Will Original Medicate cover all my expenses?
No—which is why many people opt for a Medicare Advantage plan offered by private insurance companies.
Are prescription drugs covered under Original Medicare?
Yes and No. Part A covers certain medications during hospitalization; however, routine prescriptions are not covered. You will need to purchase A Part D plan to cover brand-name and generic prescriptions. Prescription Drug coverage is typically included in a Medicare Advantage plan at no additional cost.
Can I keep my doctor and hospital after I enroll in Medicare?
With Original Medicare, you can use any Medicare-approved doctor or hospital. With a Medicare Advantage plan, you are required to use any doctor or hospital in the plan’s network.
When will my Medicare coverage become effective?
If you enroll during the Initial Enrollment Period, your coverage begins as early as the first day of your birthday month. If you are switching plans during AEP, your coverage starts on January 1.
What if I don’t enroll at 65 because I have an
employer-sponsored health plan?
If you are still working and have coverage through an employer, you may not have to pay a late-enrollment penalty. Talk to the employer benefits administrator.
Medicare doesn’t automatically know if you have additional coverage. Tell your doctor and other providers so they can send bills to the correct payer.
Members of a Fee-for-Service (FFS) plan, like Original Medicare, can see any doctor or facility that accepts Medicare insurance. While the number of available providers is typically larger than plans who contract with providers, the physician is paid a separate fee for each service provided. FFS plans can lead to unnecessary services and higher health care costs.
A Managed Care plan is an excellent choice if you desire the ease of having a primary doctor to help manage your medical care and costs. Managed Care plans provide affordable, high-quality care and reduced premiums through deductibles and out-of-pocket copays.
Members of a Clever Care Medicare Advantage HMO plan receive managed support to help navigate healthcare system complexities, providing easy, hassle-free access to quality, affordable care.