Medicare 101 Part 4

 

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Medicare Exclusions

Medicare does not cover certain things:

  • Long Term Care (Assisted Living / Nursing Home)
  • Most dental care
  • Eye exams related to prescribing glasses (in most cases)
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitment
  • Routine foot care

Welcome to Medicare Preventive Visit

Must perform within the first 12 months they have Part B

  • Height, weight, BP
  • Calculate body mass
  • Simple vision test
  • Review of risk of depression
  • Talk about advance directives
  • Plan for screenings, shots and other preventative services

Medicare Insurance Options

When someone agents into Medicare, there are two main options for healthcare and drug coverage:

Page 17 of the Medicare & You publication

Medicare and You Page 17

The left column is a Medicare Part D plan and a Medicare Supplement (Medigap) policy or the right column which is a Medicare Advantage plan with or without a Medicare Part D plan built in

Enrollment Times

Medicare Part C and D plans

7 Month Window

3 months prior, the month of their 65th birthday, and three months after

Medicare C and D 7 Month Window

Medicare Supplement Plans

6 months of their Part B start date beneficiaries are guaranteed issue into any Medicare supplement plan available to them

Medicare Medigap 6 Month Enrollment

Other Enrollment Situations

There are numerous enrollment situations that may qualify someone to change plans.

  • Coming off group coverage
  • Moving to a new service area
  • Qualify for additional help
    • Medicaid
    • Social Security Assistance
    • Certain state programs
  • Additional enrollment times can be found on Medicare.gov & in the Medicare & You publication

Additional Medicare Information

Medicare has no max out of pocket

Medicare does not cover international travel