Speak to a licensed agent (Daily 8am-8pm)

FAQ

Questions About Medicare

Medicare Frequently Asked Questions

Explore your most frequently asked Medicare questions – answered here by Connie Health’s licensed insurance agents.

 

Don’t see your question here? Submit your question to Dear Connie to have it answered.

Basic Medicare Questions

What is Medicare?

Medicare is a federal health insurance program for United States citizens (plus permanent residents with more than five years of continuous residency).

To qualify, you must be 65 or older unless you have a Social Security Administration-approved disability, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS). Learn more about becoming eligible for Medicare.

Who qualifies for Medicare?

You qualify for Medicare if you are a United States citizen or have been a continuous permanent resident for more than five years.

To qualify for Medicare, you must be 65 years of age, older, or younger if you have a Social Security Administration-approved disability, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS). Learn more about who qualifies for Medicare.

How does Medicare work?

Original Medicare (Part A & B) is a fee-for-service federal health insurance program. Original Medicare covers most but not all medically necessary and approved health care services and supply costs. 

Typically, you pay a monthly or quarterly premium, plus an annual deductible and a share of the costs for services and supplies. With Original Medicare, there is no yearly out-of-pocket maximum unless you have expanded coverage through a Medicare Supplement plan (Medigap), Medicaid, or employee or union coverage. You must also have creditable prescription drug coverage through Medicare Part D.    

Suppose Original Medicare alone doesn’t serve your health and budget needs. In that case, you can also explore a Medicare Supplement plan (Medigap), Medicare Advantage plan (Medicare Part C), or a Medicare Advantage Prescription Drug plan. Learn more about how Original Medicare (Medicare Part A and Medicare Part B) works.

What is the difference between Medicare and Medicaid?

The difference between Medicare and Medicaid is who regulates each program and their eligibility requirements.

Medicare is a federal health insurance program for those aged 65 or older or under 65 with a Social Security Administration-approved disability, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS). You are eligible for Medicare regardless of your income.

Medicaid is managed by each state and is based on income and resources. Medicaid is for those with very low income. Learn more about the differences between Medicare and Medicaid.

How old do you have to be to get Medicare?

The typical age to be eligible for Medicare is 65 unless you qualify because of a Social Security Administration-approved disability, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS).

If you retire before age 65, you may be eligible for Social Security benefits but do not qualify for Medicare. You may be subject to late enrollment penalties (increased premiums) if you fail to sign up for Medicare during your Initial Enrollment Period. Learn more about Medicare eligibility.

When to apply for Medicare?

You should sign up for Original Medicare Part A and B during your Initial Enrollment Period. This enrollment period occurs three months before you turn 65, the month of your 65th birthday, and three months after your 65th birthday. Take our Medicare eligibility quiz to discover when it’s time for you to apply for Medicare.

You can delay Original Medicare Part B if you have other health insurance coverage. Learn more about applying for Medicare Part A or applying for Medicare Part B after declining coverage.

When does Medicare start?

If you are retired and receiving benefits from the Social Security Administration, Medicare Part A and B will automatically start when you turn age 65.

However, if you are not receiving benefits but qualify for Medicare, you’ll need to enroll during your Initial Enrollment Period. This enrollment period is three months before you turn 65, the month you turn 65, and three months after your 65th birthday. You have seven months to enroll in Medicare when you first become eligible. Learn more about signing up for Medicare Part A and Medicare Part B, or take our Medicare eligibility quiz to discover when you should sign up for Medicare.

How much does Medicare cost?

Original Medicare Part A and B have fewer variable costs than Medicare Part C (Medicare Advantage), Part D prescription drug plans, and Medicare Supplement (Medigap) coverage. You can compare Medicare plans online to know what a Part C, D, or Medigap plan might cost. Premiums, deductibles, and coinsurance could change on an annual basis.

Medicare Part A is usually free unless you paid Medicare taxes for less than 40 quarters. If you paid Medicare taxes for 30-39 quarters, Part A would cost $274 per month in 2022. If you paid less than 30 quarters, the standard Part A premium is $499 per month in 2022. This does not include late enrollment penalties, which could increase your monthly premium. In addition to the monthly premium, you would need to pay for the annual deductible, coinsurance, and copayments. Learn more about Medicare Part A.

