How Are My Health Care Costs Reimbursed If I Have Medicare And Medicaid
When dual eligible beneficiaries have healthcare expenses, Medicare pays first and Medicaid pays last. But this is not the case for things Medicare doesnt cover, like long-term care. If Medicaid is covering a beneficiarys long-term care, Medicare will still be the primary payer for any Medicare-covered services like skilled nursing care or physical therapy.
Although it is less common, if a dual eligible individual has additional coverage then Medicare pays first, Medigap will pay second, and Medicaid is the last payer for their claims .
How To Sign Up For Medicare Heres What You Need To Know
You can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- Online at www.SocialSecurity.gov.
- In person at your local Social Security office.
If you worked at a railroad, enroll in Medicare by contacting the Railroad Retirement Board at 1-877-772-5772 . You can call Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
What To Do Next When You Become Eligible For Medicare
If you currently have a health plan through Covered California:
If you dont currently have a health plan through Covered California:
If youre currently enrolled in Medicare Part A, or eligible for premium-free Medicare Part A, you cant enroll in new coverage through Covered California. This is because Medicare Part A is considered minimum essential coverage under the Affordable Care Act. But depending on your income and assets, you may be eligible for additional coverage through Medi-Cal. Once youre enrolled in Medicare, you can contact your local county office or complete the Covered California application to see if you also qualify for Medi-Cal.
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What Do I Do If I Receive A Medicare Scam Call
If you receive a Medicare scam call, hang up.
Speaking to the Medicare phone scammers, even to tell them off, can encourage more scammers to call your number. If calls persist, consider discussing certain scam blocking features with your phone company.
After receiving a Medicare scam phone call that asks for your Medicare number or other personal information, reach out to 1-800-MEDICARE â TTY:â¯1-877-486-2048.
If you have already discussed personal information on the phone that you now believe is in the wrong hands, contact the Federal Trade Commission to protect yourself from the damages of identity theft.
What Happens When I Drop Part B
If you follow the above steps and delay or drop Part B coverage, this means you are relying on your existing group health plan or private coverage for medical insurance. You will not have to pay Part B premiums .
However, there are some cases in which you should carefully consider whether or not to drop Part B. If you have health insurance that is secondary to Medicare, meaning it will pay after Medicare does, and drop Part B coverage, you risk having your insurance plan deny claims that Medicare would have paid for. If this happens, you may have to pay the full cost out of your pocket. You may also face late penalties.
To avoid late penalties and having to pay out-of-pocket, you should consider keeping Part B if:
- You have health insurance you purchased on the open insurance market, not provided by an employer.
- You have health insurance through an employer, but there are fewer than 20 employees.
- You have retiree benefits from a former employer.
- You have health benefits from TRICARE.
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What Is The Medicare Advantage Disenrollment Period
The Medicare Advantage Disenrollment Period, which is now called the Medicare Advantage Open Enrollment Period, is the time of year that someone who is on a Medicare Advantage Plan can make one change to another MAP or to a Supplement with a Part D plan, says Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. You can also switch to Original Medicare without a Supplement or prescription drug coverage during this period, but this would leave you with less coverage than your MAP.
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 of each year. This is important especially if a member used the plan in the first couple of months of the year and found out that their provider no longer participates in the plan or that they chose the wrong carrier and plan for their needs, Gavino says.
Write To Insurance Companies
You may write your insurance companies with questions that you have about your coverage. If possible, type up your letter and make sure to keep a copy that indicates the date on which you mailed it.
If you arent able to type up your questions, make sure to write in clear, concise print, leaving plenty of space in between your questions. Be sure to include your contact information in any correspondence that you mail to your healthcare provider.
Before sending mail that contains important documents or your private health information, call ahead and make sure that you have the correct contact information. Mail that is sent to the wrong address is not always forwarded to the right place, especially in places that receive a high volume of mail.
Addresses for major insurance companies that provide Medicare policies:
Aetna Inc.
If your ability to talk on the phone is limited because of a health condition, you can still reach out to Medicare. TTY users can call 1-877-486-2048 to reach a hotline compatible with their devices.
