Molina Medicare 101 Terms questions and answers graded A+

How to qualify for Medicare - Answer-Must be 65 years or older If under 65 with certain disabilities: -Lateral Sclerosis -End Stage Renal Disease 4 parts of Medicare - Answer-Part A - Hospital services Part B - Outpatient services Part C - Combination of A & B Part D - Prescription drug coverage Part A - Answer-Hospital Insurance. This is for inpatient services. -Inpatient hospital care -Skilled Nursing Facility (SNF) care -Blood(inpatient) -Inpatient non- religious non-medical health care institutions -Home Health Care -Hospice Care Part B - Answer-Outpatient services such as doctor's office appointments, including lab services, some supplies and Durable Medical Equipment (DME). Part C - Answer-Medicare Advantage Plan like HMO/ PPO includes Part A, Part B and sometimes also includes Part D coverage. Part D - Answer-Medicare Prescription Drug Coverage. Medicare Coverage Choices - Answer-Original Medicare (just part A & B) or a Medicare Advantage Plan (which includes A & B and often other benefits).Original Medicare - Answer-Part A and Part B can add on Medigap and or Part D (prescription drug coverage) Medicare Advantage Plan - Answer-Part C which combines Part A&B may include, or be able to add, Part D. Medicare Advantage plans often offer additional benefits such as vision and dental. Is not available to people with End-Stage Renal Disease Special Enrollment Period (SEP) - Answer-Most people don't qualify for SEP. Must have a group health plan coverage based on active, current employment of you or your spouse. Those with SEP can enroll or dis-enroll every month if they so choose. Skilled Nursing Benefit Period - Answer-This period begins the day you first receive inpatient care and ends when you are not in hospital/Skilled Nursing Facility (SNF) 60 days in a row. The member must pay the part A deductible for each benefit period Medi-gap - Answer-Medicare Supplement Insurance, sold by private insurance companies. This coverage fills gaps in Original Medicare such as deductibles, co-insurance and co-payments. The member must pay their Part B premium to qualify to purchase Medi-gap insurance. Enrolling in Medicare when it Not Automatic - Answer-You need to enroll with Social Security or visit your local office. Initial Enrollment Period - Answer-There is a 7 month window, which begins 3 months before 65 birthday, and extends 3 months after birthday month. Qualifications for Part D - Answer-Must have Part A and or Part B Must live in the plan's service area Can't be incarceratedMedicare vs. The Health Insurance Marketplace - Answer-Medicare isn't part of the Insurance Marketplace. If you have Medicare, you are covered don't need to shop for insurance on the Marketplace. The Marketplace doesn't offer Medi-gap or Part D plans. It's against the law for someone who knows the member has Medicare to sell them a Marketplace plan