Does Medicare Pay For Stem Cell Therapy?

Does Medicare Pay For Stem Cell Therapy?

Appendix G—General Discussion of Medigap Coverage and Medicare Advantage Coverage

1. What is a Medicare Advantage Plan (Medicare Part C)?

Medicare Advantage plans are offered through private health insurance companies and are available to people eligible for both Medicare Part A and Medicare Part B. Medicare Advantage plans provide both medical and drug coverage. Medicare Advantage plans are also known as Part C plans. You may choose to enroll in a Medicare Advantage plan instead of Original Medicare (Part A and Part B).

Medicare Advantage plans offer all Parts A and B benefits, plus additional benefits. Some plans also offer extra coverage.

2. How do Medicare Advantage plans work?

Medicare Advantage plans are private health insurance plans that give you Part A and Part B coverage. These are the same benefits that Original Medicare gives you.

Medicare Advantage plans may also provide extra coverage. For example, some plans pay for extra services not covered by traditional Medicare, like dental or vision care.

Medicare Advantage plans must provide the same benefits as Original Medicare, but they can offer them in different ways. They can use the same doctors and hospitals as Original Medicare, or they may work with different doctors or hospitals.

3. How do I enroll in a Medicare Advantage plan?

You can enroll in a Medicare Advantage plan during your Initial Enrollment Period (IEP) (October 15 – December 7 each year) or during the Annual Enrollment Period (AEP) (January 1 – March 31 each year).

You can enroll in a Medicare Advantage plan during your IEP or AEP by going to Medicare.gov, calling 1-800-MEDICARE (1-877-690-1012), or visiting your local Social Security office.

You can continue to enroll in a Medicare Advantage plan during the Medicare Advantage enrollment periods that occur during the year. You can enroll in a Medicare Advantage plan at these times by calling 1-800-MEDICARE (1-877-690-1012), visiting your local Social Security office, or going to Medicare.gov.

If you do not enroll in a Medicare Advantage plan during the IEP or AEP, you will be enrolled in Original Medicare (Part A and Part B).

4. How will I know if I need to enroll in a Medicare Advantage plan?

Medicare Advantage plans can only be used if your doctor or health care provider accepts assignment (agrees to accept the plan's payment as payment in full). Assignment means that your doctor or health care provider agrees to accept Medicare Advantage plan payments for services they provide to you.

If your doctor or health care provider does not accept assignment, you must enroll in a plan that has a network of doctors and other health care providers that accept assignment.

5. How do Medicare Advantage plans work if my doctor does not accept assignment?

You must check with each Medicare Advantage plan to see if they have a network of doctors and other health care providers that accept assignment. You can do this by calling 1-800-MEDICARE (1-877-690-1012), visiting your local Social Security office, or going to Medicare.gov.

If you want to stay with your doctor or health care provider, you will need to enroll in a Medicare Advantage plan that has a network of doctors and other health care providers that accept assignment.

6. What is a Medicare Advantage plan's “Network”?

Just like traditional Medicare, Medicare Advantage plans use networks of doctors and other health care providers. These networks are called Medicare Advantage networks.

Your doctor or health care provider has to choose to accept assignment in order to be a part of the Medicare Advantage plan's network. If your doctor or health care provider does not accept assignment, your doctor or health care provider is not part of that plan's network.

7. Are there Medicare Advantage plans available for people with Medicare Advantage plans?

Yes. There are Medicare Advantage plans that are available to people who already have Medicare Advantage plans. They cover some services that Original Medicare does not cover, like a Part D drug plan.

8. What is a Medicare Advantage Prescription Drug (MA-PD) Plan?

Medicare Advantage Prescription Drug (MA-PD) plans are Medicare Advantage plans that also include a prescription drug plan (Part D). MA-PD plans are different than stand-alone prescription drug plans (PDPs).

9. Are Medicare Advantage Prescription Drug (MA-PD) plans required to be available to people with Medicare Advantage plans?

Yes. Medicare Advantage Prescription Drug (MA-PD) plans must be available to people who already have Medicare Advantage plans.

10. How do Medicare Advantage Prescription Drug (MA-PD) plans work if my doctor does not accept assignment?

You must check with each Medicare Advantage Prescription Drug (MA-PD) plan to see if they have a network of doctors and other health care providers that accept assignment. You can do this by calling 1-800-MEDICARE (1-877-690-1012), visiting your local Social Security office, or going to Medicare.gov.

If you want to use your doctor or health care provider, you will need to make sure that they are a part of the Medicare Advantage Prescription Drug (MA-PD) plan's network.

11. If I have a Medicare Advantage Prescription Drug (MA-PD) plan, will my doctor or health care provider have to accept assignment?

Your doctor or health care provider does not have to accept assignment. If you choose a Medicare Advantage Prescription Drug (MA-PD) plan, you should check with your doctor or health care provider to see if they accept assignment.

12. Are there Medicare Advantage Prescription Drug (MA-PD) plans available for people with Medicare Advantage plans?

Yes. There are Medicare Advantage Prescription Drug (MA-PD) plans

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