Medicare Part B’s 2022 standard monthly premium is $170.10, but this amount could be higher depending on your income. Depending on your income, in 2022, the Medicare Part B premium could cost as much as $579 per month. This does not include any late enrollment penalties added to the monthly premium. In addition, you would also need to pay the Part B annual deductible, 20% coinsurance, and copayments. Learn more about Medicare Part B.

How to apply for Medicare?

When it’s time to apply for Medicare Part A or B, you can reach out to the Social Security Administration and complete their application. Or you can speak with a local licensed Connie Health agent who can guide you through the application process.

Call (623) 223-8884 to receive help signing up for Original Medicare Part A or B and assistance deciding whether you need expanded coverage like Medicare Supplement (Medigap) or Medicare Advantage (Medicare Part C).

What is a Welcome to Medicare visit?

A “Welcome to Medicare” visit establishes your medical history during the first 12 months you’re enrolled in Original Medicare Part B. The “Welcome to Medicare” visit is covered by Medicare Part B (medical insurance). When you call for your appointment, you should specify that you’d like a “Welcome to Medicare” appointment.

The visit often includes taking your height, weight, Body Mass Index (BMI), blood pressure measurements, and a simple vision test. You’ll also receive counsel on vaccinations, mental health, and an opportunity to discuss advance directives. This is also an opportune time to request referrals for other services.

What is a Medicare wellness visit?

Once you’ve been enrolled in Original Medicare Part B (medical insurance) for at least 12 months, you can begin receiving an annual wellness visit. An Annual Wellness Visit (AWV) may help you create or update a personalized disease and disability prevention plan. You may also discuss additional topics such as advanced care planning during the visit. 

An Annual Wellness Visit is not a physical exam, which usually includes blood work and more extensive screenings or assessments. During an Annual Wellness Visit, there will be no diagnostic testing. Medicare only covers one Annual Wellness Visit within a 12 month period and you should let your healthcare provider know that you want a “Medicare Annual Wellness Visit” when making an appointment. 

Difference between Medicare wellness visit and annual physical?

A Medicare Annual Wellness Visit (AWV) is for creating or updating a disease or disability prevention plan. An Annual Wellness Visit is for when you’re healthy. It’s a time to discuss your medical and family history, your current providers and prescriptions, and take routine measurements such as height and weight and blood pressure. You receive personalized health advice, a screening checklist to help you keep preventative services timely and tracked, and a list of risk factors and treatment options, along with advance care planning. During an Annual Wellness Visit, you do not have blood work or other diagnostic tests taken. 

An annual physical often occurs when you’re not feeling well and want to pinpoint the cause, or your annual physical is due as a preventive measure. This will include everything an Annual Wellness Visit would include, but with additional screening. For example, the doctor may check lung performance, your head and neck, or provide abdominal or neurological exams. You may also have your urine and blood samples collected for lab testing, and your reflexes and vitals taken. When you are trying to pinpoint the cause of symptoms, you’ll want to request a physical exam, not an Annual Wellness Visit.

Medicare Part A Questions

What is Medicare Part A?

Original Medicare Part A is a United States federal health insurance program that reduces the cost of healthcare services for eligible people.

Medicare Part A is the hospital insurance piece of Original Medicare Part A and B. Medicare Part A helps cover inpatient care in hospitals, critical access hospitals, and skilled nursing facilities that are not custodial or long-term care. Learn more about Medicare Part A.

What does Medicare Part A cover?

Original Medicare Part A is hospital insurance that covers services when medically necessary and delivered by a Medicare-assigned healthcare provider in a Medicare-approved facility.

Medicare Part A covers but is not limited to inpatient care in a hospital; skilled nursing facility care if it’s not custodial or long-term care; short-term nursing home care; hospice care; and home health care. Learn more about what Medicare Part A covers.

How much is Medicare Part A?

Original Medicare Part A is typically premium-free if you are aged 65 or older, and you receive retirement benefits from the Social Security Administration or the Railroad Retirement Board, or you’re eligible for these benefits but haven’t filed for them yet. You can also receive premium-free Part A if you or your spouse had Medicare-covered government employment, or you or your spouse earned 40 credits or worked and paid Federal Insurance Contributions Act (FICA) taxes for at least ten years.

