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Medicare Resources

Medicare resources

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Medicare visits - know the difference

Don’t miss your “Welcome to Medicare” preventive visit-it’s free within the first 12 months of enrolling in Medicare part B. When scheduling, ask for a welcome to Medicare or IPPE physical exam.

When: 1-time visit within 12 months of enrolling in part B

Cost: FREE

COVERED:

  • Medical, family and social history
  • Height, weight, blood pressure
  • Simple vision test
  • Education/counseling about Preventive Services
  • Review potential risk for depression and safety level
  • Opportunity to talk about advance directives
  • Written plan for screenings, shots and preventive services

NOT COVERED:

  • Medications are not prescribed or refilled during this visit. 
  • If additional tests/services are performed, coinsurance and part B deductible apply.

When: Every 12 months, 12 months after IPPE or previous AWV visit

Cost: FREE

COVERED: 

  • Health risk assessment 
  • Medical, family and social history 
  • