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Frequently Asked Questions

There's a lot to learn about Medicare and your options. The following includes many commonly asked questions about Medicare plans.

Don't see what you're looking for? If you're already a member of one of our health plans, just call Member Service at the number shown on the front of your ID card.

Not a member and still have questions? Just Contact Us. We'll be happy to answer any questions you may have about our Medicare Advantage, Medicare supplemental insurance, and Medicare Part D plans.

What is Original Medicare?

Original Medicare View glossary definition. is a federally funded health insurance plan. It is designed for people age 65 or older and some disabled people under age 65. Medicare Part A pays for inpatient hospital care, skilled nursing facility care, and hospice care View glossary definition.. Medicare Part B pays for outpatient hospital care View glossary definition., doctor visits, and many other medical services not covered by Part A.

With Original Medicare, you get easy access to care.

  • You can use any doctor or hospital that accepts Medicare (and most do)

  • Original Medicare doesn't require you to select a primary care provider View glossary definition. (PCP) or get a referral to seek care from a specialist

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What is a Medicare Advantage Plan?

A Medicare Advantage plan is an alternative to Original Medicare and often Medicare Part D benefits which provides you with complete coverage for your Medicare benefits and often additional benefits beyond Original Medicare, such as routine vision care, routine dental coverage, and more. Many Medicare Advantage plans include Part D prescription drug coverage. Medicare Advantage plans are offered by private companies approved by Medicare.

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What is Medicare Part D and how can I join a plan?

Medicare Part D is a prescription drug option provided by Medicare-approved private insurance companies to help cover the cost of prescription drugs. Medicare offers prescription drug coverage to everyone with Medicare. Even if you don't take a lot of prescriptions now, you should still consider joining a Medicare drug plan. To get Medicare prescription drug coverage, you must join a plan offered by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. If you decide not to join a Medicare drug plan when you're first eligible, and you don't have other creditable prescription drug coverage, you will likely pay a late enrollment penalty when you do join.

There are two ways to get Medicare prescription drug coverage:

  1. Medicare Prescription Drug Plans: These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

  2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called "MA-PDs."

To join a Medicare Prescription Drug Plan, you must have Medicare Part A or Part B. To join a Medicare Advantage Plan, you must have Part A and Part B. You must also live in the service area of the Medicare plan you want to join.

If you have employer or union coverage, call your benefits administrator before you make any changes, or before you sign up for any other coverage. If you drop your employer or union coverage, you may not be able to get it back. You also may not be able to drop your employer or union drug coverage without also dropping your employer or union health (doctor and hospital) coverage. If you drop coverage for yourself, you may also have to drop coverage for your spouse and dependents.

If you have limited income and resources, you may qualify for Extra Help to pay for Medicare prescription drug coverage. You may also be able to get help from your state.

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When can I enroll in a Medicare Advantage or Medicare Part D plan or change plans?

You may join or leave a plan only at certain times. For example, each year you will be able to choose a different Medicare Part D prescription or Medicare Advantage plan View glossary definition. during an annual election View glossary definition. period. If you are eligible for both Medicare and Medicaid, you may change plans at any time.

The annual election period for Medicare Part D and Medicare Advantage plans is October 15 through December 7.

The annual disenrollment period for Medicare Advantage plans is typically January 1 through February 14, annually. During this time a Medicare Advantage member may disenroll from their plan and choose Original Medicare and a Part D prescription drug plan. For more information, contact Member Service at 1-800-200-4255 (TTY: 1-800-522-1254), February 15 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday; October 1 through February 14, 8:00 a.m. to 8:00 p.m. ET, seven days a week.

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What is a Medicare Supplement plan?

These insurance plans are offered by private insurance companies to help you cover health care costs, including co-insurance, copayments and deductibles—"gaps" in Original Medicare coverage.

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When can I enroll in a Blue Cross Blue Shield of Massachusetts' Medicare Supplement plan?

Open enrollment in Medicare supplement plans vary by plan. You can enroll in a BCBSMA Medex plan at any point during the year. You have, by law, at least 30 days to review a Medicare supplement policy. If you decide you don't want the coverage, you can get a full refund of any premiums you've paid during this "free look" period.

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Will my doctor accept my coverage?

Visit Find a Doctor and search for your provider(s) to find out if they will accept your coverage.

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I understand that financial assistance may be available. How do I find out if I qualify for help?

If you have both Medicare and Medicaid, you already qualify for low-income assistance to help pay for your prescriptions. If you don't qualify for Medicaid, you may still qualify for some assistance. If you're a Massachusetts resident, contact the Prescription Advantage Program at 1-800-AGE-INFO (1-800-243-4636), (TTY: 1-877-610-0241), Monday through Friday, 9 a.m. to 5 p.m. ET.

If you aren't getting extra help, you can see if you can qualify by calling:

  • 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048) 24 hours a day/seven days a week

  • The Massachusetts Department of Elder Affair's SHINE program office at 1-800-AGE-INFO (243-4636)

  • The Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778) Monday through Friday, 7:00 a.m. to 7:00 p.m. ET

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Can Medicare Advantage or Medicare Part D premiums be deducted from Social Security checks?

Yes, you may have the option to have these premiums View glossary definition. deducted from your Social Security check (just like your Part B premium). If you are enrolled in an employer plan you are ineligible for the deduction from your Social Security check.

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What if my employer offers to continue my group health coverage after I retire?

If your employer offers to continue your group health coverage after you retire, carefully weigh your options and consider Medicare coverage alternatives available to you as an individual. If you decline your group health coverage you may not be able to return to it if you change your mind later. Ask your benefits administrator for more information.

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