Medicare
Book - 2021
Medicare brings valuable benefits to more than 58 million people and growing, but most of us don't even know the basics of how Medicare can work best for us. That's where Medicare For Dummies, 4th Edition comes in, explaining how this complex system functions and helping you confidently navigate your way through the maze to get the most out of your coverage. This indispensable resource untangles Medicare in friendly, straightforward language. Step by step, you'll learn when and how to enroll, ways to avoid costly mistakes, and how to find the plan that brings the most benefit to you and your family. Reduce out-of-pocket expenses. Know your rights and protections. Choose the best policy for you. Using this reassuring and compr...ehensive guide, you'll be able to get the answers to all your questions, find guidance on how to act--and then get on with getting the benefits you need.
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Hoboken, NJ :
John Wiley & Sons, Inc
[2021]
- Language
- English
- Corporate Author
- Main Author
- Corporate Author
- Edition
- 4th edition
- Item Description
- "Get tips on navigating the Medicare maze. Determine the best time to enroll and how. Save money by avoiding costly mistakes" -- Cover.
"AARP"--Cover. - Physical Description
- xv, 421 pages : illustrations ; 24 cm
- Bibliography
- Includes index.
- ISBN
- 9781119689935
- Introduction
- About This Book
- Foolish Assumptions
- Icons Used in This Book
- Beyond the Book
- Where to Go from Here
- Part 1. Getting Started with Medicare
- Chapter 1. The Nuts and Bolts of Medicare: What It Is and How It Works
- Addressing Some Upfront Questions
- Coming to Terms with the ABCs (and D) of Medicare
- Part A.
- Part B.
- Part C.
- Part D.
- Recognizing That You Have Choices and Must Make Timely Decisions
- Chapter 2. Spelling Out What Medicare Covers (A Lot, but Not Everything)
- Understanding What Part A and Part B Cover
- Necessary medical care
- Preventive care
- Specialized care in certain circumstances
- Medical supplies and equipment
- Knowing What Part D Covers
- Making sense of drug coverage that can vary throughout the year
- Finding out about formularies
- Determining when drugs are covered by Part A, Part B, or Part D
- The Gaps: Discovering What Medicare Doesn't Cover
- Routine hearing, vision, dental, and foot care
- Home safety items
- Nursing home care
- Medical services abroad
- Services that may be nice but aren't necessary
- Distinguishing When Coverage Comes with Limits
- Limits on hospital stays
- Limits on skilled nursing facility stays
- Limits on mental health benefits
- Limits on therapy services
- Chapter 3. Understanding What You Pay Toward Your Costs in Medicare
- Boning Up on Premiums, Deductibles, and Co-payments
- Part A costs
- Part B costs
- Part D costs
- Medicare Advantage costs
- Paying Higher-Income Premiums
- Understanding who's liable for the surcharges
- Figuring out what the surcharges cost you
- Getting the surcharges waived
- Paying Different Premiums than Other People in Certain Years
- Paying Medicare Taxes While Receiving Medicare Benefits
- Chapter 4. Reducing Your Out-of-Pocket Expenses in Medicare
- Purchasing Medigap Insurance
- Examining Medigap policies
- Choosing and buying a Medigap policy
- Qualifying for Help from Your State
- Medicaid
- Medicaid medical spend-down programs
- Medicare Savings Programs
- PACE plans
- State Pharmacy Assistance Programs
- Examining Whether Extra Help Can Lower Your Drug Costs
- Qualifying for Extra Help
- Applying for Extra Help
- Choosing a drug plan with Extra Help
- Considering Other Ways to Cut Costs
- Taking income tax deductions for Medicare costs
- Lowering drug costs without Extra Help
- Part 2. The Hows and Whens of Medicare
- Chapter 5. Qualifying for Medicare
- Hitting the Milestone of Age 65
- Debunking some qualification myths
- Meeting the requirements for Parts A, B, and D
- Qualifying for Part A on your own work record
- Being eligible for Part A on someone else's work record
- Qualifying for Medicare under Age 65 on the Basis of Disability
- Receiving disability payments
- Suffering from permanent kidney failure (ESRD)
- Living with Lou Gehrig's disease (ALS)
- Failing through the Cracks: Health-Care Options if You Can't Get Medicare Yet
- Nice work if you can get it: Landing a job with benefits
- Paying for COBRA temporary insurance
- Purchasing individual insurance through the online Marketplace
- Buying health insurance outside of the Obamacare Marketplace
- Getting health care without insurance
- Chapter 6. Enrolling in Medicare at the Right Time for You
- At a Glance: Surveying Situations That Affect Enrollment Timing
- Understanding Your Initial Enrollment Period
- Using your IEP at age 65
- Taking advantage of your IEP when you have disabilities
- Delaying Part B if You'll Qualify for a Special Enrollment Period Later
- Being able to delay Part B without penalty
- Knowing what to do about Part A if you delay Part B
- Heeding a special warning if you have a health savings account at work
- Using the special enrollment period
- Enrolling in Other Specific Situations
