Frequently Asked Questions

Medicare Advantage Plan, also known as Part C, is a Medicare Plan run by private insurance companies.  A Medicare Advantage Plan offers all of the benefits covered under Original Medicare and more. Medicare pays a fixed fee to the plan you choose in accordance with the 2003 Medicare Prescription Drug, Improvement, and Modernization Act. It covers all of the benefits covered under original medicare, plus additional benefits.

Medicare and Medicaid are both government health care programs but they are very different. Medicare is generally for people who are older or disabled. Medicaid is for people with limited income and resources. When a person qualifies for both programs out-of-pocket costs can be minimal.

You automatically get Part A and Part B after you get one of these:

• Disability benefits from Social Security for 24 months
• Certain disability benefits from the RRB for 24 months

You don’t need to sign up if you automatically get Part A and Part B. You’ll get your red, white, and blue Medicare card in the mail 3 months before your 25th month of disability.When you decide how to get your Medicare coverage, you might choose:

• A Medicare Advantage Plan (Part C)
• Medicare prescription drug coverage (Part D)

There are specific times when you can sign up for these plans, or make changes to coverage you already have.

Financial assistance programs for people with limited income and assets include:Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. If you get Extra Help but you’re not sure if you’re paying the right amount, call your drug plan. Your plan may ask you to give information to help them check the level of Extra Help you should get.

Medicaid is a joint federal and state program that:

• Helps with medical costs for some people with limited income and resources
• Offers benefits not normally covered by Medicare, like nursing home care and personal care services

In some cases, Medicare Savings Programs may also pay Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments if you meet certain conditions.

Programs of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. With PACE, you have a team of health care professionals working with you and your family to make sure you get the coordinated care you need. Usually they care for a small number of people, so they really get to know you. When you enroll in PACE, you may be required to use a PACE-preferred doctor.