What are the differences between Medicare Advantage and Medigap?
Medicare Advantage and Medigap serve different purposes in supplementing Original Medicare. Medigap plans work alongside Original Medicare to help pay deductibles, copayments, and coinsurance. Medicare Advantage plans replace Original Medicare entirely, often including prescription drug coverage and extras like dental, vision, and hearing benefits. You cannot have both Medicare Advantage and Medigap simultaneously. When choosing […]
How can I share my Medicare claims information?
Medicare claims data can be downloaded to your computer or device so that you can print it or share it with others. In addition, you can easily share your data with doctors, pharmacies, caregivers, or others by using web applications (apps). Using Blue Button is easy, secure, and reliable. How do I download my Medicare […]
What happens if a Medicare Advantage denies a claim or pre-authorization request?
When your Medicare Advantage plan denies a claim or pre-authorization request, you have the right to appeal through a five-level process. Start by requesting reconsideration from your plan within 60 days of receiving the denial notice. The plan must respond within 72 hours for expedited requests or 30 days for standard requests. If your plan […]
What is the Medicare Beneficiary Ombudsman?
The Medicare Beneficiary Ombudsman helps you with Medicare-related complaints, grievances, and information requests. The Medicare Beneficiary Ombudsman makes sure information is available about: – Make health care decisions that are right for you. – Your Medicare rights and protections. – How to get your issues resolved. The Medicare Beneficiary Ombudsman also shares information with the […]
What Doesn’t Medicare Cover?
Medicare doesn’t cover several important healthcare services that many beneficiaries need. Understanding these gaps helps you plan for additional coverage options. Original Medicare requires significant out-of-pocket spending through deductibles and coinsurance. Part A has a $1,736 deductible per benefit period, while Part B requires a $283 annual deductible plus 20% coinsurance for most services. There’s […]
How do I drop Part A & Part B Medicare Coverage?
Generally, you can only drop Part A (Hospital Insurance) if you have to pay a premium for it, also called Premium-Part A. There are some risks to dropping coverage: – Your costs for health care: You may have to pay all of the costs for services that Medicare covers, like hospital stays, doctors’ services, medical […]
Medicare Part B premium changes for 2026
Medicare Part B premiums are increasing for 2026. The standard monthly premium will be $202.90, up from $185.00 in 2025. This marks an increase of $17.90, or nearly 10 percent, and the first time the Part B premium has topped $200 per month. The annual Part B deductible is also rising. Beneficiaries will pay $283 […]
What happens to my Medicare coverage if I unretire?
When you unretire and return to work, your Medicare coverage continues unchanged. You can work while keeping your Medicare benefits active. However, if your new employer has 20 or more employees and offers group health insurance, their coverage becomes primary and Medicare becomes secondary. You have options to consider. If the employer coverage is comprehensive […]