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frequently asked questions

What does Medicare cover?
Medicare is actually divided into two parts. The first is called Part A and it covers inpatient hospital care, skilled nursing care, home health care and hospice. Everyone who enrolls in Medicare receives Part A, which is funded by many of the taxes that are taken out of payroll checks such as Social Security payroll tax and self-employment tax. There is also a Part B, which is optional because it is financed in part by premiums people pay and mostly by the Federal Government. Part B covers portions of physician services, lab and other diagnostic tests, therapy, outpatient care and other related expenses.

Why do I need a Medicare Supplement insurance policy?
Neither Medicare Part A nor Medicare Part B pays 100% of your health care costs. A Medicare Supplement insurance policy helps pay the bills not fully paid by Medicare.

What types of supplements are available?
To help consumers compare coverage and prices offered by different insurance companies, the Federal Government standardized Medicare Supplement insurance policies to several standard plans (not in MA, MN, WI), ranging from a basic plan to the most comprehensive plan. All Medicare Supplement insurance providers must offer the most basic plan.

When is the best time to purchase a Medicare Supplement insurance policy?
Medicare Part A benefits begin automatically for most people on the first day of the month of your 65th birthday. Just before you turn 65, you have to decide whether or not to take Medicare Part B. At this time, you should consider purchasing a Medicare Supplement insurance policy.

Can I be turned down because of my health?
No. As long as you apply for your Medicare Supplement insurance policy during the six-month period beginning from the date you are both age 65 and enrolled in Medicare Part B, you don't have to answer any health questions.

How will my Medicare Supplement insurance policy keep up with rising deductibles and co-insurance amounts?
Medicare Supplement insurance policies always keep up with Medicare increases. Remember, all premiums may change and go up each year because of rising health care costs and increased benefits.

What if I plan on working after I'm 65?
Whether you decide to continue working or retire, your main goal may still be the same — to maximize medical coverage and minimize out-of-pocket expenses.

So, because you're entitled to Medicare benefits beginning the first day of the month of your 65th birthday, you should still enroll in the program through the Social Security Administration. You should also look into the types of Medicare Supplement insurance policies available to you, as well as the benefits available to you through your employer. Your employee health coverage may still pay first on hospital and medical bills, while Medicare pays secondary benefits for eligible expenses that weren't covered.

Can I choose my own doctor and hospital?
With all the Medicare Supplement insurance policies, you don't have to worry about giving up the doctor you've been with for years. You choose the physician who treats you and you'll always have the option to choose your own Medicare-approved hospital.

If you have a physician you are comfortable with, then your peace of mind is what's most important. And when it comes to choosing a hospital, your choices are just as open. You can choose the hospital nearest you, or one that is well known for a speciality you may need, as long as it is Medicare-approved!

Will I need a referral?
As with all Medicare Supplement coverage, you won't need to worry about getting referrals. You will always have the choice to see a specialist without a referral.

Source: Medicare and You, Choosing a Medigap Policy - 2004


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Physicians Mutual Insurance Company offers reliable health insurance, long-term care insurance and dental insurance coverage while Physicians Life Insurance Company provides important life and medicare supplement insurance, as well as annuities. Neither Physicians Life Insurance Company nor its agents are connected with or endorsed by the U.S. Government or the Federal Medicare Program.

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