Centers for Medicare & Medicaid ServicesOffices of Hearings and Inquiries 7500 Security Boulevard, Mail Stop S1-13-25Baltimore, MD 21244-1850
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When Can I Enroll In Medicare Prescription Drug Coverage
Medicare prescription drug coverage is optional and does not occur automatically. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage, also known as a Medicare Advantage Prescription Drug plan. Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Please note that you cannot have both a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes prescription drug coverage.
Does Medicare Call Your Home
Spammers found a niche in claiming to be Medicare, so if you get a call from a person saying theyre with Medicare, you can guarantee its spam. You may also find that youll start getting spammy emails in your inbox if it sounds suspicious, it more than likely is! Please do not reply to any emails seeking personal information, and be sure to report it as spam immediately. You should never share your Medicare Identifier or Social Security number with a stranger.
If you get calls from someone claiming to be Medicare, get a name and phone number, and call Medicare to make a report.
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What Can I Do If My Call To Medicare Customer Service Is Unsuccessful
If you make a call to Medicare and are dissatisfied with your conversation or a lack of resolution, don’t fret. You have options available to you.
First, if you haven’t already, write down what happened during the call. You’ll want this in front of you when making future contact with Medicare, as it will be easier to explain what happened.
Next, call back: Every phone representative is different and you may find that the next person you speak to has better training and is able to address your concern.
If you have a complaint about your Medicare plan or Medicare prescription drug plan, you can submit a complaint to Medicare via a form on its website. This is not a good option for urgent issues, however and other concerns need to be dealt with on the phone or by mail.
Finally, you can send a letter via postal mail to Medicare that outlines your questions or concerns.
Cigna Medicare Advantage Plans In Arizona Only
Looking for a new Cigna Medicare Advantage Plan in Arizona? Call toll free:
For TTY service for hearing impaired callers, call 711 for Telecommunications Relay Service and enter the toll free number you are calling.
Looking for information on your current Cigna Medicare Advantage Plan in Arizona? Call toll free:
For TTY service for hearing impaired callers, call 711 for Telecommunications Relay Service and enter the toll free number you are calling.
Contact Customer Service by mail: Cigna
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How To Apply Online For Just Medicare
If you are within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet, you can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.
To find out what documents and information you need to apply, go to the .
Medicare Phone Number: Speaking To A Person At Medicare
Sometimes, it may be preferable to speak with someone at Medicare. The Medicare phone number is 800-MEDICARE, or 800-633-4227. A deaf or partially deaf person may call 877-486-2048.
An individual may call Medicare with questions about coverage, medical records, claims, billing, and expenses.
In addition to speaking with Medicare over the phone, individuals may acquire much of the information they need through two websites.
This article provides an overview of Medicare, explains what to expect when calling Medicare, and discusses alternate contact methods and contact methods for people with specific needs. Lastly, it examines non-Medicare sources for Medicare information.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare is the federal insurance program for individuals who are aged 65 and older, along with some younger people who have specific health conditions. It also provides coverage for a person of any age with end stage renal disease.
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What Is The Part B Premium Reduction Benefit
When you’re enrolled in Medicare Part B, you must pay a monthly premium of $170.10. The giveback benefit, or Part B premium reduction, is when the Part C Medicare Advantage plan reduces the amount you pay toward that premium. Your reduction could range from less than $1 to the full premium amount.
Even though you’re paying less for the monthly premium, you don’t technically get money back. Instead, you just pay the reduced amount and are saving the amount you’d normally pay.
If your premium comes out of your Social Security check, your payment will reflect the lower amount. If you don’t pay that way, the giveback benefit would be credited to your monthly statement. Instead of paying the full $148.50, you’d only pay the amount with the giveback benefit included.
For example, if you typically pay $170.10 per month but your MA plan’s giveback benefit is $50, you don’t get $50 back each month. Instead, you’d only pay $120.10 per month, keeping that $50 in your wallet. If your plan offers a full $170.10 refund, you wouldn’t have a Part B monthly premium to pay.
Unitedhealthcare Senior Care Options Plan
UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.
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Cigna Medicare Advantage Plans
For TTY service for hearing impaired callers, call 711 for Telecommunications Relay Service and enter the toll free number you are calling.
