Medicare FAQs

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Welcome to Next Step Insurance Group’s Medicare FAQs page! We understand that Medicare and Medicaid can be confusing topics, so we’re here to provide you with all the information you need to make informed decisions about your healthcare coverage. Whether you’re just starting to explore your Medicare options, or you’re looking for answers to specific questions, we’ve got you covered. Read on to learn more about the ins and outs of both health care solutions.

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While both Medicare and Medicaid are government programs that provide health coverage, there are some key differences between the two:

Medicare is a federal program that provides coverage primarily for older adults and individuals with disabilities, while Medicaid is a joint federal and state program that provides coverage primarily for low-income individuals and families.
Medicare has different parts that cover specific services, such as hospital stays, doctor visits, and prescription drugs, while Medicaid coverage varies by state and may include a broader range of services.
Medicare is available to all individuals who meet eligibility criteria, while Medicaid eligibility is based on income and other factors, and varies by state.

You can apply for Medicare during your Initial Enrollment Period, which is a seven-month period that starts three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. If you miss your Initial Enrollment Period, you may have to pay a late enrollment penalty and may have to wait to enroll during the General Enrollment Period, which runs from January 1 to March 31 each year.

Original Medicare is the traditional fee-for-service program offered by the federal government. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). With Original Medicare, you can see any doctor or healthcare provider who accepts Medicare, and you do not need referrals to see specialists.

Medicare Advantage Plans, on the other hand, are private insurance plans that are approved by Medicare. These plans provide all of your Part A and Part B coverage, and many also offer additional benefits such as prescription drug coverage, vision and dental care, and fitness programs. Medicare Advantage Plans often have network restrictions and may require referrals to see specialists.

In summary, Original Medicare gives you more flexibility in choosing healthcare providers, while Medicare Advantage Plans may offer additional benefits but have more restrictions on where you can receive care.

Medicare Part D is a government program that helps pay for prescription medications. Part D coverage is provided through private insurance companies that are approved by Medicare. If you have Original Medicare or a Medicare Advantage Plan that does not include prescription drug coverage, you can enroll in a stand-alone Part D Prescription Drug Plan to help cover the cost of your medications.

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At Next Step Insurance Group, we’re committed to helping you understand your Medicare options and make informed decisions about your healthcare coverage. So if you have any additional questions about Medicare or Medicaid, please feel free to reach out to us at any time. We’re here to help you every step of the way on your healthcare journey.

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