FAQ

Why do you Need a Health Insurance?

As the medicare industry is advancing, healthcare costs also increase. The main aim of medical health insurance is to help you in sying for your Medicare. It enables you to protect your family financially in any event of unexpected illness or injury, which can be very expensive.

You need to have health insurance at your disposal because you can’t predict what your medical bills will be, and for that, you need a medicare agent such as the cache insurance agency by your side to cover your bills.

If you already have health insurance, you will have peace of mind knowing that you are protected from all sides.

How do I Know Which Medicare Plan is Best for Me & My Family?

If you do not have health insurance or if you are interested in buying a new one, you might want to buy a plan on your own via a local medicare agent such as a cache insurance agency.

Begin by learning how health insurance works. Generate a list of information about your household income and set your budget for health insurance. Try to understand the difference between various types of plans so that you can decide which one is the best for you and your family.

You can even find additional information on Healthcare, the federal health insurance marketplace, and HealthSherpa, which is an online tool that offers you thorough health coverage.

Find out more about the current doctors, hospitals, and pharmacies. Learn some standard insurance terms, specifically the ones that describe your share of costs, like out-of-pocket maximums.

How Does Medicare Work?

Medicare is a national health insurance program that is funded by the U.S. government and administered by the Centers for Medicare and Medicaid Services. The program extends coverage to younger people, people the age of 65 and above, people with particular disabilities, and people with end-stage renal disease.

As long as you are eligible to receive Social Security benefits at the age of 65, you will automatically be enrolled in Medicare Part A, which covers hospital costs, and Medicare Plan B, which covers your visits to the doctor. You do not need to do anything in order to enroll in these programs.

When can Medicare Advantage Plans (MAPD) expect to see the PDF of the Quarterly Enrollment and Payment Certification Schedule posted to the CMS.gov page?

The Quarterly Enrollment and Payment Certification Schedule is generally available on the MAPD help desk website no later than October. If the schedule is not on the MAPD help desk website by October, you can then contact the MAPD help desk.

What do you mean by Original Medicare?

The term Original Medicare refers to Medicare Plan A and Plan B. Plan A covers the cost of hospital-related care, which includes inpatient services, lab tests, and surveys. Part B is the medical insurance component of Medicare, which will help in covering doctor visits, outpatient care and certain preventive services.

What is an M.A. Plan?

Medicare Advantage Plans are offered by private insurance companies- such as Humana- which are contracted by the federal government. Medicare Advantage, also known as Medicare Part C, covers the same healthcare services as the Original Medicare except for hospice care.

What are Out-of-Network Services, and Do I Have Any Coverage For Them?

Out-of-network services are the services provided by a doctor or hospital that do not have a contractual relationship with their health plans. Not all the plan covers out-of-network services, but if they do, your share of the cost is usually significantly higher than if the service was provided in the network.

What Rights Do I Have If My Insurance Firm Denies Coverage For a Service?

You have the right to ask your plan to reconsider its decision. If your plan still denies payment after considering your appeal, the law permits you to have an independent review organization decide whether to uphold the plan’s decision. This final check is often said to be an external review. If you are not satisfied with the way your insurance firm addresses your appeal, each state has an insurance department that you can contact about your coverage.

What are the Benefits of Choosing Medicare Advantage Over Medicare?

M.A. Plans are required to cover benefits like lab visits, MRI, etc., which are equal to Medicare. Some of the Medicare Advantage plans also include additional benefits like gym memberships, dental, vision, and hearing, which are not covered via the standard Medicare.

Medicare Advantage Plans have a yearly Maximum Out-of-Pocket (MOOP) for Medical expenses. If someone has a high medical expense year, the plan picks up at 100% once the MOOP has been reached.
Most of the time, your prescription drugs are less expensive with the Medicare Advantage. This is because you do not have the monthly premium for the stand-alone Part D plan as with traditional Medicare.
If someone has concerns about their Medicare Advantage, the customer service department at their insurance agency can help with the questions.

What Fee Schedule is used for the Medicare Advantage Plan?

Most of the commercial PPO plans use the same network fee schedule for their commercial business as for their M.A. business. This can vary by each different M.A. plan, as it is recommended that you ask the plans for a copy of their M.A. plan fee schedule before signing the agreement.

How Can You Join a PDP Plan?

According to Medicare, once you have chosen a Medicare drug plan, below is how you can join a PDP plan.

Enroll on the Medicare Plan Finder’s website.
Finish the paper enrollment form.
Call the plan.
Contact: 1-800-MEDICARE (1-800-633-4227).

Who is an Independent Medicare Broker?

A Medicare Broker works independently, presenting various insurance carriers and a vision to find the best plan for every client’s requirements and having a broad range of Medicare plans to offer the clients which ensures that every client’s needs are met.

What is the Role of a Medical Advisor?

Medical Advisors play a crucial role in the healthcare industry by providing valuable guidance on medical care. They primarily perform case reviews to evaluate previous medical actions and determine whether to confirm the initial physician’s findings and recommendations.

What is Medicare in U.S. Healthcare?

Medicare is federal health insurance which is for people 65 or older, and also for some people under 65 age with various disabilities. Colache is a trusted Medicare and Medicaid service provider who provides services on healthcare.

What is referred to as Medicare Advantage?

A Medicare Advantage is a Medicare-approved plan that comes from a private firm and is then offered as an alternative, say to Original Medicare, for your health and drug coverage. These include plans such as Part A, Part B, and Part D.

What do you mean by Final Expense Insurance?

Final expense insurance is a tiny but permanent plan that is designed to help cover expenses such as funeral costs and medical bills. Death benefits are somewhat smaller than the standard life insurance policies and the premiums are often lower than other policies.

What are Prescription Drug Plans?

A prescription drug plan, commonly known as a (PDP) plan, is a stand-alone plan that offers Medicare prescription drug coverage (Part D) which comes via a private insurance firm.

What are Medicare Supplement Plans?

Medicare Supplement Plans (Medigap) is the extra insurance that you can buy from a private health insurance firm to help pay your share of out-of-pocket costs.

How Can I Contact an Experienced Medicare Agent?

You can contact an experienced medicare agent by dialing this phone number: 1-800-633-4227.

Do I Automatically Get Medicare When I Turn 65?

Possibly yes; if you are under 65 years of age and start receiving Social Security retirement benefits, you wil be automatically enrolled in Part A and Part B.

Is Medicare Free?

Medicare is not free. It is a government-funded program for people over 65 of age and people who have disabilities. Still, the beneficiaries are responsible for paying premiums and deductibles for the coverage they receive.

I am turning 65, When Do I Need to Enroll For Medicare?

As now you are turning 65, you can sign up for Medicare in the starting three months before you turn 65, and coverage will begin the first day of your birthday month.