You can always purchase Medicare Part A if you don’t qualify under one of these four ways. The cost depends on how many questers you or your spouse worked. If you paid Medicare taxes for 30-39 quarters, Part A would cost $274 in 2022. If you paid Medicare taxes for less than 30 quarters, the monthly standard Part A premium is $499 in 2022. 

You should avoid the Medicare Part A late enrollment penalty which can increase your monthly premium. If you choose not to enroll in Medicare Part A when you first become eligible, your premium may go up by 10% annually. Plus, you’ll pay the increased premium twice the number of years you didn’t sign up.

Beyond the monthly premium and potential late enrollment penalties, you’ll need to pay the annual deductible, coinsurance, and copayments for care. These amounts can change yearly. 

It’s important to note that Original Medicare Part A and B do not have a maximum for out-of-pocket expenses, which is why many people choose to expand their coverage with a Medicare Supplement or Medicare Advantage plan. Learn more about what Medicare Part A could cost.

How do I sign up for Medicare Part A only?

If you’re already receiving retirement benefits from the Social Security Administration or the Railroad Retirement Board, you may not need to sign up for Medicare Part A. You may be automatically enrolled. 

However, if you are eligible for Medicare Part A and are not retired, you can contact the Social Security Administration in-person, online, or by phone to complete their enrollment process. Or you can speak with a local licensed Connie Health agent to guide you through the application. Call (623) 223-8884 to receive help signing up for Original Medicare Part A.

Medicare Part B Questions

What is Medicare Part B?

Original Medicare Part B is a United States federal health insurance program that reduces the cost of healthcare services for eligible people.

Original Medicare Part B is the medical insurance component of Original Medicare Part A and B. If you qualify for Medicare Part A, you can also enroll in Medicare Part B.  Learn more about Medicare Part B.

How much is Medicare Part B?

Original Medicare Part B has a monthly premium. The standard monthly premium for 2022 is $170.10, and most people pay this amount. However, suppose your Modified Adjusted Gross Income (MAGI), as reported on your IRS tax return from two years ago, is higher than a certain amount. In that case, you’ll pay the standard premium plus an Income Related Monthly Adjustment Amount (IRMAA). The IRMAA amount changes every year and is based on income tiers. 

You can reduce the cost of the Medicare Part B premium by appealing the IRMAA adjustment amount or enrolling in a low-income Medicare Savings Program, should you qualify.

In addition to the monthly Medicare Part B premium, costs include an annual deductible, coinsurance, and copayments. The Medicare Part B premium in 2022 is $233. After the deductible is met, you pay 20% of Medicare-approved services, outpatient therapy, and Durable Medicare Equipment (DME). 

Original Medicare Part A and B do not have a maximum on out-of-pocket expenses. This is why most Medicare enrollees expand their coverage with a Medicare Supplement or Medicare Advantage plan. Learn more about what Medicare Part B could cost.

What does Medicare Part B cover?

Original Medicare Part B is the hospital coverage that covers preventative and medically necessary services. This includes care to prevent illness or detect illnesses early on and the services or supplies needed to diagnose or treat a medical condition. 

Medicare Part B covers but is not limited to orthopedic, cardiology, radiology, and other specialists; inpatient and outpatient mental health services; screenings for common medical conditions; preventative care, including annual wellness checkups; vaccinations; ambulance services; Durable Medicare Equipment (DME); and limited outpatient prescription drugs. 

There are many tests, items, and services that are not covered by Medicare Part B. These include routine dental, vision, and hearing care. To get these benefits, many people expand their coverage with a Medicare Advantage plan. Learn more about what Medicare Part B could cover.

How to sign up for Medicare Part B?

If you haven’t signed up for Medicare Part A, you can contact the Social Security Administration in-person, online, or by phone and complete their enrollment application. Or you can speak with a local licensed Connie Health agent who can guide you through the application process. Call (623) 223-8884 to receive help signing up for Original Medicare Part A or B and assistance deciding whether you need expanded coverage – such as Medicare Supplement or Medicare Advantage. 

If you’ve already signed up for Medicare Part A and delayed Medicare Part B enrollment, that’s a different process. A Connie Health local licensed agent can help enroll in Medicare Part B, which may require gathering secondary evidence. Learn more about enrolling in Medicare Part B after delaying enrollment. Or call (623) 223-8884 to receive help signing up for Original Medicare Part B and deciding whether you need a Medicare Supplement or Medicare Advantage plan.

Medicare Part C Questions (Medicare Advantage)

What is Medicare Part C?

