Medicare and Insulin
Your costs in Original Medicare: The one-month supply of each Part D-covered insulin is capped at $35, and you don’t have to pay a deductible for insulin. This applies to everyone who takes insulin, even if you get Extra Help. If you get a 60- or 90-day supply of insulin, your costs can be at […]
How can I stop my Medicare Part B?
To stop your Medicare Part B coverage, you must complete a voluntary termination process through the Social Security Administration. This is a serious decision that requires careful consideration, as you may face penalties and coverage gaps if you decide to re-enroll later. The termination process requires submitting Form CMS-1763 to the Social Security Administration and […]
What Medicare Benefits are available for people with Disabilities?
People under 65 with disabilities are eligible for Medicare. People eligible for Social Security Disability benefits must have received benefits for at least 24 months or suffer from End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). The waiting period for Social Security Disability benefits begins five months after a beneficiary is determined to […]
How is Medicare Financed?
Medicare financing comes from several sources depending on the part. Part A, covering hospital stays, skilled nursing facilities, some home health visits, and hospice care, is primarily funded through payroll taxes. Employers and employees each pay 1.45% of earnings, totaling 2.9%. High earners pay an additional 0.9% Medicare tax on income above $200,000 for singles […]
Medicare to cover medically necessary conditions requiring dental services
Medicare covers dental services when they are medically necessary and directly related to specific medical conditions or treatments. Since January 1, 2023, Medicare has expanded coverage for certain dental procedures that are integral to treating covered medical conditions. Medicare now covers dental services in these specific situations: reconstruction of a ridge when performed during surgical […]
Medicaid and Medicare Integration
The Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office) serves people who are dually enrolled in both Medicare and Medicaid, also known as dually eligible individuals or Medicare-Medicaid enrollees, to make sure dually eligible individuals have full access to seamless, high-quality health care and to make the system as cost-effective as possible. The goals of […]
What is Medicare Payment Advisory Commission (MedPAC) ?
The Medicare Payment Advisory Commission (MedPAC) is a nonpartisan, independent legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program. In 1997, Congress created the Medicare Payment Advisory Commission (MedPAC) as an independent congressional agency to advise it on Medicare issues. Additionally, MedPAC advises Congress on Medicare’s traditional […]
If I have Medicare, can I get a stand-alone dental plan through the Marketplace?
In most cases, no. If the Marketplace in your state is run by the federal government, you won’t be able buy a stand-alone dental plan unless you’re also buying a health plan. If your state is running its own Marketplace, you may be able to purchase a stand-alone dental plan. For a long time, dental […]
The Pros and Cons of Medicare Advantage
Medicare Advantage plans offer several benefits that make them attractive to many beneficiaries. These Part C plans combine Parts A, B, and often D coverage into one plan, typically with lower copayments than Original Medicare. Many include extra benefits not covered by Original Medicare, such as dental, vision, hearing aids, and fitness programs. Monthly premiums […]
Medicare: Can I be penalized if I don’t register on time?
Yes, you can face significant financial penalties if you don’t register for Medicare on time. These penalties can permanently increase your monthly premiums and create gaps in your coverage. For Medicare Part B, the late enrollment penalty is 10% of the current premium for each full 12-month period you delay enrollment. For example, if you […]