Medicare Coverage Helpline: All You Need To Know About Medicare

You might have heard of the phrase “health is not valued until sickness comes”. Many people forget the importance of health until they become sick enough to make them realize how wrong they have been for not taking care of it. The cost of saving wealth just to sacrifice health is the worst decision made by anyone, and they end up feeling unaccomplished and weak.

To ensure that people go for regular checkups and get treatment for any complication, medical insurance has become a common facility to buy. The government and private companies introduced this insurance so that people can afford medical expenses to live a healthy life.

Medicare is also a medical insurance program that is widely bought by people living in the United States to gain medical benefits. It is affordable and convenient to every person who lives in the country as it is managed by the state government.

You can contact the Medicare Coverage Helpline to know everything about Medicare and its insurance plans. But before you contact, you need to know the basics about Medicare so that you don’t get confused.

Here’s everything you need to know about Medicare and Medicare Coverage Helpline:

What is medical insurance?

Medical insurance is a financially smart way of saving up money and getting the best medical treatment in the state without any loss. This type of insurance is signed between an individual and insurance company over agreed policies set by the government and company for medical benefits.

Medical insurance includes all the medical services one might need in life to remain healthy. There are different types of medical insurance plans that people have the option to select that they can afford to pay premiums for on a monthly basis. The premium amount is enough to take out money from your monthly income and afford the best medical treatment for yourself and your family.

Medical insurance is a very large industry around the world. There are insurance companies established as private or government organizations to facilitate their members with medical expenses.

Why is medical insurance necessary?

Medical insurance has become an important necessity in life for a healthy lifestyle. People who choose to not buy medical insurance end up suffering from financial losses or find it hard to pay their medical bills at the time of an emergency.

We live in a world where unexpected situations happen all the time and there might be no one to help us financially to cover the cost. Medical insurance is necessary so that you do not have to worry about medical bills during difficult times. When no one else has your back, medical insurance has it. Your pathway to survival and comfort is buying the right medical insurance for yourself.

Medicare definition

Medicare is a program administered by the federal government, a medical insurance program that facilitates the citizens of the United States. Medicare is a type of program that covers the medical cost for people older than 65 or young people who suffer from an illness.

This insurance program consists of many plans that are specific to medical services needed for treatments and other expenses. There are Medicare hospitals and centers where people who buy Medicare insurance can visit for treatment and get compensated financially.

Medicare has certain deductibles that you have to pay for the insurance plan to pay the rest of the amount with a copayment. There is also an out-of-pocket maximum set by the plan that a person who signed with Medicare should follow. You can contact the Medicare Coverage Helpline to get more information about Medicare too.

How does Medicare work?

Medicare is a big program that every citizen from the United States chooses to buy for a healthy lifestyle. As Medicare is administered by the federal government it is much affordable compared to private insurance companies.

Medicare works the same as any other insurance company you sign to. You pick an insurance plan that ranges from parts to sub-divided programs based on the medical condition of the person.

Medicare consists of parts, coverages, and health plan programs that are introduced by the government to facilitate its members with medical insurance. It gives compensation to people with certain disabilities, or if they suffer from end-stage renal disease and amyotrophic lateral sclerosis (ALS), and Lou Gehrig’s disease.

Medicare is different from normal private health insurance. Although it covers medical services, there are other exceptions that separate it from health insurance. For private insurance, you can buy it for your family, but Medicare is only for individuals who fall under the age or have a disability.

You can buy any of the plans based on your medical condition and your needs. If you are planning to buy insurance as a disabled or old person then you are eligible to apply through the Medicare Coverage Helpline.

Is Medicare free?

Medicare is an insurance program introduced by the state and federal government to U.S citizens. Medicare can be premium-free for people who fulfill the payroll taxes under the Federal Insurance Contributions Act.

Furthermore, the individual who themselves or their spouses can be qualified for free Medicare based on their work history, but only for Part A premium. You will have to pay for the premium of Part B even if your work history is eligible for free Medicare.

People who do not fulfill any of these requirements have to pay the full of cost premium to benefit from Medicare insurance services.

What are the parts of Medicare?

