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Answers to Your Medicare Questions

Answers to Your Medicare Questions

Care providers John Leal, DNP, and aesthetician and registered nurse Tori Leal, BNP, at Encino Park Family Health & Wellness Clinic in San Antonio, Texas,offer the following information to help you understand the basics of Medicare and get answers to common questions.

What is Medicare?

Medicare is a federal health insurance program designed to provide coverage for individuals aged 65 and older and certain younger individuals with disabilities. It consists of several parts:

Medicare Part A

Part A is hospital insurance that covers inpatient hospital stays and hospice care. It also provides coverage for skilled nursing facilities, nursing home care (non-custodial or long-term care) and some home health care services.

Medicare Part B

Part B provides your preventive service coverage such as screenings, vaccinations, and counseling for diabetes, cardiovascular disease, cancer, and other conditions. It covers doctor visits, medically necessary services, outpatient care, medical supplies needed to diagnose or treat your medical condition. Part B also covers ambulance services, prescription medication, and mental health services.

Medicare Part C

Also known as Medicare Advantage, these are plans offered by private insurance companies approved by Medicare. They provide all-in-one coverage, including Parts A, B, and often Part D (prescription drug coverage).

Medicare Part D

Prescription drug coverage that helps pay for prescription medications.

When should I enroll in Medicare?

The initial enrollment period for Medicare starts three months before your 65th birthday and ends three months after. Enrolling outside of this period results in late enrollment penalties unless you have a special enrollment period or you're still covered by an employer or union insurance plan.

Do I need additional or supplemental coverage?

Medicare Parts A and B are designed to cover the majority of your healthcare needs but they don't cover all costs. Many people choose to get additional coverage to help reduce out of pocket expenses for anything Parts A and B doesn’t cover. 

You can choose a Medicare Supplement Insurance (Medigap) policy or a Medicare Advantage plan. These options provide additional benefits and help reduce out-of-pocket expenses.

How do I choose the right Medicare plan?

You want to choose the Medicare plan that fits your unique healthcare needs best. When reviewing your options, consider factors such as cost, coverage, network of providers, prescription drug coverage, and flexibility. We always recommend reviewing your options carefully and consulting with a trusted healthcare professional if you need help with the decision-making process. 

Can I change my Medicare plan?

You can review and change your Medicare plan during the Annual Enrollment Period (AEP), which runs from October 15th to December 7th each year. You have the option of switching between Original Medicare and Medicare Advantage, changing or enrolling in a Part D plan, or switching between Medicare Advantage plans.

We understand Medicare can be confusing. The team at Encino Park Family Health & Wellness is committed to providing information and support to help you make informed decisions about your healthcare. If you have questions about your Medicare coverage and the services we provide, call Encino Park Family Health & Wellness Clinic or request an appointment online any time. 

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