- You're a legal permanent resident
- You live outside the United States
- You're in a nontraditional marriage or domestic partnership
- You're incarcerated
- Deciding Whether and When to Sign Up for Part D Drug Coverage
- Assessing drug coverage you have from elsewhere
- Debating whether you need Part D if you don't take medications
- Figuring the best time to enroll in Part D
- Understanding the Consequences of Not Signing Up at the Right Time
- Missing your deadline for Part B
- Passing your deadline for Part A
- Neglecting your deadline for Part D
- Figuring out whether you can get a late penalty revoked
- Chapter 7. Discovering How to Sign Up for Medicare
- Being Automatically Enrolled in Medicare Parts A and B
- Sign Me Up! Applying for Medicare Parts A and B
- Signing up from inside the United States
- Enrolling while you're living abroad
- Opting Out of or Disenrolling from Part A or Part B
- Declining Part A
- Opting out of Part B
- Disenrolling from Part B
- Knowing When Your Coverage Begins
- When you sign up during the first three months of your IEP
- When you sign up during IEP months four through seven
- When you are awarded Medicare coverage retroactively
- Transitioning from Obamacare to Medicare
- Figuring out whether you need to make the switch
- Knowing how and when to switch from Marketplace to Medicare
- Chapter 8. Understanding How Medicare Fits In with Other Health Insurance
- Understanding Medicare's Coordination of Benefits System
- Helping Medicare help you: Filling out your initial enrollment questionnaire
- Keeping Medicare informed if your coverage changes
- Seeing How Medicare Works with an Employer's Health Insurance Plan
- Working with insurance from a current employer
- Having insurance from a former employer
- Figuring Out How Other Federal Health Benefits Fit In with Medicare
- The Federal Employees Health Benefits Program
- TRICARE and TRICARE For Life
- The Veterans Affairs health system
- The Indian Health Service
- The Black Lung Program
- Mixing Medicare with Workers' Comp or No-Fault or Liability Insurance
- When you first make a claim
- If the claim isn't settled promptly
- When the claim has been settled
- Part 3. Making Smart Choices among Medicare's Many Options
- Chapter 9. Making Sense of Medicare's Many Options
- Seeing the Big Picture: Your Starting Point to Navigating the Medicare Maze
- Understanding the consequences of your choice of system
- Weighing the two systems
- Recognizing when you may not have a choice
- Being on your guard against "auto-enrollment"
- Digging into the Details of Traditional Medicare versus Medicare Advantage
- Opting for traditional Medicare
- Looking at Medicare Advantage plans
- Checking out three other types of Medicare health plans
- Discovering How Medigap Policies Differ from Medicare Advantage Plans
- Chapter 10. Choosing Wisely If You Go with Traditional Medicare
- Understanding the Need to Compare Part D Plans Carefully
- Knowing what not to do
- Defining "the best plan"
- Recognizing that comparing plans is worth the effort
- Seeing how comparing plans can save big bucks
- Getting organized with two crucial lists
- Picking the Part D Plan That's Best for You
- Assessing the Plan Finder's reliability
- Using the Medicare Plan Finder to discover options available to you
- Drilling down to important bits of info when comparing Part D plans
- Choosing the Medigap Supplemental Policy That's Best for You
- Choosing a Medigap policy
- Buying a Medigap policy at the right time
- Buying Medigap if you're under 65
- Suspending a Medigap policy
- Chapter 11. Making Smart Choices If You Opt for Medicare Advantage
- Comparing Medicare Advantage Plans
- Comparing plans' medical benefits
- Adding prescription drug coverage
- Choosing the Medicare Advantage Plan That's Right for You
- Figuring out which providers accept the plans you're considering
- Enrolling in a Medicare Advantage plan
- Taking action if you change your mind
- Chapter 12. Getting Help in Making Medicare Choices
- One on One: Getting Personal Help on Medicare Issues
- Asking family and friends
- Contacting State Health Insurance Assistance Programs
- Calling Medicare's help line
- Seeking advice from other sources
- Buyer Beware! Avoiding Scams and Hard-Sell Marketing
- Steering clear of outright scams
- Resisting hard-sell marketing tactics
- Part 4. Navigating Medicare from the Inside
- Chapter 13. Starting Out as a New Medicare Beneficiary
- Playing Your Cards Right
- Understanding when to use each card
- Replacing your cards
- Beyond the Cards: Checking Out the Extent and Limits of Your Coverage
- Managing Premiums
- Discovering different ways to pay Medicare premiums
- Knowing what can happen when you don't pay your premiums on time
- Keeping Track of Your Expenses
- Understanding Medicare Summary Notices
- Maintaining hard-copy records you can rely on
- Tracking information online
- Dealing with Doctors
- Finding doctors who accept Medicare patients
- Understanding what doctors can charge you
- Filling Prescriptions for the First Time with a Part D Plan
- When does my coverage begin?