Medicare Part C, also known as Medicare Advantage, is offered by private insurance companies that contract with the Centers for Medicare and Medicaid Services (CMS). Medicare Part C plans provide all of the benefits of Original Medicare Part A and B, but with additional benefits and often lower out-of-pocket costs. Call (623) 223-8884 to discover if a Medicare Part C plan is right for your health and budget.

What does Medicare Part C cover?

Medicare Part C plans, also known as Medicare Advantage, are required to cover all of the services that Original Medicare Part A and B offer. Some Medicare Part C plans offer additional benefits that Original Medicare doesn’t cover. These include dental, vision, hearing, reduced cost-sharing, over-the-counter and wellness products, transportation assistance, telemedicine, fitness programs, rewards and incentives programs, and more. 

You can also enroll in a Medicare Part C plan with prescription drug coverage. These plans are called Medicare Advantage Prescription Drug plans. Instead of enrolling in Medicare Part D, you would receive all coverage under the Medicare Advantage Prescription Drug Plan, with only one card. Call (623) 223-8884 to discover if a Medicare Advantage or Medicare Advantage Prescription Drug plan could help you lower costs and increase your benefits.

Why do I need Medicare Part C?

Many people enroll in Medicare Part C, also known as Medicare Advantage, because they offer low or no-cost monthly premiums, lower out-of-pocket costs, and additional benefits. Original Medicare Part A and B do not have an annual out-of-pocket maximum which could expose you to financial risk, while Medicare Part C plans have an out-of-pocket maximum. A Medicare Part C plan could lower your out-of-pocket costs.

You need a Medicare Part C plan if you’re also looking for additional benefits that Original Medicare doesn’t offer. These benefits could include dental, vision, hearing, reduced cost-sharing, over-the-counter and wellness products, transportation assistance, telemedicine, fitness programs, rewards and incentives programs, and more. 

To find a plan that suits your needs, let your local licensed agent know what benefits are most important to you. Call (623) 223-8884 to speak with a local licensed agent about expanding your benefits and lowering your healthcare costs.

How much does Medicare Part C cost?

You can expect to pay between $0 and $50 for your Medicare Advantage monthly premium. $0 is the lowest monthly premium for a Medicare Part C plan, also known as Medicare Advantage. 100% of people with Original Medicare Part A and B have access to a Medicare Advantage plan with a $0 monthly premium. Premiums range from $20 per month for HMOs to $32 per month for local PPOs and $47 per month for regional PPOs. The majority are Medicare Advantage beneficiaries enrolled in an HMO. 

Cost depends on the plan you choose and your location. Your county determines Medicare Part C plan availability and price. You should call (623) 223-8884 to discover which Medicare Part C plan is best for your health, budget, and available where you live. Or use our Medicare plan navigation tool to review Medicare Part C plans in your area.

Is Medicare Advantage a scam?

Medicare Advantage may be seen as a scam because it is offered through private insurance companies, but it is not a scam. Depending on your health needs, Medicare Advantage plans are cost-effective options for getting the necessary services and treatments. Medicare Advantage plans offer dental, hearing, and vision services that original Medicare does not.

Medicare Part D Questions (Prescription Drug Coverage)

What is Medicare Part D?

Medicare Part D, also known as Prescription Drug coverage, is a Medicare insurance plan for prescription medication needs. Those enrolled in Medicare Part D pay a monthly premium, annual deductible, coinsurance, and copayments. In exchange, you use the insurance carrier’s network of pharmacies to purchase prescription drug medication. 

While Medicare Part D is an option, creditable prescription drug coverage is a requirement of Medicare. If you choose not to enroll in a Medicare Part D plan and don’t have creditable coverage from another source, you will face enrollment penalties when you sign up. Call (623) 223-8884 to speak with a local licensed agent about your prescription drug coverage needs.

Who is eligible for Medicare Part D?

All individuals enrolled in Original Medicare Part A and/or Part B are eligible to enroll in a standalone Medicare Part D prescription drug plan.

What does Medicare Part D cover?

Every Medicare Part D plan provides a unique list of covered prescription drugs called a formulary. All plans do NOT cover the same prescription medications. However, each Medicare Part D plan includes brand-name and generic drug coverage and requires drugs in certain protected classes, such as treatment for HIV/AIDS and cancer.

