We Help You Find the Best Medicare Options that Fit Your Needs and Budget

While “What is Medicare?” may seem like a basic question, it’s actually very common. Here’s what Medicare is, at its core:

Medicare is a federally funded and operated health insurance program originally designed for people who are 65 or older. However, throughout the years, Medicare has expanded to include disabled people under 65 and those with special circumstances. The program is divided into four parts: A, B, C, and D.

You’re eligible for Medicare if you meet the following requirements:

1. You must be a U.S. citizen or a qualified legal resident.
2. Both U.S. citizens and qualified legal residents have to be one of the following:

• Age 65 or older
• Younger than 65 with a qualifying disability
• Any age with a diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s Disease)

To qualify as a legal resident, you must have lived in the United States for at least five years in a row before applying for Medicare.

The need for health coverage can arise before your need for Social Security benefits. Social Security and Medicare are interrelated, but it’s possible to sign up for one without the other. You’re allowed to collect Social Security as early as age 62. Meanwhile, Medicare eligibility begins for most people at age 65.

When you have surgery, you pay for more than just the procedure. You pay for anesthesiology services, facility fees to use the operating suite, and of course, the surgeon’s fees. What you may not consider is the care you receive in the hospital after surgery – nursing care, tests such as lab work or X-rays, medications, and physical therapy, if you need it – that add to the bill.

You may have read about health insurers allowing mid-year enrollment and other insurance changes due to the coronavirus, and wondered what the changes mean for your Medicare coverage. The Centers for Medicare and Medicaid Services (CMS) has approved two special enrollment periods due to the coronavirus – meaning you’ll be able to change your Medicare Advantage or Part D coverage, or enroll in Medicare for the first time if you missed your initial enrollment period (IEP), Part B special enrollment period (SEP), or the general enrollment period (GEP).

Key takeaways:

• The penalty for delaying enrollment in Medicare Part B is an increased premium.
• Beneficiaries can get a Part B penalty waived if their enrollment delay was the result of bad advice from the government.
• To file an appeal, you’ll need to provide details about the bad advice – including when you received it.

With all the uncertainty around the new coronavirus, you may be wondering how your Medicare coverage will work if you need to be tested or even treated for COVID-19. There’s some obvious good news when it comes to testing, but when it comes to treatment, the answer is “it depends.”

Medicare already covers a number of telehealth services, and now provides significantly expanded telehealth benefits for the duration of the coronavirus crisis.

Before the public health emergency, Original Medicare-covered telehealth visits only if they took place through a video-based teleconference. (Telehealth also had to be delivered using HIPAA-compliant software.) Beneficiaries needed to live in a rural area to be eligible and had to travel to a facility-based “originating site” to have their visit.

Due to the emergency, telehealth is temporarily available to all Original Medicare beneficiaries – not just those in rural areas – and you can now connect through software platforms such as FaceTime and Skype. Check with your healthcare provider to see whether they have a preferred platform for telehealth.