MEDICARE 101 PART 4: MEDICARE PART B

MEDICARE EXCLUSIONS

Medicare does not cover certain things:

  • Long Term Care (Assisted Living / Nursing Home)
  • Most dental care
  • Eye exams related to prescribing glasses (in most cases)
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitment
  • Routine foot care

MEDICARE PREVENTATIVE VISIT

Must perform within the first 12 months they have Part B

  • Height, weight, BP
  • Calculate body mass
  • Simple vision test
  • Review of risk of depression
  • Talk about advance directives
  • Plan for screenings, shots and other preventative services

MEDICARE INSURANCE OPTIONS

When someone agents into Medicare, there are two main options for healthcare and drug coverage:

Page 17 of the Medicare & You publication

The left column is a Medicare Part D plan and a Medicare Supplement (Medigap) policy or the right column which is a Medicare Advantage plan with or without a Medicare Part D plan built in.

ENROLLMENT TIMES: MEDICARE PART C AND D PLANS

7 Month Window

3 months prior, the month of their 65th birthday, and three months after.

MEDICARE SUPPLEMENT PLANS

6 months of their Part B start date beneficiaries are guaranteed issue into any Medicare supplement plan available to them

OTHER ENROLLMENT SITUATIONS

  • Coming off group coverage
  • Moving to a new service area
  • Qualify for additional help
    • Medicaid
    • Social Security Assistance
    • Certain state programs
  • Additional enrollment times can be found on Medicare.gov & in the Medicare & You publication

ADDITIONAL MEDICARE INFORMATION

Medicare has no max out of pocket

Medicare does not cover international travel

CONGRATULATIONS! YOU’VE COMPLETED MEDICARE 101!