Plan 65

General Questions About Medicare

What does Medicare cover?
Medicare Part A helps pay for medically necessary inpatient hospital care, inpatient care in a skilled nursing facility following a hospital stay, home health care, hospice care and psychiatric inpatient care. There are some limits on the number of hospital or skilled nursing facility days that Medicare helps pay for in a benefit period.

Medicare Part B helps pay for doctors' services, outpatient hospital care, emergency room, diagnostic tests, durable medical equipment 80 percent of the Medicare approved amount for blood starting with the fourth pint, and ambulance services.

In most cases you do not pay a premium for Medicare Part A but you pay a monthly premium of $104.90 for Medicare Part B.

Does Medicare have a deductible?
In 2015, Part A, the hospital part of Medicare has a $1,260 deductible. Part B, the medical part of Medicare, has a $147 deductible.

Will I be covered by Medicare when I'm out of the country?
No, but some supplements do have limited foreign travel coverage.

Does Medicare cover durable medical equipment?
For questions about durable medical equipment please call Cigna at 1-800-899-7095.

Does Medicare cover chiropractic care?
Medicare will pay for chiropractic care in some instances. For more information please call Medicare at 1-800-423-3531 or visit www.medicare.gov.

Do I have to be 65 or over to receive Medicare?
No, in some instances you can qualify for Medicare if you are disabled. Call Medicare to find out more at 1-800-423-3531 or visit www.medicare.gov.

Does Medicare cover prescription drugs?
If you meet certain income and resource limits, you may qualify for extra help from Medicare to pay the costs of Medicare prescription drug coverage. For more information call 800-633-4227.

Do I have to enroll in Medicare Parts A and B?
Generally yes. In some instances you can choose not to enroll in Part B. If you did not take Part B when you were first eligible you may have to pay a penalty; in some cases this penalty does not apply. Call Medicare at 800-633-4227 to find out for sure, or visit www.medicare.gov/physiciancompare.

Does Medicare cover ambulance services?
If the use of an ambulance is medically necessary, the service is covered.

What if I am a veteran?
If you are a veteran or a military retiree, you may be entitled to medical benefits. If you are a veteran, call the U.S. Department of Veteran Affairs at 1-800-827-1000. If you are retired from the military, call the U.S. Department of Defense at 1-800-538-9522.

What is the difference between Medicare and Medicaid?
Medicare was designed to help with your medical costs as you age. Medicaid is a program for individuals who have a qualifying low income. Medicaid may pay some or all of your Medicare premiums and may also pay your Medicare deductibles and coinsurance. To find out if you qualify for Medicaid please call Social Security at 1-800-772-1213.

What if my doctor doesn't work with Medicare?
A physician who does not accept assignment can charge up to 15 percent more than the Medicare approved amount. You must pay that extra amount. This is called the “limiting charge” and you do not have to pay more than this amount. However, you will have to file all of your claims with Medicare yourself. You should contact your doctor if you are unsure if they participate with Medicare.

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