The Medicare Insurance Lady

Celebrating since 2008 as a Medicare Insurance Specialist

(This Is NOT A Government Newsletter)

📧 tcangemi@RetirementHPMS.com

📱 Cell: 315.727.4933

Hello Theresa,

New Name: Retirement Health Plans Made Simple




MEDICARE SECTION: Medicare covered vaccines, billed under Part B or Part D?


HEALTH SECTION: People confuse Medicare & Medicaid but what's the difference?




ANNOUNCEMENT: NOW LICENSED in NY and Florida.

If you are moving and relocating to Florida, I can help you find a new Medicare insurance plan. Please give me a call.

Referrals to friends and family are always welcomed and appreciated! 

Keep reading!

Theresa Cangemi CSA, CLTC

"The Medicare Insurance Lady" 

PERSONAL NOTE TO CLIENTS:


I hope everyone had a wonderful Easter weekend filled with family, relaxation, and joy.

MEDICARE SECTION


Medicare covered vaccines.


Most vaccines are covered under Part D, the prescription drug benefit, but some are paid for by Part B. 


For Part D (Rx), check with your insurance plan to confirm that the ones your doctor is recommending are included on your particular prescription plan. 


Certain vaccinations are always covered by Part B


Part B also covers vaccines after you have been exposed to a dangerous virus or disease. For example, Part B will cover a tetanus shot if you step on a rusty nail, or a rabies shot if you are bitten by a dog. 


Medicare covers all vaccines that the Advisory Committee on Immunization Practices (ACIP), an independent government body, recommends for adults. Medicare covers these vaccines without cost-sharing, so at no cost to you. This includes some vaccines that you might need before you travel outside the US. Vaccines that are not recommended by ACIP may be included on your plan’s formulary, but your deductible and copay will apply.  


To avoid billing issues, make sure that your doctor or pharmacy administering the vaccines bills the appropriate part of Medicare, Part B or Part D (Rx).


When you get a vaccine at your doctor’s office, ask your doctor to contact your plan first to find out how they can bill your insurance plan directly. 


Article taken from Dear Marci newsletter from Medicare Rights Center.



HEALTH SECTION


People confuse Medicare and Medicaid all the time, but what's the difference?



Medicaid is funded by states and the federal government combined.


Medicaid enrollees typically aren't charged premiums or deductibles, depending on their income and asset levels.


Medicare and Medicaid are two distinctly different healthcare programs.


What is Medicare?

Medicare is a federal health insurance program that typically serves people aged 65 and older. Enrollment before age 65 may be possible for people with certain disabilities, end-stage renal disease, or ALS.


People collecting Social Security or certain disability benefits are enrolled in Medicare automatically at age 65.


Otherwise, enrollees typically get a seven-month period to sign up that begins three months before the month they turn 65 and ends three months after the month of their 65th birthday. Although, if you wait to sign up (for Medicare health insurance benefits) after your 65th birth month (the three months after) you might not have health insurance benefits or lose health insurance coverage if employer coverage or ACA/Obama Care health insurance ends the month you turn age 65.


What is Medicaid?

Medicaid is a health insurance program for low-income individuals jointly funded by states and the federal government. Although the federal government oversees Medicaid, each state administers it for its residents. Each state is tasked with setting its income thresholds for eligibility and deciding what benefits its Medicaid plans offer.


Many enrollees in Medicaid don’t pay premiums or deductibles since they’re based on income.


Differences in coverage

One key difference between Medicare and Medicaid is that the former (Medicare) is largely age-based, while the latter (Medicaid) is income-based. This means that people 65 and over can qualify for Medicaid despite also being eligible for Medicare.


Medicaid covers low-income adults under, over, or exactly 65, children, and people with certain disabilities.


Medicare only covers Americans 65 and over and those with certain disabilities or the health conditions noted above.


Not only are Medicare and Medicaid different in terms of eligibility, but they also differ in terms of the services they cover.


All states must provide certain benefits through their Medicaid programs, including physician services, hospital services, lab work, and X-rays.


Some state Medicaid programs also cover dental care, eye exams, and glasses — services often covered by Medicare Advantage plans but not original Medicare.


Medicaid plans may also cover additional services not paid for by Medicare, including nursing home care, personal care, and home-based services.



To read the whole article, click below. (Article for informational purposes, not political)

Kiplinger newsletter: CLICK HERE FOR THE FULL ARTICLE



New October 2022 CMS (government) REQUIRED disclaimer:


“Every plan may not be available in your area. Any information we provide is limited to those plans we do offer in your area.” 


***********************************************************************

Theresa’s disclaimer: I DO OFFER Medicare Insurance plans from MANY different insurance companies; in NY and Florida.


The available insurance plans will depend on your state, zip code, and eligibility.

* This article is for information purposes only. I don’t recommend, support, or diagnose any featured writer or article. I am not a doctor. Your health is one of a kind. What works for one person may not for another, so the information in these articles should not take the place of an expert opinion. Before making significant lifestyle or diet changes, please consult your primary care physician or nutritionist. You and your doctor will know your own health best.

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