Each plan’s formulary must consist of at least two drugs in the most commonly prescribed categories and classes. This allows people with varying medical conditions to get the prescription drugs they rely upon. If your formulary for your plan doesn’t include your medication, a similar drug should be available. Sometimes, if there is no substitute, you can request an exception. 

Medicare Part D plans are available based on the county that you live in. To find the best Medicare Part D for your needs, have a list of your prescription drugs available, and call (623) 223-8884 to speak with a local licensed agent.

What drugs are covered by Medicare Part D?

All Medicare Part D plans must consist of at least two drugs from the most commonly prescribed categories and classes. All Part D plans must also cover drugs in certain protected classes, such as treatment for HIV/AIDs, antidepressants, antipsychotic medications, anticonvulsive treatments for seizure disorders, immunosuppressants, and treatments for cancer, unless covered by Medicare Part B. 

Medicare Part D must also cover most vaccines, except for those covered by Medicare Part B. Call (623) 223-8884 to speak to a local licensed agent – and discover which Medicare Part D plan is best for your health and budget.

How much is Medicare Part D?

Medicare Part D costs include a monthly premium, an annual deductible, plus medication coinsurance and/or copayments. In 2022, the average basic monthly premium for standard Medicare Part D is $33. However, the monthly premium is based on plan availability in your county and your plan selection. You may choose a lower premium plan but may have high out-of-pocket costs. 

The Medicare Part D annual deductible also depends on your chosen plan. However, no Medicare Part D plan can have a deductible higher than $480 in 2022. Some Medicare Part D plans do not have a deductible. 

Most plans place drugs into categories called “tiers.” These tiers determine the out-of-pocket cost or copayment of that medication. The higher the tier, the higher the price. If you’re looking to save money on your prescriptions, a generic version will save you money. The Food and Drug Administration (FDA) says that generic drugs are copies of brand-name drugs. 

If you take insulin, you may be able to get a prescription drug plan that offers special insulin savings. Call (623) 223-8884 to speak to a local licensed agent – and discover which Medicare Part D plan is best for your health and budget.

How to apply for Medicare Part D?

To enroll in a Medicare Part D prescription drug plan, you can sign up during your Initial Enrollment Period. If you miss that, then you still have the opportunity to enroll during the General Enrollment Period or a Special Enrollment Period if you qualify. 

You must sign up for Medicare Part D when you first qualify or don’t have creditable prescription drug coverage, or you may face late enrollment penalties. Creditable drug coverage means you have as good – or better – coverage as basic Medicare Part D coverage. To find the best Medicare Part D for your needs, have a list of your prescription drugs available, and call (623) 223-8884 to speak with a local licensed agent.

Medicare Supplement Questions (Medigap)

What is Medicare Supplement?

Medicare Supplement, also known as Medigap, helps pay for some or all out-of-pocket costs not covered by Original Medicare Parts A and B.

Medicare Supplement plans work with Original Medicare and are not stand-alone plans. You must be enrolled in Medicare Part A and B to enroll in a Medicare Supplement plan. Private insurance companies offer Medicare Supplement plans. Call (623) 223-8884 to discover if a Medicare Supplement plan is right for your health and budget.

Do I really need Medicare Supplement insurance with Medicare?

Many people enroll in a Medicare Supplement plan, also known as Medigap, in addition to their Medicare Part A and B plans because Medicare Parts A and B don’t have a maximum for out-of-pocket costs. A Medicare Supplement plan helps pay for some or all out-of-pocket expenses. A Medicare Supplement plan can help shield you from high and unexpected out-of-pocket costs. Call (623) 223-8884 to discover how a Medicare Supplement plan could help you save on out-of-pocket healthcare costs.

What is the difference between Medicare Advantage and Medicare Supplement?

A Medicare Advantage plan includes the same coverage as Medicare Part A and B, plus additional benefits, often with a no or a low-cost premium, and lower out-of-pocket costs compared to Medicare Parts A and B alone. Medicare Advantage plans offer additional benefits such as dental, vision, hearing, reduced-cost-sharing, over-the-counter and wellness products, transportation assistance, telemedicine, fitness programs, rewards and incentives programs, and more. These plans also cap out-of-pocket costs, unlike Original Medicare Parts A and B. Many Medicare Advantage plans also include prescription drug coverage, which are called Medicare Advantage Prescription Drug plans. With a Medicare Advantage plan, you can receive all your coverage with one card instead of many. 

