medicare benefits through a private insurance company. This was created by the Balanced Budget Act of 1997 as well as the Medicare Modernization Act of 2003. Below are some of the examples of the Medicare Advantage Program:

  • Preferred Provider Organization plan (PPO)
  • Private Free-for-Service plan (PFFS)
  • Health Maintenance Organization plan (HMO)

What is HMO?

The Health Maintenance Organization program features specific list of networked hospitals, doctors and other providers where you can receive benefits. These in-network program provides additional benefits that are not covered in the original Medicare. These include prescription drug coverage, reduced cost-sharing, fitness and wellness programs.

Can you elaborate more on Medicare Part D?

The Medicare Part D took effect on January 1, 2006 where anyone who is entitled to Medicare Part A or anyone enrolled to Medicare Part B, regardless of income, will be eligible to enroll in this plan, which is a prescription drug benefit program that is designed to help Medicare members handle the rising cost of drugs at the same time give them access to prescription medication easily. This is a great addition to the Florida health care for seniors.

What are the things that I need to keep in mind when choosing a Medicare health plan?

You will need to consider and answer the following questions before you choose a Medicare Health Plan:

  • Do you already have a doctor or eyed a doctor of your preference?
  • Are you deciding to choose a new doctor?
  • Do you consider the liberty of going to any hospital or any doctor very important to you?
  • Will you be needing a prescription drug plan?
  • What’s your previous at the same time current health condition?
  • Do you currently take prescription drugs?
  • Are these drugs that you are taking covered in the formulary of the plan?
  • Have you asked your doctor about your healthcare needs?