Looking for information on your current Cigna Medicare Advantage Plan? Call toll free:
For TTY service for hearing impaired callers, call 711 for Telecommunications Relay Service and enter the toll free number you are calling.
Contact Customer Service by mail: Cigna
When Do I Apply For Other Kinds Of Medicare Coverage
Are you thinking about signing up for a Medicare Advantage plan, a stand-alone Medicare prescription drug plan, or a Medicare Supplement insurance plan?
No matter what type of Medicare coverage you want, youll generally want to start by signing up for Original Medicare, Part A and Part B. Then, its usually a good idea to sign up for any other type of Medicare coverage you want, promptly.
Heres a quick rundown on the main Medicare coverage options you have besides Original Medicare and when to sign up.
- Medicare Advantage this program gives you an alternative way to get your Medicare Part A and Part B benefits . You need Part A and Part B to qualify, and then the plan manages those benefits for you. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Advantage enrollment periods.
- Stand-alone Medicare prescription drug plan you might want this type of plan if you need prescription drug coverage. You need Part A or Part B to qualify. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Part D enrollment periods.
Be aware that if you have a Medicare Advantage plan, it might include prescription drug coverage, so you wouldnt need a stand-alone plan. In fact, you generally cant have both a Medicare Advantage prescription drug plan and a stand-alone Part D prescription drug plan.
New To Medicare?
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Do I Need Medicare If I Am Covered By My Spouse’s Insurance
If you have insurance through a spouse’s employer, you may also be able to delay Medicare past age 65. However, this depends on the rules the employer has for covered dependents of Medicare age. Some employers may require covered dependents to enroll in Medicare at age 65 in order to remain on the employer plan. In this case, you’ll need to talk directly with the employer’s benefits administrator to learn about what you can do about Medicare enrollment.
How To Find Important Information About Medicare
If youre looking to find important information about your Medicare coverage, the Medicare hotline might not always have the answers youre looking for.
If you have Medicare Advantage, Medigap, or Medicare Part D prescription coverage, you may have to go directly to those private insurance providers for answers to your questions.
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Medicare Supplement Insurance Plans
Medicare Supplement Insurance plans also referred to as Medigap provide additional coverage for benefits not covered by Parts A and B. Medigap can help cover the following:
- Co-insurance
- Co-pays
- Part A or Part B deductibles
A Medicare Supplement Insurance plan may be right for you if you are already enrolled in Parts A and B. With a Medigap plan, visiting a doctor outside of the plans network may also be an option.
If you are interested in a Medicare Advantage plan, or have questions about Medicare Advantage, call 1-888-510-1750 to speak with a licensed insurance agent.
TTY: 711
What Is The Medicare Advantage Plan Initial Coverage Election Period
Most beneficiaries are first eligible to enroll in a Medicare Advantage plan during the Initial Coverage Election Period. Unless you delay Medicare Part B enrollment, this enrollment period takes place at the same time as your Initial Enrollment Period , starting three months before you have both Medicare Part A and Medicare Part B and ending on whichever of the following dates falls later:
- The last day of the month before you have both Medicare Part A and Part B, or
- The last day of your Medicare Part B Initial Enrollment Period.
If youre under 65 and eligible for Medicare due to disability, your IEP will vary depending on when your disability benefits started.
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Before You Call The Medicare Phone Number
Before calling 1-800-MEDICARE, have your Medicare card ready in case the representative needs to know your Medicare number. If you are calling with a question about a claim or a bill, have the bill or the Explanation of Benefits handy for reference.
It can also be helpful to keep a pen and paper ready to write down any important information your Medicare representative may share, such as additional phone numbers, dollar amounts, dates and more.
As Soon As You Are Automatically Enrolled In Medicare
You will no longer qualify for financial help to pay for your Covered California plan after your two-year waiting period ends. You will need to cancel your health plan through Covered California at least 14 days before you want your coverage to end. If you were enrolled in Medi-Cal instead of Covered California, you can ask your local county office if you will continue to qualify for other Medi-Cal programs that can lower your Medicare costs.
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