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Connect One Health is your expert at guiding you through the Medicare health plan maze. We are here to help you understand your choices and answer all of your questions about Medicare, Medicare Advantage, and the Prescription Drug plans. We can help you with questions about Supplemental Insurance, and Medicare B. We are patient, and we explain things in plain English.

There are several ways to contact us. You can call us toll free at 1-877-766-4448 to talk with one of our helpful professionals. You can also chat live with one of professionals through our Internet Chat link. We are here to make this easy for you. Contact us today.

Questions? Call Us at 1-877-766-4448

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Medicare: Basics

Quick FAQ

What is Medicare?Medicare is a health insurance plan that is owned and managed by the Federal Government. Medicare is found within the Department of Health and Human Services and managed by the Centers for Medicare and Medicaid Services.

Medicare is a government sponsored health program that most people automatically qualify for once they reach the age of 65. Medicare is also used to support medical insurance for people with qualifying disabilities and who are younger than 65 years of age.

Medicare is divided into four categories. Those are Medicare A, B, C, and D. Medicare A covers inpatient services like hospitalization. Medicare B works in conjunction with Medicare A to cover outpatient services such as doctors visits and therapy visits. Medicare A and B are often called Original Medicare.”

Medicare C is Medicare A and B but managed by third party health systems such as Kaiser. Medicare D is the prescription drug coverage that goes along with Medicare A, B, and C. Most Medicare C plans come with a variation of Medicare D. Medicare C is also referred to as Medicare Advantage.

To qualify for Medicare you need to have worked and paid into the program for a certain amount of years. If you have not qualified by working, you may still be eligible for services, but the penalty is a higher cost each month.

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What happens if I did not enroll in Medicare Part B during my election period?The answer depends on why you did not sign up for Medicare Part B during your initial enrollment period. If you need to enroll in Medicare part B you will need to call Medicare at 1-800-722-1213.

Considerations

  • If you are just newly 65 you may still have time. Your enrollment time is 3 months prior to your 65th birthday and extends to 7 months past your 65 birthday.
  • If you have private coverage you can sign up Medicare part B anytime you are still covered by your Employer, Union or Spouses’ Employers health plan for up to 8 months after the health plan ends.
  • General Enrollment periods occur each year and run from January 1 through March 31. When you enroll in during a General Enrollment your coverage begins July 1 of the year you enrolled.
    Penalties for late enrollment are 10% of your premium for Medicare B for each year (12 month period) that you were eligible for Medicare B but did not enroll. So for two years your penalty will be 20%.

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 What if I have a Secondary Health Care Insurance?The answer to that question depends on the rules of Coordination of Benefits. Sometimes Medicare will pay first, and your secondary insurance will pay second. Sometimes it is the other way around. What happens is that each type of insurance that you have is listed as a payer. Then each payer is assigned a number Primary payer, Secondary payer, etc. Who pays first is determined through a range of rules.

Things you can do to Help the Process

Give all of your insurance cards to your healthcare provider to copy. This helps your healthcare provide sort out who to send bills to first. You can call the Benefits Coordination & Recovery Center at 1-855-798-2627 toll free. Have your Medicare card handy when you call. This is a company that acts on behalf of Medicare to help answer questions about pay order for Medicare.

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Medicare Part A: What does it Cover?Medicare Part A covers hospital type medical expenses. These expenses would include part or all of the costs of inpatient medical stay, supplies for treatment while admitted, skilled nursing facility admissions, hospice care, and even home health care services.

Medicare part A is comprehensive, but it does not cover eyeglasses, routine dental care, or hearing aids. Medicare A can be paired with Supplement Medicare Insurance, which is sometimes referred to as Medi-gap insurance, as a means of providing complete financial coverage for most health issues. Medicare A is also paired with Medicare B to provide outpatient coverage.


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