Medigap Questions

1. Does Mom keep her private insurance if she gets Medicaid?

   Your mother is now what's called a "dual-eligible" -- meaning she's enrolled in both Medicare and Medicaid. That changes the other insurance she needs.
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2. Will black lung benefits or Medicare Parts A and B pay for a skilled nursing home?

   The answer's a mixed bag. Federal Black Lung benefits do not cover inpatient costs in a skilled nursing facility, but Medicare Part A can cover some skilled nursing facility care. The rules of Medicare Part A nursing facility coverage are quite strict...
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3. Does a Medigap policy make sense for my mother?

   Whether it's a good idea at this point for your mother to buy a Medigap supplemental insurance policy depends on several factors. One is the question of what Medigap policies she's now eligible for . Because she didn't buy a Medigap policy within the first six months after she first...
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4. Does Medicare cover massage therapy, physical trainer and physical therapy?

   Medicare Part B can cover outpatient physical therapy, occupational therapy, and speech therapy as prescribed by your doctor. Neither a physical trainer nor a massage therapist is covered by Medicare, but similar services may be part of what's provided by a physical therapist who's experienced with Parkinson's patients...
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5. How long will coverage for Medicare physical therapy last after a knee replacement?

   Not long. First of all, your physician needs to prescribe the therapy, and periodically needs to review your continuing need for it. But no matter how much therapy your doctor prescribes, Medicare will only pay a limited amount...
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6. Am I eligible for a Medigap disablility insurance policy if I'm on Social Security disability?

   It depends on where you live. You are eligible for all parts of Medicare when you've been receiving Social Security Disability Insurance (SSDI) benefits for 24 months. But eligibility for private Medigap supplemental insurance policies is guaranteed by the federal government only if you are enrolled in Medicare and are age 65 or older...
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7. Do any Medigap policies include drug coverage, or must you also get a Part D supplement from another source?

   No Medigap policies sold to new enrollees today include any prescription drug coverage. That's because drug coverage through Medigap was replaced by the Medicare Part D prescription drug program , which went into effect January 1, 2006. [Before 2006, a few Medigap policies (in categories H, I and J) included some prescription drug coverage...
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8. Is there any "gap" plan we can buy to help cover what Medicare Part D isn't?

   There are at least two things you can do. The first is to try to find free or low-cost prescription drugs for the time your father is in the donut hole. There are a number of programs and tactics for seniors on Medicare to obtain free or low-cost medications; they are explained in the...
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9. How do I manage insurance and Medicaid while moving Mom from state to state?

   Moving seniors from one state to another can be very complex because of health insurance issues. Original Medicare, Part A and B, are the only portable part of the insurance. Medicare Advantage and Medicare Supplement programs are generally for a specific area as contracts are with service providers in that area and/or licensed in a specific service area...
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10. Will being on my wife's insurance count as a Medigap policy?

    Let's start with your question about your wife's employer-sponsored group health insurance being the equivalent of a Medigap supplemental health insurance policy. Most employer-sponsored or union-sponsored group health plans coordinate with Medicare for employees or spouses age 65 or older...
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11. How do I help my father choose the right Medigap plan for him?

    You'll need to begin by looking at your father's medical history and how often he uses various healthcare services. Then figure out how much he's spending on healthcare. You have to assume that his healthcare spending will go up as he gets older and these health problems become more of an issue.
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12. How can I evaluate the insurance companies that offer Medigap plans?

    Although Medicare does not directly sell Medigap policies, it does regulate what the policies must include and certifies companies to participate in the program. Take a look at the Medicare website, which offers a link called "Compare Health Plans and Medigap Policies in Your Area." Click on that tool and enter the state of Maryland and your zip code...
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13. Where can I find the rule regarding Medicare and COBRA coverage?

    Since your husband has Medicare because he's over 65, Medicare is the primary payer of his covered medical bills, with COBRA coverage through your work being a secondary payer. You can find this rule explained in the Medicare booklet Medicare and Other Health Benefits: Your Guide to Who Pays First ...
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14. Are accidents in a foreign country covered by Medicare?

    Original Medicare (Part A and Part B) doesn't cover any medical care in Europe, but a Medicare Part C Medicare Advantage plan or a Medigap supplemental insurance policy might.
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15. Do I have coverage from Medicare when traveling to Canada?

    Medicare doesn't normally cover regular or emergency medical care in Canada, whether you're living or vacationing there. Medicare can cover medical care in Canada in a few very limited circumstances. They are: (1) If you're in the U.S. when an emergency arises but a Canadian emergency room is closer than any in the U...
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16. How can I get financial help for my parents who are at their donut hole with their prescriptions?

    One of several big concessions Congress made to the pharmaceutical industry when enacting the Medicare Part D prescription drug program's was the "donut hole" -- a period of no coverage when each of your parent's total drug expenses for the year reach $2,510 but out-of-pocket costs haven't yet reached $4,050...
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17. Is choosing another insurance company a good idea?

    Many people find themselves in the same boat as you, realizing that the first Medigap insurance policy that they bought is no longer the best or most affordable for them. You always have a right to switch to a new policy, but unless you are still within six months of when you first enrolled in Medicare...
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18. Does switching Medicare plans affect my coverage?

    When you turn 65 and enroll in Medicare Part B, you will have a six-month "guaranteed enrollment" eligibility period in which to purchase any Medigap (Medicare supplement) insurance policy available in your state. This means that you will be able to buy any Medigap policy, at the same rates as charged...
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19. Does my dad still need his Medigap Part C insurance if his nursing home is covered by Medicaid?

    It's a little hard to answer your question because you seem to be mixing up two different terms -- "Medigap" and "Part C" -- so I'm not exactly sure what insurance you're referring to. Medicare Part C plans, called Medicare Advantage, are insurance plans, usually a kind of managed care, that some people...
    1 Expert Answer, 1 Community Answer

20. How can you apply for Medicare supplement insurance without a Medicare number?

    My husband turns 65 in January of 2010. The social security office tells him they are behind and he should get it sometime in January. He wants to send an application for supplemental insurance but they require a Medicare number which he cannot provide. It takes 2 months usually to be approved. Any suggestions...