The Medicare insurance program consists of three parts that are made to facilitate old people aged more than 65. These parts are specific to certain medical services so that they are able to afford the expenses and bills easily. You can contact the Medicare Coverage Helpline to know more about these parts.

Here are the three parts of the Medicare program offered to citizens of the United States:

Part A

Medicare Part A consists of certain medical services that are associated with hospital insurance. This part is also known as the inpatient coverage as it covers the hospital bills and expenses for the insured person.

If you have a frequent visit or stay in the hospital, you can choose this part and benefit from the coverage plan. Note that only hospitals under Medicare can be covered by medical insurance.

Those people who have Social Security benefits automatically get Part A in their medical insurance. The deductible for Part A is $1,556 and daily coinsurance costs $389, for daily lifetime reserve days it is $778. You also get coinsurance for the nursing facilities in this part which is around $194.50. This amount is the estimated rate for 2022.

Part B

Medicare Part B offers services in medical to people who need coverage. In other words, this part is called the outpatient services that benefit the people who need medical attention more often.

People who need home healthcare services or medical equipment can opt for this part as it covers the cost of it. Medicare hospitals are not allowed to charge you more than the coverage plan when you have signed with the insurance.

The standard monthly premium that an individual has to pay for Part B is $170.10. This part offers an annual deductible of $233. This amount is the latest for 2022.

Part D

Medicare Part D covers the cost of prescription drugs from certain brands or a limited amount for the insured person. This part is also known as drug coverage because it solely covers drug costs.

This part is bought under a Medicare insurance plan so that you are able to afford drugs and get medical treatment benefits as well.

All these parts are usually bought together in health plans to ensure that there is no financial inconvenience. Part A and Part B are often bought together under plans designed by Medicare. Part D is bought with other health plans as well.

Medicare Health plans

Medicare health plans are managed by a private company that has to follow all the guidelines given by Medicare. It gives benefits to the members who have bought Medicare and need options in terms of health plans that fulfill their demands.

You can phone the Medicare Coverage Helpline to know more about these health plans in detail as well. Or you can read this article that has everything you need to know about health plans.

There are types of main Medicare health plans under which there are different types of insurance plan that one can buy for themselves only:

Original Medicare

Original Medicare is a type of plan that covers Part A and Part B together. Original Medicare is designed for people who need medical services from both parts in an insurance plan. This Medicare plan gives you the facility to visit any hospital in the United States that is under Medicare and receive insurance coverage.

There is a certain deductible amount set by Medicare that you have to pay before the insurance covers the cost of the rest. However, there is no out-of-pocket limit as you have copayment with the insurance plan. You will not suffer from any out-of-pocket loss under this plan as long as you follow the policies which you signed for.

Medicare Advantage plans

Medicare Advantage (MA) plans, also known as Part C of Medicare coverage because it offers medical services of both Part A and Part B, and some of Part D as well. These plans are approved by Medicare and offered to people at an affordable cost.

Under the Medicare advantage plan, there are four types of plans that you can choose from:

Health Maintenance Organization plan

Health Maintenance Organization or HMO is a plan that covers the cost of medical services under the plan’s network of health professionals and hospitals. You can only be covered by insurance from out-of-network hospitals in case of an emergency.

Most of the HMO plans under Medicare need to follow certain guidelines. They require you to get referrals from a primary doctor to see a specialist.  Some cover the cost of certain services outside of the network as well, but it depends on the premium you are willing to pay.

Preferred Provider Organization plan

Preferred Provider Organization or PPO plan is a type of Medicare advantage plan that a private insurance company offers to Medicare members. This plan consists of medical professionals, doctors, and hospitals under Medicare that you can go for treatments without any referrals under the insurance plan.

You can also choose to get covered services outside of the network but that will cost more than in-network. The emergency situations are also covered by this plan.

You pay by deductibles and copayments in this insurance plan, like any other to benefit from the medical services. Part D for prescription drugs can also be covered by the PPO plan with drug coverage in the policy. If you buy the plan without it, the insurance will not cover the cost.

