THE SENIOR MOMENT

FREQUENTLY ASKED QUESTIONS

Get a FREE consultation from experienced insurance agents Victor Whang and Lauren Ferguson who help seniors navigate the complexities of Medicare, Long-Term care, prescription plans and pricing, and other programs ensuring they have the right coverage for their healthcare needs and peace of mind during their golden years. Call 1-833-783-6669 (SVE-MONY) or fill out our contact form.

Medicare Insurance FAQ

  • What is Medicare insurance?

    Medicare insurance is a federal health insurance program in the United States that provides health coverage for individuals aged 65 and older, as well as certain younger individuals with disabilities or certain medical conditions.

  • Who is eligible for Medicare insurance?

    Eligibility for Medicare insurance generally includes individuals aged 65 and older who have paid into the Medicare system through payroll taxes during their working years, as well as certain younger individuals with disabilities or end-stage renal disease (ESRD).

  • What does Medicare insurance cover?

    Medicare insurance has different parts that cover different aspects of healthcare. Medicare Part A covers hospital stays, skilled nursing facility care, and some home health care. Medicare Part B covers medical services and supplies, such as doctor visits, preventive care, and outpatient services. Medicare Part D provides prescription drug coverage. There is also Medicare Part C, also known as Medicare Advantage, which is an alternative to Original Medicare and provides additional benefits through private insurance companies.

  • What are the costs associated with Medicare insurance?

    Medicare insurance has various costs, including premiums, deductibles, copayments, and coinsurance. Premiums are monthly payments for coverage, and the amount can vary depending on the parts of Medicare an individual chooses. Deductibles are the amount individuals need to pay out of pocket before Medicare starts covering the costs. Copayments and coinsurance are the portions of the cost of services or medications that individuals are responsible for paying after meeting the deductible.

  • Can I have other insurance along with Medicare?

    Yes, individuals can have other insurance in addition to Medicare. This can include employer-sponsored health insurance, retiree coverage, or private insurance policies. It's important to understand how Medicare works with other insurance to coordinate benefits and ensure that all coverage is maximized and costs are minimized.

Long-Term Care Insurance FAQ

  • What is Long-Term Care insurance?

    Long-Term Care insurance is a type of insurance policy that provides coverage for long-term care services, such as nursing home care, assisted living, in-home care, and other services that may be needed due to a chronic illness, disability, or cognitive impairment.

  • Why do I need Long-Term Care insurance?

    Long-Term Care insurance can help protect your assets and provide financial security in the event that you require long-term care services in the future. It can help cover the costs of care that may not be covered by health insurance or Medicare, which can be expensive and potentially deplete your savings or retirement funds.

  • When should I consider purchasing Long-Term Care insurance?

    It's generally recommended to consider purchasing Long-Term Care insurance while you are still relatively young and healthy, usually in your 50s or early 60s. Premiums tend to be lower when you're younger and in good health, and it allows you to have coverage in place before any health conditions may arise that could make it more difficult or costly to obtain coverage.

  • What does Long-Term Care insurance typically cover?

    Long-Term Care insurance policies typically cover a range of long-term care services, including nursing home care, assisted living, in-home care, and adult day care. Some policies may also include coverage for care coordination services, which can help you navigate the complex healthcare system and find appropriate care options.

  • How does Long-Term Care insurance work?

    If you need long-term care services covered by your Long-Term Care insurance policy, you will typically submit a claim to the insurance company, and they would reimburse you for eligible expenses up to the policy's coverage limits. The policy may have a waiting period, also known as an elimination period, which is a specific period of time you must wait before coverage begins after you've been deemed eligible for benefits. It's important to review and understand the policy's terms and conditions, including any limitations or exclusions, before purchasing Long-Term Care insurance.

MAPD FAQ

  • What does MAPD stand for?

    MAPD stands for Medicare Advantage Prescription Drug plans.

  • What is a Medicare Advantage Prescription Drug plan?

    A Medicare Advantage Prescription Drug (MAPD) plan is a type of Medicare health insurance plan offered by private insurance companies that combines both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage, and often includes prescription drug coverage (Medicare Part D) as well.

  • How does a MAPD plan differ from Original Medicare?

    Unlike Original Medicare, which is the traditional fee-for-service Medicare program offered directly by the federal government, a MAPD plan is offered by private insurance companies approved by Medicare. MAPD plans typically provide additional benefits beyond what Original Medicare offers, such as prescription drug coverage, vision, dental, and hearing coverage, and may have different costs, rules, and network restrictions.

  • Who is eligible for a MAPD plan?

    Generally, individuals who are enrolled in both Medicare Part A and Part B and live in the service area of a MAPD plan, are eligible to enroll in a Medicare Advantage Prescription Drug plan. Eligibility also depends on factors such as age, residency, and Medicare enrollment periods.

  • How do I enroll in a MAPD plan?

    You can enroll in a MAPD plan during certain times of the year, such as the Annual Enrollment Period (AEP) which occurs from October 15 to December 7 each year, or during special enrollment periods (SEPs) triggered by certain life events, such as moving to a new area or losing existing coverage. You can enroll in an MAPD plan by contacting Victor Whang and Lauren Ferguson directly or by using the Medicare.gov website or calling the Medicare hotline for assistance.

DENTAL INSURANCE FAQ

  • What is dental insurance?

    Dental insurance is a type of insurance coverage that helps individuals and families pay for dental care expenses, including preventive care (such as cleanings and exams), restorative care (such as fillings and crowns), orthodontics, oral surgery, and more.

  • How does dental insurance work?

    Dental insurance typically involves paying a monthly premium to an insurance provider in exchange for coverage for a portion of the cost of dental services. Depending on the plan, dental insurance may have deductibles, copayments, and/or coinsurance, and may have coverage limits or restrictions on certain treatments or procedures.

  • What does dental insurance typically cover?

    Dental insurance coverage varies depending on the plan, but it typically includes preventive care (such as exams, cleanings, and X-rays), basic restorative care (such as fillings and simple extractions), and sometimes orthodontic treatment, oral surgery, and other services. Coverage levels and limitations can vary widely, so it's important to review the specifics of your dental insurance plan.

  • Are there waiting periods or pre-existing condition limitations with dental insurance?

    Some dental insurance plans may have waiting periods before certain treatments are covered, particularly for more extensive procedures like orthodontics or oral surgery. Additionally, some plans may have limitations or exclusions for pre-existing dental conditions, meaning that dental issues you had before obtaining the insurance may not be covered.

  • Can I use any dentist with dental insurance?

    Dental insurance plans may have a network of preferred providers, and some plans may require you to use dentists within that network to receive the full benefits of your coverage. However, many plans also allow you to see any licensed dentist, although the coverage levels may differ depending on whether the dentist is in-network or out-of-network. It's important to check with your dental insurance provider to understand the specifics of your plan's network and coverage.

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