WHAT IS A MEDICARE ADVANTAGE PLAN?

Medicare Advantage Plan, also known as Part C, is a Medicare Plan run by private insurance companies.  A Medicare Advantage Plan offers all of the benefits covered under Original Medicare and more. Medicare pays a fixed fee to the plan you choose in accordance with the 2003 Medicare Prescription Drug, Improvement, and Modernization Act. It covers all of the benefits covered under original Medicare and more, like Dental, Hearing and Vision.

WHERE CAN I GET HELP PAYING FOR MEDICARE?

Financial assistance programs for people with limited income and assets include:

Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. If you get Extra Help but you’re not sure if you’re paying the right amount, call your drug plan. Your plan may ask you to give information to help them check the level of Extra Help you should get.

Medicaid is a joint federal and state program that:

• Helps with medical costs for some people with limited income and resources
• Offers benefits not normally covered by Medicare, like nursing home care and personal care services

In some cases, Medicare Savings Programs may also pay Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments if you meet certain conditions.

Programs of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. With PACE, you have a team of health care professionals working with you and your family to make sure you get the coordinated care you need. Usually, they care for a small number of people, so they really get to know you. When you enroll in PACE, you may be required to use a PACE-preferred doctor.

I AM DISABLE, WHEN CAN I GET MEDICARE?

You automatically get Part A and Part B after you get one of these:

• Disability benefits from Social Security for 24 months
• Certain disability benefits from the RRB for 24 months

You don’t need to sign up if you automatically get Part A and Part B. You’ll get your red, white, and blue Medicare card in the mail 3 months before your 25th month of disability.

When you decide how to get your Medicare coverage, you might choose:

• A Medicare Advantage Plan (Part C)
• Medicare prescription drug coverage (Part D)

There are specific times when you can sign up for these plans or make changes to coverage you already have.

WHAT IS THE DIFFERENCE BETWEEN MEDICARE AND MEDICAID?

Medicare and Medicaid are both government health care programs but they are very different. Medicare is generally for people who are older or disabled. Medicaid is for people with limited income and resources.

8 THINGS YOU NEED TO KNOW ABOUT MEDIGAP POLICIES?

1. You must have Medicare Part A and Part B.
2. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
3. You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
7. Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006, aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
8. It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you’re switching back to Original Medicare. In other words, you cannot have both a Medigap policy and a Medicare Advantage Plan.