Original Medicare In Raleigh NC
What is Medicare? Medicare is health coverage that is managed by the federal government, usually for individuals who are over the age of 65 years (though some exceptions may be made for younger people with approved medical conditions). Original Medicare is known a Medicare Part A & Medicare Part B and each of these plans will provide discounted rates for your medical and healthcare needs. However, Original Medicare doesn’t often cover the entire cost of the visit, which can also mean that there are out of pocket costs to customers each time they need medical help.
Understanding Medicare Part A in Raleigh
Medicare Part A is your coverage for hospitals, nursing care facilities, inpatient care, home healthcare, and hospice facilities. Medicare Part A has a deductible that is subject to change every year, but as long as you have paid your Medicare taxes for at least 40 quarters of your working career, there is no cost to you for this.
Raleigh Medicare Part B
Medicare Part B covers your medical insurance, such as services that that are medically necessary or preventative medical services. The cost for Medicare Part B has a deductible that can change from year to year. After the deductible has been met, Medicare will pay 80% of your medical needs and you will be responsible for the other 20%. The cost for your Medicare Part B premium is based on your income and if you don’t enroll when you are first eligible, you may have to pay a late enrollment fee.
Frequently Asked Questions About Original Medicare In Raleigh
Can I choose any hospital, doctor, health care facility or health care provider?
For the most part, you can choose the doctors and medical providers you want to see. However, these providers or facilities must be accepting new Medicare patients and must be enrolled with medicare.
Are medication prescriptions covered with Medicare Part A + B?
Most prescription drugs are not covered by Medicare Part A or Part B, however, if you need prescription drug coverage, there are options. Medicare Part D and some Medicare Advantage Plans cover prescription drug costs.
Do I need to have a primary physician or doctor with Medicare Part A & Medicare Part B?
No, you do not need to choose a primary care physician to enroll in Original Medicare.
What about specialists? Do I need a referral?
Most of the time you do not need a referral to go see a specialist, however, the specialist must be enrolled in medicare and must be accepting new medicare patients.
Should I get Medigap (Medicare Supplemental Insurance) or Medicare Advantage?
This is a tricky question and it depends on your specific situation. There are some customers that can benefit greatly from Medicare Advantage or Medigap and others who don’t have a need at the current time in their life. If you think you might need to get a supplement to Medicare, give our experts a call at 919-679-9914and we can help you decide what options are best for you.
Is there anything I should know about Original Medicare in Raleigh?
- Normally, you will pay a deductible for your healthcare before Medicare pays it’s portion of the cost. There is no yearly limit for your out of pocket expenses.
- Usually, you won’t need to file a medicare claim because federal law makes it a requirement for medical providers to file your claims for the services and supplies you get that are covered. This includes hosptails, doctors, home health care companies and nursing homes.
- You generally don’t need to file Medicare claims. The law requires providers and suppliers to file your claims for the covered services and supplies you get. Providers include doctors, hospitals, skilled nursing facilities, and home health agencies.
Medicare Part A (Hospital Insurance)
In general, Part A covers:
- Inpatient care in a hospital
- Skilled nursing facility care
- Inpatient care in a skilled nursing facility (not custodial or long-term care)
- Hospice care
- Home health care
How Do I Know If Raleigh Medicare Part A & Part B Will Cover My Needs?
You should talk to one of the experts at Triangle Health and Life. We will ask questions to determine what your medical needs are and find out if Original Medicare will give you the coverage that you need. It is also worth asking your health care provider about the services and supplies you currently need and if Medicare will cover them. Medicare won’t always cover things that your doctors think are medically necessary, which means that you may want to look into getting Medicare Advantage or a Medicare Supplemental Plan. When you talk to one of our medicare advisors, we will help you determine the best plan for your needs and budget.
Contact Triangle Health & Life To Speak To An Expert Today
We get it, understanding Medicare is difficult, especially since it can vary from state to state and the costs can vary from year to year. At Triangle Health & Life we are experts at navigating the confusing world of Original Medicare in Raleigh. We can help you decide if you need a Medicare Supplemental (Medigap) Plan, Medicare Advantage Plan, or Medicare Part D Prescription Drug Plan. We also provide final expense and burial insurance in Raleigh, to help make sure your loved ones are covered in case of your passing. We provide our free insurance consultations all over the country and North Carolina, including the following cities: Raleigh, Charlotte, Cary, Durham, Apex, Chapel Hill, Fayetteville, Southern Pines, Pinehurst, Wilmington, Greensboro, Asheville, and the rest of the state. For your free consultation, contact us online or give us a call at (919)679-9914.