- Which kind of pharmacy can I use?
- What happens if I go to an out-of-network pharmacy?
- How do I prove I have Part D coverage?
- How can I ensure I get my meds?
- Chapter 14. Getting the Inside Scoop on Using Certain Medicare Benefits
- Taking a Closer Look at Part A
- Understanding hospital benefit periods
- Taking note of the three-day rule
- Defining observation status
- Being aware of the improvement standard
- Fighting premature hospital discharge
- Proceeding if the hospital makes a mistake
- Knowing your rights in a skilled nursing facility
- Zooming In on Part B
- Checking on whether Medicare will cover your treatment
- Receiving a notice saying that Medicare may not pay
- Determining whether you can find out a service's cost in advance
- Maximizing your chances for coverage
- Recognizing your right to second opinions
- Filing a claim directly to Medicare
- Delving into Part D
- Understanding how a plan may restrict your drug coverage
- Grappling with the tier system of co-pays
- Navigating the doughnut hole
- Using Part D to get the shingles vaccine
- Taking advantage of free Medication Therapy Management benefits
- Chapter 15. Changing Your Medicare and Medigap Coverage
- Switching Coverage during Open Enrollment or Disenrollment
- The open enrollment period
- The disenrollment period
- Taking Advantage of Special Enrollment Periods
- Recognizing when you can use SEPs to change plans
- Making sure your records and prescriptions are transferred
- Dropping a Plan (Or Being Dropped)
- Leaving a plan on your own
- Getting the boot from your plan
- Deciding Whether to Stay or Switch to Another Plan for Next Year
- Reading your Annual Notice of Change to understand plan alterations
- Comparing plans (yes, all over again!)
- Looking at extra factors influencing your decision
- Changing to Another Medigap Policy
- Knowing the consequences of switching Medigap policies
- Exploring a change of Medigap coverage
- Exercising your right to a 30-day free look
- Chapter 16. Knowing Your Rights
- Understanding Your Right to Accurate Information
- Knowing whom to call
- Seeking a second opinion
- Asking for an Investigation
- Requesting equitable relief
- Contacting an ombudsman
- Reaching out to your Quality Improvement Organization
- Getting ahold of your plan
- Filing a grievance
- Taking Steps toward an Appeal
- Obtaining a formal denial
- Requesting a coverage determination
- Having a game plan in mind before you move ahead with an appeal
- Filing a Formal Appeal
- Walking through the five levels of appeal
- Getting help in making an appeal
- Part 5. The Part of Tens
- Chapter 17. Top Ten Medicare Mistakes
- Thinking You Must Reach Full Retirement Age before Signing Up
- Assuming You Don't Qualify If You Haven't Worked Long Enough
- Failing to Enroll in Part B When You Should
- Believing You Don't Need Part B If You Have Retiree or COBRA Coverage
- Not Signing Up for Part D Because You Don't Use Prescription Drugs
- Picking a Part D Drug Plan for the Wrong Reasons
- Misunderstanding Enrollment Periods
- Being Too Late to Buy Medigap with Full Protections
- Failing to Read Your Annual Notice of Change
- Not Realizing You May Qualify for Help to Lower Your Costs
- Chapter 18. Ten Ways to Stay Healthier beyond Age 65
- Taking Action to Avoid Falls
- Exercising Regularly
- Quitting Smoking
- Eating Healthfully
- Cutting Out Soft Drinks and Extra Sugar
- Keeping an Eye on Prescription Drugs
- Continuing to Work or Stay Active
- Staying Connected and Engaged
- Keeping Your Brain in Shape
- Addressing Tough Choices before They're Necessary
- Part 6. Appendixes
- Appendix A. Sources of Help and Information
- Government Help Lines and Websites
- The Centers for Medicare & Medicaid Services
- The Social Security Administration
- State Health Insurance Assistance Programs
- The Eldercare Locator
- Independent Sources of Direct Help
- The Medicare Rights Center
- The National Alliance for Hispanic Health
- The National Asian Pacific Center on Aging
- Resources for Saving Money
- Consumer Information and Advocacy Organizations
- Sources for Updates on Medicare
- Appendix B. Glossary
- Index