Is Medicare A Federal Program?

Is Medicare A Federal Program?

A: No, it's a state program. However, the federal government will pay a portion of the benefits for those seniors who qualify for both Medicare and Medicaid.

Q: Is it a good idea to join the plan if you are already on Medicare?

A: Yes, especially if you are on a low income. You may be able to save a considerable amount of money -- it depends on your income and where you live.

Q: What other plans are there besides the B & C Health Plans?

A: The state contracts with several managed care companies to offer HMO-Medicare plans and PPO-Medicare Plans. The plans are basically the same, but the managed care companies are different.

Q: What is an HMO-Medicare plan?

A: HMO stands for Health Maintenance Organization. These are the more economical plans that guarantee you will be seen by a primary care physician. They require you to stay within a certain geographic area and they will generally provide you with a list of doctors from which you may choose.

Q: What is a PPO-Medicare plan?

A: PPO stands for Preferred Provider Organization. These are more expensive plans that allow you to go to doctors that are not on their list, but they will give you a discount on the service.

Q: What happens if I move out of the area, or go out of network?

A: That depends on the plan you select. They will outline their requirements in the plan literature.

Q: What happens if I need to go to the emergency room?

A: You can go to any hospital, but you will have to pay the first $50 of the bill and any difference between what the doctor charges and what the plan pays. Please see the literature in the plan for details on this.

Q: What happens if I need to go to a nursing home?

A: That depends on the plan you select. Please see the literature in the plan for details on this.

Q: What happens if I need a prescription?

A: Many plans have a mail order program. They will send you the medications and you pay for them with a credit card.

Q: What happens if I need help with nursing care?

A: If you are in an HMO-Medicare plan you must receive this through the plan. If you are in a PPO-Medicare plan you are responsible for paying for this care. However, many people choose to enroll in the hospice program, which is covered by Medicare.

Q: What happens if I need home care?

Q: What happens if I'm in a hospital?

A: You are responsible for the first $100 of the bill and any difference between what the doctor charges and what the plan pays. Please see the literature in the plan for details on this.

Q: What happens if I get sick while traveling?

A: Medicare has an optional plan called the Medicare Advantage Plan (MAP) for travel. This plan only covers care received in the US. The MAP basic plan costs $51.00 per month and the MAP Silver plan costs $94.00 per month. It is important to keep receipts for any out of country medical care, as Medicare will only pay for care if it's received in the hospital.

Q: Will I ever need to pay for my Medicare prescription drugs?

A: If you have a Medicare Prescription Drug Plan (Part D) you will not have to pay a monthly premium. You will only pay a small co-payment for each prescription and the plan will pay the rest.

Q: Will I ever need to pay for my Medicare supplemental insurance?

A: If you have a Medicare supplemental insurance (Medigap) policy you will not have to pay a monthly premium. The co-payments will be paid by the plan and the plan will also pay the cost of your Medicare Part B premium.

Q: What other resources are available to me?

A: The State Health Department and the Senior Health Insurance Assistance Program (SHIP) offer free, unbiased, unbiased assistance to help you decide which plan is the best fit for you. You can visit their website at http://www.aging.state.ny.us/publications/SHIMS.html

Q: What are the names of the Medicare plans?

A: This information is also available on the SHIP website.

Q: What are the names of the Medicare Part D plans?

Q: What are the names of the Medicare Part C plans?

Q: What are the names of the Medicare Advantage plans?

A: This information is available on the SHIP website.

Q: What are the names of the Medicare Prescription Drug plans?

Q: I'm confused. What's the point?

A: If you're confused about Medicare, you're not alone. There's a lot of information out there and it's hard to tell what's true. That's why it's important to educate yourself. You can also contact the State Health Department and the Senior Health Insurance Assistance Program (SHIP) at 1-877-690-1012 or visit their website at http://www.aging.state.ny.us/publications/SHIMS.

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