How do I submit a bill to Medicare?
In almost all cases, if you are enrolled in a Medicare Advantage plan, you will not have to worry about submitting bills to Medicare. However, if you are enrolled in Original Medicare or Medicare and a Medicare Supplement, there can be times you need to file a claim for Medicare reimbursement. If you do, these […]
Do Medicare Advantage payments count towards my “out of pocket” maximum?
Yes. In 2026, all Medicare Advantage plans have an out-of-pocket maximum, also called a MOOP. This is the most you’ll pay for Medicare-covered medical services in a year. Once you reach your MOOP, your plan pays 100% of covered services for the rest of the year. The maximum MOOP allowed by Medicare in 2026 is […]
What’s the difference between a Medicare Advantage HMO and a PPO?
HMO stands for Health Maintenance Organization and is a type of plan that requires you to see doctors in its network. If you see a doctor outside the network, you will be responsible for all of the costs. The only exception to this is medically necessary emergency or urgent care services. There is also a […]
Can a Medicare Advantage plan be “free”?
In some respects, yes. There are Medicare Advantage plans available that have premiums that are $0. However, it is important to know that it does not mean that all of your care is free. You may not have a plan premium to pay, but you will still have to pay your Medicare Part B premium. […]
A friend has Medicare Plan F and loves it but says they no longer offer it. How come?
As of January 1, 2020, Medicare Supplement plans that cover the Part B deductible are not allowed to be sold to those newly eligible for Medicare. As a result, Medicare Supplement Plans C and F are no longer available to those newly eligible for Medicare beginning January 1, 2020. If you are already enrolled in […]
What are Medicare “star ratings” and how are they measured?
Medicare rates Medicare Advantage and Part D (prescription drug plans) using something called Medicare stars. A 5-star rating is the best, while a 1-star rating is the worst. When you’re trying to choose a Medicare Advantage or Part D (prescription drug) plan, all the choices can be overwhelming. The star rating program was put in […]
How do I know which doctors accept Medicare assignment?
First off, let’s define what Medicare assignment is and the impact it can have on your out-of-pocket costs. One of the most significant potential gaps in Original Medicare is healthcare providers’ ability to bill you for something called excess charges if they don’t accept Medicare Assignment. They may still accept you as a Medicare patient, […]
What is the “Welcome to Medicare” physical all about?
Medicare Part B (Medical Insurance) covers a “Welcome to Medicare” preventive visit once within the first 12 months you have Part B. This visit includes a review of your medical history and counseling about preventive services. There is no cost to you for the “Welcome to Medicare” preventive visit if your doctor or other qualified […]
What happens if my doctor no longer accepts Medicare payment?
While most doctors accept Medicare, some do not. If you turn 65 and your physician does not accept Medicare, you will have some decisions to make. Choosing to stay with a doctor that does not accept Medicare can result in high out-of-pocket costs for you. There is a difference between a doctor who does not […]
What happens if my doctor no longer accepts Medicare payment?
While most doctors accept Medicare, some do not. If you turn 65 and your physician does not accept Medicare, you will have some decisions to make. Choosing to stay with a doctor that does not accept Medicare can result in high out-of-pocket costs for you. There is a difference between a doctor who does not […]