FAQs - Florida Medicare Options

Frequently Asked Questions

See what other FMO customers and potential FMO agents are asking.
  • What is Medicare?
    Medicare is health insurance for people age 65 or older, under 65 with certain disabilities, and any age with End-State Renal Disease – ESRD (permanent kidney failure requiring dialysis or a kidney transplant). There are different parts to Medicare coverage that eligible beneficiaries qualify to join. These different parts help cover specific services if certain conditions are met.
  • What is Medicare Part B?
    Medicare Part B (Medical Insurance) helps to cover some doctor services, outpatient services and home health care.  Additionally Part B can help to cover some preventative services to maintain health or prevent illness from worsening.
  • What is Medicare Part D?
    Medicare Part D is a prescription drug coverage policy. It covers most generic and name brand drugs. Its purpose is to help people who already have high prescription drug costs as well as help with rising prescription drug costs.
  • Do I have to elect Part B when I turn 65?
    It’s not necessary to be retired to apply for Medicare, you can opt out from your group plan and keep working.  This may save you money on premiums and/or may also improve benefits. If you do not elect Medicare Part B when eligible and do not have “creditable” group coverage you may be subject to a Late Enrollment Penalty. Those approaching Medicare that are still actively employed have the same enrollment periods as those that are not working.
  • Is there any ways to get extra help with health care costs?
    Yes, you may be eligible for help with prescriptions, and other Medical expenses depending on income and assets. For a private and confidential consultation please call 855-366-2983
  • Is there a way to receive a complete presentation on The Medicare ABC’s
    Yes, please call 855-366-2983 to find out if there is a “Lunch and Learn” scheduled near you or to arrange a private consultation.
  • What is Medicare Part A?
    Medicare Part A (Hospital Insurances) covers inpatient hospital care, care in a skilled nursing facility, hospice and home health care.
  • What is Medicare Part C?
    Medicare Part C (Medicare Advantage Plus) allows Medicare benefits to be provided through a private company who is approved and contracted under Medicare. This plan includes Part A, Part B, Part D and other benefits that Medicare may not cover such as vision and dental services and may also include prescription drug coverage
  • When should I apply for Medicare?
    You are enrolled in Part A automatically at age 65, or when you qualify through disability- there is no additional premium for Part A. You must elect Medicare Part B if You are not getting Social Security or Railroad Retirement Board benefits (for example, you are still working).   You qualify for Medicare because you have End-Stage Renal Disease(ESRD).   Apply 3 months before age 65, and 3 months after (7 months in total including the birthday month).   Medicare coverage becomes effective on the 1st day of the month of your birthday unless your birthday is on the 1st (assuming you apply in a timely manner).   There is a monthly premium for Part B coverage.
  • What is a Star Rating?
    Medicare Advantage Plans are evaluated yearly on Quality of Care.   The results of this evaluation generates a Star Rating   ·Health Plans with a higher Star Rating are paid more than health plans with a low rating   · Health Plans that continue to receive a low rating are eliminated   · 5-Star Plans enjoy year round open enrollment   ·Rating is determined by: health outcomes, preventive care, case management and customer satisfaction
  • What are the deductibles, and co-pays?
    Part A hospital inpatient deductible and coinsurance Beneficiary pays: $1,340 deductible for each benefit period (there could be more than 1 per year) Days 1-60: $0 coinsurance for each benefit period Days 61-90: $335 coinsurance per day of each benefit period Days 91 and beyond: $670 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime) Beyond lifetime reserve days: all costs Part B premium The standard Part B premium amount is $134 (or higher depending on your income). However, some people already receiving benefits have been “grandfathered in” to lower premiums. Those already on Medicare may be paying less due to low Cost of Living Increases in recent years (Congress by law is not permitted to increase the Part B premium more than the percentage increase in the yearly Social Security COLA for current Social Security recipients).   Part B deductible and coinsurance $183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment. Part B Covers Doctor visits, ambulatory services, ambulatory surgery centers, X-rays, Lab work, DME, and Urgent care. Late Enrollment Penalty (LEP) A 10% of the premium on a period of 12 months will be applied to the Part B Premium for each year that the person delay his or her enrollment. There is a separate Late Enrollment Penalty for not electing Part D   Those in higher income brackets will pay higher premiums for part B through Social Security deductions.
  • When can I apply for a Medicare Advantage plan?
    You may also apply for a Medicare Advantage plan during a Special Enrollment Period (SEP).  These include, but are not limited to, the following: The 3 months before, the month of, and the 3 months following your initial eligibility (usually when you reach 65), moving into a new county, leaving your group health plan, loss of your current plan, eligibility for Medicaid, and many more.  To see if you qualify for a Special Enrollment Period call us for some friendly advice at (800) 921-0442.

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