A Medicare Supplement plan works with Original Medicare Parts A and B. These plans help reduce exposure to high out-of-pocket costs you might face with Original Medicare alone. Medicare Supplement plans can pay for some or all of Original Medicare’s out-of-pocket costs. Medicare Supplement plans do not include additional benefits, like Medicare Advantage plans, and do not include prescription drug coverage. You still need to enroll in Medicare Part D for creditable prescription drug coverage.

Call (623) 223-8884 to discover if a Medicare Supplement or Medicare Advantage plan is best for your health and budget.

Medicare Coverage Questions

What does Medicare cover?

Original Medicare Part A is hospital insurance that covers services when medically necessary and delivered by a Medicare-assigned healthcare provider in a Medicare-approved facility. Medicare Part A covers but is not limited to inpatient care in a hospital; skilled nursing facility care if it’s not custodial or long-term care; short-term nursing home care, hospice care, and home health care. Learn more about what Medicare Part A covers.

Original Medicare Part B is the hospital coverage that covers preventative and medically necessary services. This includes care to prevent illness or detect illnesses early on and the services or supplies needed to diagnose or treat a medical condition. Learn more about what Medicare Part B could cover.

Does Medicare cover dental?

Original Medicare Part A and Part B do not include dental care.

Medicare Part A may cover any dental procedures if you are in the hospital, but in general, Medicare does not cover routine dental care. Many Medicare Advantage plans (Medicare Part C) offer dental coverage, including cleanings, fillings, dentures, and tooth extractions. Some plans also provide coverage for dental implants. Call (623) 223-8884 to find a plan with the dental benefits you seek.

Does Medicare cover hearing aids?

Original Medicare Part A and B do not cover hearing aids.

Medicare Part B may cover hearing tests as part of a doctor-recommended medical treatment and bone-anchoring hearing aids (BAHAs). In both scenarios, the enrollee would be responsible for paying 20% of the Medicare-approved amount and the Part B annual deductible. 

Medicare Supplement plans (Medigap) do not cover hearing aids. However, many Medicare Part C plans (Medicare Advantage) offer hearing coverage, including hearing aids and exams. Medicare Advantage plans are typically the most cost-effective choice for comprehensive hearing coverage. Call (623) 223-8884 to find a plan with the hearing benefits you seek.

Does Medicare cover Shingle vaccine?

Medicare Part A hospital insurance and Medicare Part B medical insurance do not cover the Shingles vaccination.

The primary way to have Medicare cover this shot is to have it administered as a prescription from your Primary Care Physician (PCP). If it is administered as a prescription, it should be covered under the Medicare Part D prescription drug coverage or a Medicare Advantage Prescription Drug plan. You should contact your Medicare Part D plan or Medicare Advantage Prescription Drug plan provider to ensure the Shingles vaccination is covered.

Does Medicare cover chiropractic?

Original Medicare Part A does not cover chiropractic.

However, Medicare Part B covers manual manipulation of the spine by a chiropractor or other qualified provider to correct vertebral subluxation. Medicare does not cover other services or tests that a chiropractor orders. These could include X-rays, massage therapy, or acupuncture unless it’s for treating chronic lower back pain. Call (623) 223-8884 to find a Medicare Advantage plan that provides chiropractic coverage.

Does Medicare cover home health care?

Original Medicare Part A and/or Medicare Part B cover approved home health services such as part-time skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, Durable Medicare Equipment (DME), medical supplies for use at home, a part-time or intermittent home health aide care, and more. These services are usually coordinated by a home health care agency based on the doctor’s orders. 

Medicare will not pay for 24-hour care in the home, meal delivery, homemaker services such as shopping, cleaning, and laundry services if they aren’t related to the plan, or custodial and personal care for daily living activities. Call (623) 223-8884 to find a plan with the home health care benefits you seek.

Does Medicare cover cataract surgery?

Yes, Original Medicare Part A and Part B cover cataract surgery.

Cataract surgery occurs most often as an outpatient in an ambulatory surgery center or a hospital outpatient department. If the surgery happens as an outpatient, it would fall under Medicare Part B benefits. However, if the surgery occurs in an inpatient hospital, it would fall under Medicare Part A coverage. 

