Understand your Medicare coverage choices

If you already have Medicare or are having difficulty paying for healthcare coverage, you may be eligible for Medicare programmes that can assist you in saving money on pharmaceutical and medical costs.

Medicaid

If you have a low income and few assets, you may be eligible for Medicaid, a federal-state programme that assists with medical costs. Medicaid as well provides services that are not ordinarily covered by Medicare, such as nursing home care and personal care assistance. Each country has its own set of rules for determining eligibility and trying to apply for Medicaid. To find out if you meet the criteria, how to apply, and also how Medicare appears to work with Medicaid, consult one’s state's Medical Assistance (Medicaid) office.

Understand your Medicare coverage choices

Whenever it comes to getting Medicare coverage, you have choices. Original Medicare and Medicare Advantage are the two main options.

Consider these factors when determining which coverage is best for you:

Cost

  • Original Medicare requires you to pay a monthly Part B premium as well as any co-payments, coinsurance, and deductibles. There is no restriction to how much you can earn out of pocket, and you can get help by purchasing a Medicare Supplement Health coverage (Medigap) policy.
  • Medicare Advantage: You pay the Part B insurance payment as well as the plan's premium (if they have one). You must also pay any co-payments, species, as well as deductibles, however, once you reach the policy's yearly maximum, you will pay nothing at all for health care services for the remainder of the year.

Coverage

  • Original Medicare: Provides coverage for supplies in hospitals, doctors' offices, as well as other health-care settings under Part A (Hospital Insurance) or Part B (Medicare Advantage) (Medical Insurance). Users can supplement your prescription coverage by enrolling in a Medicare drug plan.
  • Medicare Advantage Plans: These plans must cover all of the services and supplies that Original Medicare does, and the majority of them include drug coverage. They may also have additional benefits such as dental or vision coverage.

Doctor and hospital choice

  • Original Medicare: You can choose any hospital or doctor who accepts Medicare.
  • Medicare Advantage: You may be required to use hospitals and doctors in the network of that plan.

Initiatives for Savings on Medicare

Even though you're not eligible for Medicaid, one of the following four Medicare Savings Programs may be able to assist you in paying your premium costs as well as other Medicare costs:

  • QMB (Qualified Medicare Beneficiary) Program
  • SLMB (Specified Low-Income Medicare Beneficiary) Program 
  • QI (Qualifying Individual) Program 
  • SLMB (Specified Low-Income Medicare Beneficiary) Program 

To see if you are eligible for savings through these programmes, contact your state Medicaid programme.

Extra Assistance

If you qualify for Assistance or maybe one of the Medicare Savings Programs listed above, you will automatically receive Extra Help paying for your prescription drugs. Additional Assistance is a programme that assists people with low income in paying Medicare prescription drug prices such as premiums, deductibles, and coinsurance. If you do not meet the criteria for Extra Help automatically, you can submit an application to us.

 


By Allen Sharen | Jun 15 2022

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