If you commonly use prescription medications, you most likely have a Medicare Part D Prescription Drug Plan. These plans are designed specifically to provide medication coverage for Original Medicare recipients. Or, you may also have a Medicare Advantage plan that includes prescription drug coverage. Each of these plans can differ in the specific medications that […]
Coverage
Are All Medicare Advantage Plans Available Everywhere?
Over 24 million Americans have chosen to get their Medicare benefits through a Medicare Advantage (Part C) healthcare plan. Anyone who is eligible for Part A and Part B can enroll in a Medicare Advantage plan. MA plans are offered by private insurance companies who contract with Medicare. They are required to provide the same […]
Are All Medicare Part D Plans the Same?
Anyone who is eligible for Original Medicare benefits is also eligible for prescription drug coverage plans, or Medicare Part D. Medicare Prescription Drug Plans (PDPs) and Medicare Advantage plans with prescription drug coverage provide beneficiaries with coverage that helps them pay for brand-name and generic drugs. More than 43 million Americans are enrolled in Part […]
What Should I Do With My Part D Explanation of Benefits (EOB)?
If you have Medicare prescription drug (Part D) coverage, either from a stand-alone policy, or as additional coverage with your Medicare Advantage plan, you have probably received Explanation of Benefits notices after you receive medical services or supplies that are covered by your plan. An Explanation of Benefits (EOB) is not a bill that you […]
How Can I Get Extra Help Paying for Prescriptions?
Prescription drugs can be extremely expensive, and if you have more than one prescription to take or you take medications daily, the costs can be even greater. Medicare offers Part D to help lower the out-of-pocket costs of prescription drugs. Part D coverage can complement Original Medicare or be included in a Medicare Advantage plan. […]
Does My Medicare Coverage Change if I Move Out of Assisted Living?
Medicare recipients who reside in assisted living facilities most commonly leave because they need a higher level of health and custodial care. For many, this means moving into a skilled nursing facility where they can get help with their daily living activities and have access to around the clock nursing care. In some assisted living […]
What is the Part B late enrollment penalty?
Medicare Part B is optional coverage, but most people will choose to enroll during their initial enrollment period. This can be when you turn 65, or under the age of 65 if you’ve been receiving disability payments from Social Security or the Railroad Retirement Board for 24 months. If you don’t enroll in Part B […]
What is a Maximum Out-of-Pocket Limit?
When it comes to health insurance, there are lots of terms that get thrown around. However, not all of them are a simple as they seem. One of these terms is the out-of-pocket maximum. It is important to be aware of what this term means and how it relates to your Medicare Advantage plan. What […]
Why Should I Choose a PPO?
Medicare beneficiaries who enroll in a Part C, or Medicare Advantage, plan can expect to find a variety of options when it comes to how different plans manage their services and the access enrollees have to healthcare providers. A Preferred Provider Organization (PPO) plan is a type of Medicare Advantage that may give you access […]
What Drugs are Excluded from Part D Plans?
Whether you take medication on a daily basis to manage symptoms of a chronic medical condition or you occasionally need prescription drugs to treat acute healthcare concerns, there’s no denying that medications are an important part of the US healthcare system. As a result, many people who receive Medicare benefits opt to take part in […]
What is the Part D late enrollment penalty?
Original Medicare benefits include Part A and Part B, but most Medicare recipient choose to enroll in Part D when they are first eligible for Medicare. Part D helps cover prescription drugs and is an optional plan available to Medicare beneficiaries. Although it is voluntary, a late penalty may be imposed if Part D is […]
When Can I Enroll in a DSNP?
You may qualify for a Dual-Eligible Special Needs Plan (DSNP) if you get healthcare benefits from both Medicare and Medicaid. A DSNP is a type of Medicare Advantage plan that provides healthcare coverage for people who are eligible for both programs. Private insurance companies in many states offer DSNPs. These insurance companies are required by […]
What are CMS Star Ratings?
Unfortunately, not all healthcare providers are created equal. Having a poor experience with a physician or other medical professional can be frustrating and mentally draining, but it can have a negative impact on your health and wellness. The Internet provides patients with the ability to leave reviews about their experiences with healthcare providers, and these […]
What is a DSNP?
For millions of Americans who qualify as dual-eligible healthcare beneficiaries, trying to coordinate their health care with both Medicare and Medicaid services can be confusing. For this reason, there are Special Needs Plans from Medicare Advantage that provide you with a convenient way to manage your healthcare services under one policy. People who have dual […]
Do I Need a Referral to See a Specialist with Medicare Advantage Plans?
Depending on what type of Medicare Advantage plan you have, you may need a referral from your primary care physician before you can see a specialist covered by your plan. Common Types of Medicare Advantage Plans Insurance carriers who have been contracted by Medicare to offer recipients Part C options may offer different types of […]
When Can I Change My Prescription Drug Coverage?
Whether you have coverage through a standalone Part D prescription drug plan (PDP) or a Medicare Advantage plan paired with prescription drug coverage (also called MA-PD), you’ll be able to make changes to your coverage at certain times throughout the year. Initial Enrollment Period Medicare enrollment for those who are 65 years of age or […]
Can I get my prescriptions delivered with Medicare?
Upon eligibility for Medicare, the first step is to enroll in Part A and Part B. Drug coverage is offered to all Medicare recipients but requires enrolling in either a Medicare Prescription Drug Plan (PDP), or a Medicare Advantage that includes prescription drug coverage. Plans are sold by private insurance companies and will differ in premiums, […]
Do I Need Prescription Drug Coverage?
Medicare Part D prescription drug coverage has been available as an option for Medicare enrollees since 2006. Before that, Medicare beneficiaries had to pay full cost for all their drugs, which was a financial burden for millions of people. Luckily, Medicare recipients have the opportunity to sign up for prescription drug coverage to help them […]
Is Medicare Affected if I Move?
If you are thinking about moving to a different state, or outside your current Medicare service area, you many have questions about how this move will affect your healthcare coverage. The correct answers depend on what type of Medicare coverage you have. There are different procedures if you have Original Medicare coverage, Medicare Advantage, or […]
What Would “Medicare For All” Cost?
The term “Medicare for All” (MFA) is currently used to describe political proposals for expanding or replacing both of the now functioning Medicare and Medicaid programs. Even if Medicare for All may never be introduced into legislation, it can be helpful to understand what the conversations are about, and what the pros and cons of […]