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Medicare FAQ

Frequently asked questions by the clients of BGA Insurance Group.

Updated 10/15/18


General Medicare

Are Medicare and Medicaid the same?

They are not the same. Medicaid is a Federal-State health insurance program for low-income and needy people.

Are Medicare premiums tax deductible?

Yes, if you meet certain conditions required by the IRS.

Are Medicare premiums paid in advance?

Part A premiums have been paid in advance through tax dollars. Part B premiums are paid monthly or quarterly when you elect Part B.

Are Medicare premiums based on income?

Medicare Part B premiums are based on income levels.

Are Medicare wellness visits mandatory?

A Medicare Wellness visit in not mandatory, but is a benefit that pertains to your best interest.

Are Medicare and Medicaid federal programs?

Medicare is a federal run program while Medicaid is a state run program run within federal guidelines.

Are Medicare cards changing?

Yes they are! All Medicare recipients will be issued new cards by 2019 that will no longer feature your social security number.

How is Medicare funded?

Medicare is funded by taxpayers through the social security administration.

How does Medicare pay doctors?

The doctor bills Medicare direct and Medicare pays the doctor direct, unlike Medicare Advantage carriers.

How does Medicare work with other insurance?

Medicare is compatible with a Medigap plan and a Part D plan. You cannot simultaneously have a Medigap and Advantage plan.

Will Medicare pay for assisted living?

Medicare will cover the recipient but not the actual facility.

Will Medicare pay for glasses?

Some Medicare Advantage plans have certain allowances for prescription glasses.

Which Medicare plan covers hospice?

Medicare does cover some hospice care.

Will medicare pay for a hospital bed?

Medicare Part A will cover a portion of your hospital bed.

Will Medicare pay for nutritional supplements?

Medicare does not pay for nutritional supplements, only drugs prescribed by the doctor.

Will Medicare pay for a lift chair, mobility scooter, walker, or wheelchair?

Medicare will cover durable medical equipment if prescribed by a licensed physician.

Will medicare pay for a hot tub?

Medicare will not pay for luxury items such as a hot tub unless it’s prescribed by a licensed physician to treat a specific condition.

Will Medicare pay for home health care?

Medicare will pay a certain amount of days for skilled nursing care. A Medigap Plan can cover some gaps for up to a 100 days.

Will Medicare pay for dental implants?

Medicare will not pay for dental coverage or implants.

Will Medicare pay for dentures?

Will Medicare pay for acupuncture?

Will Medicare pay for viagra?

Medicare does not cover viagra.

Which Medicare part is free?

There are no parts of Medicare that are free. You pay Part A through taxes during your employment career. You pay Part B from your social security benefits and you pay pay for Part D when elect to join a prescription plan.

Can Medicare be primary insurance?

If you choose Medicare over an Advantage plan it becomes your primary insurance.

Which Medicare plan covers dental?

Medicare advantage plans cover some preventative dental. Traditionally Medicare itself does not cover dental or vision.

Can Medicare cover dental?

Not in the traditional sense, only if it’s medically necessary.

Can Medicare negotiate drug prices?

At this point Medicare can not negotiate drug prices, only private insurance carriers can.

Can Medicare be secondary?

Medicare can be secondary, in most cases if you have employer coverage.

Can Medicare cards be laminated?

Yes, you can laminate your Medicare card.

Can Medicare take your house?

No, Medicare cannot take your house or place of residence.

Can Medicare be used overseas?

Medicare itself does not cover overseas, but some Medigap plans have foreign travel benefits.

Is Coolief covered by Medicare?

Is Quell covered by Medicare?

Is an INR Testing Machine Covered by Medicare?

Will Medicare pay for a 3d Mammogram?

Will Medicare pay for a portable oxygen concentrator?

Will Medicare pay for a lift chair recliner?

Will Medicare pay for a wheelchair ramp?

Will Medicare pay for home health care? Do I qualify for aide services?

Will Medicare pay for a colonoscopy and preparation services?

Will Medicare cover assisted living?

Can Medicare pay for Diabetes Testing Supplies?

Will Medicare pay for bariatric weight loss surgery?

Will Medicare pay for chiropractic care?


Medicare Advantage

Are Medicare Advantage plans hmos?

Medicare Advantage plans include HMO’s, PPO’s, SNP’s and PFFS plans offered by private insurance carriers.

How does Medicare Advantage work?

Medicare Advantage plans are private insurance carriers approved by Medicare that cover all Medicare benefits.


Medicare Part D

How does Medicare Part D work?

Part D is an independent prescription plan which is subsidized by Medicare.

Is Entresto covered by Medicare?

Will Medicare pay for a shingles shot?


Medicare Supplements

Who needs Medicare supplements?

Any senior age 65 and over who no longer will have credible coverage through an employer and some people under the age of 65 who qualify for Medicare disability.

Can Medicare supplements deny coverage?

Supplements will only deny coverage if Medicare denies coverage first. Medicare is the primary and supplements are only the secondary, Medicare pays first.

Can employers pay for Medicare supplements?

Yes, we have numerous clients where their employer will pay for the coverage.

Can you have two Medicare supplements?

No, you cannot have two Medicare supplements.

Will Obamacare affect Medicare supplements?

You can never predict the future, but right now Obamacare has not affected Medicare that we know of.

Do Medicare supplements pay for hearing aids?

No, Medicare does not cover hearing aids, but we do sell a separate policy for hearing aids.

Do Medicare supplements cover prescriptions?

Medigap plans do not cover scripts, you need a Part D Plan.

Do Medicare supplements cover dental?

Medicare supplements do cover dental, some Advantage plans do or a separate dental plan will.

Do Medicare supplements have networks?

When you have traditional Medicare and a supplement you have an open network throughout the United States. Medicare is an open network insurance therefore a supplement also has an open network.

Do Medicare supplements cover nursing homes?

Medicare will cover a certain amount of days for skilled nursing care, not custodial or intermediate care.

Who can sell Medicare supplements?

Licensed agents who are contracted by private insurance carriers.

Are Medicare supplements guaranteed issue?

Some plans are guaranteed issue. Depends on the situation, for example someone who had Medicare but are losing their employer coverage.

Are Medicare supplements underwritten?

Supplements are underwritten for people who are not in their Initial Enrollment Period.

Do Medicare supplements cover chiropractic?

Medicare does not cover routine visits, it will only covers manual manipulation of the spine if medically necessary.

Which Medicare supplements have Silver Sneakers?

There are very few supplements that do cover Silver Sneakers most notably United Health Care.

What companies sell Medicare supplements?

Private insurance carriers.

Do Medicare supplements cover vision?

Medicare supplements do not traditionally cover vision unless for cataracts or glaucoma which are medical conditions.

Can Medicare supplemental insurance be denied?

If Medicare is your primary your supplement cannot be denied.

BGA Insurance Group are licensed insurance brokers that can help with any questions that you may have regarding your current plan, changing your plan, retirement implications, life insurance and financial planning.

Looking for plan or premium specific pages with the latest information for 2019 enrollment?

For New Jersey plans click here.

For Pennsylvania plans click here.

For Delaware plans click here.

For Florida plans click here.

*Please note – information on this page is subject to change at any time due to changes in law, plans, policies, etc.

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