Private Fee-for-Service plan

Private Fee-for-Service or PFFS plan is different from Original Medicare as it determines the cost of coverage for medical bills.

Just like other Medicare plans, this plan also requires you to get treatment from Medicare providers who have agreed to treat Medicare members. Only then the plan will cover the cost of medical expenses.

In short, the plan determines itself as to how much they will cover the cost for you based on certain documents on an annual basis.

Special Needs Plan

Special Needs plan, SPNs, is a type of plan that limits coverage for people with certain disabilities or diseases. People who are categorized in the special needs population are eligible for this plan because their needs are different from other people.

They are covered for provider choices and drug formularies medical benefits that are specific to special needs people. This plan requires you to have a primary doctor but you can get out-of-network coverage based on the plan you opt for. You can only see the specialist once you get a referral from the primary doctor.

People who live in a nursing facility or suffer from a long-term disability can also apply for this Medicare plan. If a person stays in an institution, there are plan providers who take care of them. You can contact that Medicare Coverage Helpline to know more about this plan.

Medicare Medical Savings Account plans

Medicare Medical Savings Account plans are types of Medicare health plans that are essential to many people for their medical benefits and affordable premium. Medicare has signed with many private insurance companies that offer plans to the members and facilitate them by getting the best plans. This plan is also known as the consumer-directed Medicare Advantage plan.

Medicare MSA plan is like health savings accounts plans but it is offered under Medicare. This plan gives you the option to choose your health professionals and hospitals. They do require you to receive treatment from their own network like the Medicare advantage plans.

This plan covers everything that a Medicare Advantage plan should cover and also includes the dental, vision, and hearing service expenses. Although to gain this coverage, you need to pay an extra amount.

Medicare MSA plans are divided into two kinds from which you can choose based on your needs:

High-deductible health plan

MSA plan offers a special plan that no other health plan can offer. This plan covers Part C of the Medicare insurance.

Just as the name suggests, you have to reach a certain high deductible on a yearly basis for the insurance plan to cover the cost for you. This deductible amount is set by the company and they inform you about it before you sign with them.

Medical Savings Account plan

This plan comes under Medicare to save the cost of premiums and other expenses of insurance plans through a medical savings account. They deposit money into the savings account that you can use to pay your medical expenses.

You can only pay the cost from this account before you reach the deductible limit set by the plan.

Other Medicare health plans

Other than these three health plans, there are three more plans offered by Medicare. These plans cover Part A and Part B services that are not mentioned in other plans. There is also a separate plan for people who need Part D. You can know more about this plan by contacting the Medicare Coverage Helpline.

Here are other Medicare health plans that you can pick from:

Medicare Cost plans

This Medicare plan is the same as the Medicare Advantage plans with more specifications. It provides services that are more than the Original Medicare. This plan is for people who have Part B, or both Parts in their plans and need additional medical benefits.

Medicare Cost plans offer you the facility to receive coverage outside of the network, unlike the MA plan. They also give the option for an individual to choose Part D with their Medicare. You also have the option to buy another drug coverage even if it is offered in the Cost plan.

Medicare members are allowed to subscribe to this plan whenever they want or leave if they are under Original Medicare.

Demonstrations/pilot programs

Medicare holds demonstration programs that are on a trial basis for the sake of improving the health plans. These special projects are limited to only a few people that are selected for a few areas that need improvement.

These programs provide medical benefits to the members and you have to give feedback to these programs. You can contact the Medicare Coverage Helpline to know when the demonstration program takes place.

Program of All-Inclusive Care for the Elderly plan

Program of All-Inclusive Care for the Elderly or PACE is a plan offered by Medicare and Medicaid to elderly living in facilities. This plan provides medical as well as social services to old people in the facilities.

The requirement for the elderly is to be registered members of Medicare or Medicaid.

How much does the Medicare plan cost?

Medicare plans have a wide range of rates. As each plan is made by keeping in mind to make it affordable for the citizens, they are economical for everyone with a good wage or savings.