Medicare Supplement plans can help with the out-of-pocket costs of cataract surgery. If performed in an outpatient facility, Medicare Part B would cover 80% of costs, while a Medicare Supplement plan would cover the remaining 20%. As a Medicare Supplement enrollee, you would still be responsible for the Medicare Part B annual deductible and monthly premiums. 

Medicare Advantage plans also cover cataract surgery. Any procedure that Medicare Part A and Part B cover, Medicare Advantage plans also cover.

Does Medicare cover eye exams?

Original Medicare Parts A and B do not cover eye exams.

These exams are sometimes called “eye refractions” and are used to determine the prescription for eyeglasses or contact lenses. Under Original Medicare, you would pay 100% for eye exams, eyeglasses, or contact lenses. 

The only Medicare plan that offers comprehensive vision coverage is a Medicare Advantage plan. Benefits vary, but Medicare Advantage plans may cover routine eye exams, eyeglasses, contacts, and fitting for those frames or contact lenses. These benefits would be in addition to the preventative or diagnostic vision services and treatment provided under Original Medicare Parts A and B. Call (623) 223-8884 to find a plan with the eye exam benefits you seek.

Does Medicare cover COVID testing?

Yes, Medicare covers COVID-19 FDA-authorized testing during the COVID-19 public health emergency.

As long as the public health emergency is in place, you can receive testing from a laboratory, pharmacy, doctor, or hospital where Medicare covers the test. Medicare also covers up to 8 free over-the-counter tests each calendar month.

Medicare covers COVID-19 antibody tests, COVID-19 monoclonal antibody treatments, and COVID-19 vaccines. Coverage could change when the public health emergency declaration ends.

Does Medicare cover dental implants?

Original Medicare Part A and B do not cover dental implants. Neither do Medicare Supplement plans (Medigap).

The only plans that provide comprehensive dental benefits are Medicare Advantage plans (Medicare Part C). In addition to dental implant coverage, many Medicare Advantage plans offer coverage for cleanings, fillings, dentures, and tooth extractions. Call (623) 223-8884 to find a Medicare Advantage plan that covers dental implants.

Does Medicare pay for assisted living?

Original Medicare Part A and B do not typically cover assisted living or long-term care.

Family members may pay out-of-pocket to cover the costs or get long-term care insurance for the cost of assisted living or nursing home care. Some states offer Medicaid waivers to help pay for assisted living or a nursing home if you qualify for Medicaid.

Does Medicare cover acupuncture?

Yes, Medicare Part B covers up to 12 acupuncture visits within 90 days for chronic lower back pain.

Medicare Part B will cover an additional eight sessions (20 in total) if there are signs of improvement. If your physician decides the chronic lower back pain isn’t improving or is getting worse, Medicare won’t cover additional treatments. A total of 20 acupuncture treatments are covered over 12 months.

Does Medicare cover dentures?

Original Medicare Part A and Part B do not cover dentures. Nor do Medicare Supplement plans (Medigap).

The only plan that offers comprehensive dental coverage, including dentures, is Medicare Advantage. Private insurance companies offer Medicare Advantage plans (Medicare Part C) that cover most dental procedures such as cleaning, fillings, dentures, and tooth extractions, and some plans offer dental implants. Call (623) 223-8884 to find a Medicare Advantage plan that covers dentures and other dental benefits you’re seeking.

Does Medicare cover hospice?

Yes, with Original Medicare Part A, hospice care is covered.

If the doctor certifies that you have a terminal illness with less than six months to live, you are eligible for care under Medicare. Hospice care is not for curing the disease but relieving pain and making you as comfortable as possible. Learn more about what hospice care coverage is available with Medicare Part A.

Does Medicare cover vision?

Original Medicare Part A and B do not cover vision, and neither do Medicare Supplement plans (Medigap).

The only Medicare plan that offers comprehensive vision coverage is the Medicare Advantage plan. While benefits vary from plan to plan, most Medicare Advantage plans cover routine eye exams, eyeglasses, contacts, and fitting for frames and contact lenses. Call (623) 223-8884 to find a plan with the vision coverage you seek.

Does Medicare cover annual physicals?

No, Medicare does not cover physicals. 

Original Medicare Part B (medical insurance) does cover a “Welcome to Medicare” exam in the first 12 months of enrolling in Part B. Original Medicare Part B also includes an “Annual Wellness Visit” after you’ve been enrolled in Part B for 12 months or longer. 

