Medicare questions? FCA offers free assistance

Medicare questions? FCA offers free assistance

One of the great things about reaching age 65 is becoming eligible for Medicare insurance. Medicare is a federally run health insurance program for people who are 65 years of age or have collected Social Security Disability for 24 months. It is also available for individuals with permanent kidney failure or Lou Gehrig’s Disease.
Medicare coverage can be somewhat confusing for those new to the process, as there are various options to explore. Choosing the right plan requires a careful consideration of your specific needs.

If you need help understanding or choosing a plan, Family and Children’s Association (FCA) can help guide you through the process with free help available by calling the Nassau County Health Insurance Information Counseling and Assistance Program at 516-485-3754.

If you are already collecting Social Security, you will get your Medicare card automatically in the mail. If you are not yet collecting Social Security, you have to apply for Medicare during the three-month period before your 65th birthday.

If you do not apply, you face delays in coverage and financial penalties. You may apply for Medicare by calling the Social Security Administration at 1-800-772-1213 or on-line at:
There are four basic parts of Medicare:
Hospital Insurance (Part A) provides inpatient coverage in a hospital or skilled nursing or rehabilitation facility, or for skilled home care after a hospitalization. Medicare Part A also can cover hospice care in the event of a terminal illness. For most people Medicare Part A is premium free.
Medicare Medical Insurance (Part B) covers physician and other outpatient services. These services include doctor visits, hospital outpatient services, lab tests; physical, speech or occupational therapy; and durable medical equipment for use in the home.

The standard Part B premium amount in 2022 is $170.10 per month. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount.

IRMAA is an extra charge added to your premium. Prescriptions are covered through Medicare Part D when you elect Part B coverage.
Medicare Part C You may opt for Medicare Advantage plans rather than using Part B. Medicare Advantage offers a variety of managed care plans including Health Maintenance Organizations and Preferred Provider Organizations.

These plans generally have a set network of providers. In an HMO you must use providers in that network. If you join a PPO, you can go out of the network, but you will have a higher copayment for out-of-network services. Medicare Advantage plans generally cover prescription drugs and often cover non-Medicare services such as vision, dental and hearing services.
Medicare Part D is prescription coverage. There are 19 drug plans to choose from in New York State. These plans vary in premium cost and formularies. It’s important to make sure any maintenance prescription drugs you take are covered under the Part D plan you choose.
There are Medicare supplement plans known as Medigap. These are standardized plans that can fill most of the Medicare gaps such as deductibles and co-insurance.

In order to best determine which type of plan works best for you, it pays to make a free call to the Nassau County Health Insurance Information Counseling and Assistance Program, HIICAP hotline. HIICAP has no affiliation with insurance companies, agents or brokers. Call 516-485-3754. We are here to help in any way we can.

Barry Klitsberg is an Assistant Health Insurance Information Counseling and Assistance Coordinator at FCA in Garden City and an Aging Services Program Specialist at the U.S. Department of Health and Human Services.

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