Medicare health plans cost depends on what additional benefits you have added, but a rough cost just to give an idea is as follows:

Cost for Part A

Part A premium is usually paid by the government for most people if they have a record of payroll taxes or if their spouses paid Medicare taxes while working. This part is also known as Premium free Part A because a majority of people do not need to pay a premium for it.

You can get premium Part A if you are 65 and retired with benefits from Social Security. You can also be exempted from paying a premium for Part A if you have End-Stage Renal Disease (ESRD) and fall under certain requirements set by Medicare.

For Premium Part A, you have to pay $274 or $499 based on your or your spouse’s working history.

Cost for Part B

The premium cost for Part B has to be paid by people except those who have Social Security benefits. Medicare also sees the tax payment record to charge you for the monthly premium.

For an individual that has no benefits, the premium for Part B is $170.10; this amount is only for standard Part B. If you add drug coverage or other benefits, then you might have to pay higher. This amount can also be affected based on the gross income and IRS tax return for 2 years, in which you have to pay a standard premium as well as IRMAA. You can know more about this through the Medicare Coverage Helpline.

Cost for Medicare health plans

Medicare health plans are many so the cost of each plan varies from another. Furthermore, if you add drug coverage or dental, vision coverage you are charged for it as well.

All Medicare health plans have to pay on premium with few exceptions. Some plans might require you to pay only for Part B based on certain requirements. It is also affected by how much you visit and do copayment on the insurance plan.

Therefore, the cost of the insurance plan that your acquaintance or friend pays will be different from yours because it is the case-by-case cost. You can know the exact amount of cost for Medicare health plans by contacting the Medicare Coverage Helpline.

Which Medicare plan is best for you?

Medicare health plans are so many that you might get confused about which one is best for you. Medicare offers very specific plans but also general plans that fulfill the demands. Remember that Medicare is only eligible for those who are older than 65 or have a disability, or suffer from a terminal disease as mentioned before.

The best Medicare plan is picked based on your needs in daily life. If you go for frequent medical checkups then you should pick plans that are specific to medical insurance or Part B. If you need plans that can ease you in hospital expenses, then you can pick those plans which center around Part A.

Part C offers services from both Part A and Part B, so if you need both medical services, you can opt for the Medical Advantage plans.

There are people who need to buy expensive drugs that can give them financial loss, Medicare offers a Part D drug coverage plan that can cover the cost of drugs of certain brands or formularies. However, you can only buy drug coverage if you have Medicare.

If you are still unsure about which medicare plan to pick you can contact the Medicare Coverage Helpline.

What is Medical Coverage Helpline?

Medical Coverage Helpline is a special service offered by Medicare to people who want insurance. This helpline is made to help elderly people aged more than 65, or with a disability to facilitate all the processes of applying.

Medical Coverage Helpline assigns an agent to every individual to sign up for Medicare. These agents are insurance licensed and have the right expertise to guide you and advise you about Medicare plans based on your needs.

This is done through call, which is free of cost. You are connected to an agent who briefs you about Medicare plans. They ask about your medical history and other personal information that can fit the criteria of a certain plan. As Medicare plans can be quite complex, they simplify the policies and modify them based on your requirements for a perfect plan you can afford to pay a premium for.

Medicare Coverage Helpline deadline

The Medical Coverage Helpline is available from 8 am to 8 pm Eastern time (ET), from Monday to Friday. The agents can pick your call around this time.

When should I contact Medicare?

Medicare offers 247 services to all its customers and members. They have the best operators who are certified insurance agents to help you with anything. The agents are available during a specific time, but if you want to contact Medicare for general inquiry you can call anytime.

To speak with a licensed agent, you can call at 1-800-976-6274.

For general inquiries about billing and expenses, you can call on 1-800-633-4227.

Conclusion

Medicare is a program to facilitate U.S citizens to lead a healthy and happy life at an old age. The government has been making a lot of efforts to create the best plans and charge less to old people so that they can live in peace without being a burden to anyone.

Personally, getting medical insurance through Medicare is a way to better your lifestyle in old age. If you Social Security benefits, you get even more advantages as a Medicare member. You do not even have to pay a premium for certain parts based on your service and working history.

So, register for a Medicare health plan today through the Medicare Coverage Helpline.