Are you confused about New York Medicare? Do you want to know what plan is best for you? Is it hard to decipher all the insurance terms? That’s okay, we understand that it can be confusing. That is why we have resources readily available to you.
With our Frequently Asked Questions (FAQ), you can see if your question is already answered. Our glossary also has a list of all the Empire Medicare terms that you need to know. If you still have questions, feel free to contact us.
We have listed below FAQs on New York Medicare plans that you can reference to see if your question has already been answered.
Q: What is Medicare and how am I eligible?
A: Medicare is a Federal run health insurance program for people 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease. Original Medicare has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).
Q: What is a Medicare Supplement Plan (Medigap)?
A: A Medicare Supplement Plan or Medigap, is a health insurance plan sold by private insurance companies to fill ‘gaps’ in coverage that are left unpaid by Original Medicare. Medigap can help lower out-of-pocket expenses or cover benefits that Medicare doesn’t cover.
Q: Do I have to switch my primary doctor?
A: If your doctor is a Medicare provider you would be able to keep seeing them. Medicare supplement insurance companies do not have set networks.
Q: How many Medicare Supplement policies do I need?
A: You only need to find one plan that will fit your need and budget. In fact, it is illegal for insurance companies to sell you more than one policy.
Q: If I have a preexisting condition, will a Medicare Supplement plan cover me?
A: Possibly. Insurance companies will usually ask for proof of prior coverage before offering coverage for conditions, but there are some instances were it’s not necessary to show proof of previous coverage.
Q: If I am declined for a Medicare Supplement Plan, what should I do?
A: Each insurance company has their own underwriting standards. Being declined from one insurance company does not mean you will be denied coverage at another company. Our insurance advisors can guide you in the correct and best plan to fit your needs.
Q: Can I terminate or cancel my Medicare supplement insurance at any time or reason?
A: No. The Federal Government gives protection against the current insured from this happening. However, any insurance company is allowed to terminate your health coverage if you fail to pay premiums, having misrepresentations on your application, the company becomes insolvent, or any other action illegal against the company’s policy.
Q: Will a Medicare Supplement plan cost less if I purchase directly with an insurance company instead of Senior Healthcare Benefits Group?
A: No. Medicare supplement rates are regulated by the federal government and the Department of Insurance. This means that rates will be the same whether you purchase the plan through us or an insurance carrier. With Senior Healthcare Benefits Group, you get the added benefit of our insurance agents to help you make the right choice for your needs and budget. Lastly, you will never be obligated to purchase.
Q: What is a Medicare Advantage Plan?
A: Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are sometimes called “Part C.” As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan.
Q: If I join a Medicare Advantage Plan do I loose my Medicare status?
A: No, you do not loose your Medicare status but when you have a Medicare Advantage Plan your original Medicare becomes inactive.
Q: Can I cancel or change my Medicare Advantage Plan at any time?
A: You can only change or cancel your plan during the AEP (Annual Enrollment Period) which is from October 15th-December 7th, unless you qualify for a SEP (Special enrollment period).
Q: What is Part D?
A: Prescription drug coverage that covers outpatient prescription drugs exclusively through private plans, either standalone prescription drug plans or through Medicare Advantage plans that offer prescription drugs.
Q: Do I have to sign up for a Part D plan when I turn 65?
A: No, you have 63 days from the time you turn 65 to enroll in a Part D (prescription drug plan), however if you do not enroll in a Part D plan before the 63 days then there is a LEP (Late enrollment penalty), unless you have creditable coverage through a major medical plan that includes prescription drugs.
Q: What is a formulary?
A: A formulary is a list of prescription drugs covered by a particular drug benefit plan.
Q: What is my Part D (prescription drug coverage) premium?
A: The premiums are different depending on the carrier and plan that you choose.