Medicare Support – FAQ
Here you will find the questions we come up against most often. If you require additional assistance, feel free to contact us at anytime. We will be happy to assist you in any way we can.
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Can I change my Medicare coverage outside of the Medicare Open Enrollment period?
You can, but generally only under special circumstances that qualify you for a Special Enrollment Period (SEP). These circumstances include (but are not limited to) moving to a new location that is outside of your current plan’s service area or where additional plan options are available, moving back into the U.S. after living abroad, moving into or out of a facility, or if Medicare terminates your current Medicare Advantage plan. You can learn about all of the situations that qualify for a Special Enrollment Period at the Medicare website “Special circumstances (Special Enrollment Periods).”
Some beneficiaries can change coverage on a quarterly basis. This includes enrollees who receive assistance from Medicaid and enrollees who receive Extra Help paying their Medicare drug plan premiums and cost sharing, who can switch Part D plans or Medicare Advantage plans once per calendar quarter in the first three quarters of the year, and during the Medicare Open Enrollment period that runs from October 15 through December 7 each year. Some beneficiaries can change coverage from month to month. This includes beneficiaries in certain institutions, such as nursing homes, who can switch Medicare Advantage or Part D plans once a month for as long as they are living there.
If you are currently enrolled in a Medicare Advantage plan and would like to switch to traditional Medicare, or switch to another Medicare Advantage plan, you may do so during the Medicare Open Enrollment period, which runs from October 15 through December 7 each year, or during the second Open Enrollment Period just for people in Medicare Advantage plans (the Medicare Advantage Open Enrollment period), which runs from January 1 through March 31. If you are in traditional Medicare, you can switch Part D plans or switch to a Medicare Advantage plan during the Medicare Open Enrollment period that runs from October 15 through December 7; you cannot use the Medicare Advantage Open Enrollment period (from January 1 to March 31) unless you are enrolled in a Medicare Advantage plan before January 1.
Additional support information can be found on Medicare.gov.
How do I get a replacement Medicare Card?
You can request a replacement red, white, and blue Medicare card online using your personal Social Security account. Social Security will mail your replacement card within about 30 days to the address they have on file. You can also print an official copy of your card from your secure Medicare account.
For additional support: contact@newnanmedicare.com
What is Medicare Part C?
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
For additional plan support, contact: Newnan Medicare
How do I enroll in Medicare?
The Social Security Administration handles Medicare eligibility and enrollment. You can contact the Social Security Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether you are eligible.
Once you enroll in Part A & Part B, Newnan Medicare can provide additional support with plan selection in your area!
Where can I find a doctor that accepts Medicare and Medicaid?
To find a doctor that accepts Medicare payments, you can visit Medicare.gov and use the Care Compare tool. You can search by street address, city, state, ZIP code, type of provider and doctor’s name or the name of a practice or facility.
To find a doctor that accepts Medicaid, you can contact your health plan or the Medicaid agency in your state.
What is Medicare Part D?
Medicare Part D is Prescription Drug Coverage. Since January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage has had access to prescription drug coverage.
Who’s eligible for Medicare?
Generally, Medicare is for people 65 or older. You may be able to get Medicare earlier if you have a disability, End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease). Check out Medicare.gov for more information on eligibility.
What’s the difference between Medicare and Medicaid?
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage and support to some people with limited income and resources.
Help with Enrollment and More
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Medicare Part B Premium and Deductible
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022.
The 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm. Lower-than-projected spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund, which can be used to limit future Part B premium increases. The decrease in the 2023 Part B premium aligns with the CMS recommendation in a May 2022 report that excess SMI reserves be passed along to people with Medicare Part B coverage.
Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10.
Support Source: CMS.gov on 12/27/2022