The difference between a physical exam and the “Welcome to Medicare” and “Annual Wellness Visit” is that a physical exam often tries to determine the cause of symptoms. During a physical exam, you’ll often have your lungs, heart, neck, and abdomen checked and provide urine and blood samples for laboratory testing. These diagnostics are not taken during a Medicare Part B covered Welcome to Medicare or Annual Wellness Visit. If you’d like diagnostic testing performed, you should request it when making your appointment.

Connie Health Questions

What is Connie Health?

Connie Health helps Medicare eligibles find their optimal healthcare plan with the right doctor for you. And helps navigate the plans’ benefits—and the Medicare system.

We achieve this by pairing technology with local Medicare expertise and personalized human interactions. Connie Health’s advanced technology simplifies the selection process with unbiased plan advice based on the doctors, medications, and benefits that are important to you—and available in your community.

All the while, a local licensed expert is available to answer your questions and guide you through the process to help make the right decision for yourself or your loved ones. Once enrolled in a plan, you can access a local Medicare care team. Your Connie Care Team can help you find doctors and specialists and explain your plan benefits.

How does Connie Health make money?

Connie Health provides its services at no cost to you and is paid a flat-rate commission from insurance companies. Unbiased advice is assured as our agents receive the same commission regardless of the insurance company or plan selected. Therefore, we recommend plans based solely on individual needs, not financial incentives.

Who owns Connie Health?

Connie Health was co-founded by Oded Eran, David Luna, and Michael Scopa. After dozens of years working in healthcare and insurance, they witnessed time and time again how difficult, confusing, and often frustrating health is for older Americans. This inspired them to launch Connie Health.

Why should I use Connie Health?

Connie Health provides unbiased Medicare plan recommendations that are best for your individual health and budget. And our local agents are part of the community they serve. Because our agents are within driving distance of you, they are experts in your healthcare market and embedded in the social fabric of your community. Your Connie Health agent is uniquely positioned to help you throughout your Medicare journey, which could last 20 or more years.

Our white-glove concierge service supports you in finding the right doctor for you and understanding your plans’ benefits. We also support you through often complex and stressful billing dilemmas – even if it requires extensive communication with a plan or provider. Our Connie Care Team provides continuous support post-enrollment and for your entire Medicare journey, no matter what.

How will Connie Health help after I enroll?

Connie Health is your healthcare advocate throughout your entire Medicare journey. Once enrolled in a plan, your Connie Care Team helps you find providers and doctors for your healthcare needs and walks you through your benefits. 

And if you ever have a question or concern about your Medicare coverage, including billing, your concierge team member is only a phone call away. The Connie Care Team provides continuous support post-enrollment and for your entire Medicare journey, no matter what.

Do I have to pay extra for Connie Health’s services?

You’ll never pay for Connie Heath’s services. There is no cost for us to help you find the right plan for your health and budget and the right doctors. Nor will there ever be a cost for our concierge services. Connie Health is here to support you throughout your Medicare journey, with no cost, no hidden fees. Connie Health’s services are absolutely free to you.

How will Connie Health help with customer service issues?

Call your Connie Care Team member if you ever have a customer service issue with your benefits, billing, or something else. We’re committed to providing our members with the best possible customer service support. Our white-glove concierge service will assess the issue and offer a solution or options whenever possible. We’ll also take the initiative to work with your insurance carrier, provider, doctor, or Medicare, to resolve whatever issues arise. You can count on Connie Health to be in your corner throughout your Medicare journey.

How will Connie Health help me save money?

It can be difficult to accurately evaluate the difference in out-of-pocket costs between different Medicare options. There are no “one size fits all” solutions because every person’s healthcare needs are different. A plan may seem less expensive upfront but cost you more in the long run.

Your local licensed Connie Health agent will walk you through the best options based on your personal healthcare needs, lifestyle, and budget. We will help you find the coverage you need with the maximum out-of-pocket savings.

How does Connie Health help me find providers?

When you select your plan, your Connie Health agent will offer provider and doctor suggestions. With their local hospital network, provider, and doctor knowledge, they’ll help you choose a new high-quality Primary Care Physician (PCP) that meets your needs. 

However, if you’d like to keep your current doctors, Connie Health can check to see if they accept Medicare assignment or belong to any Medicare plans.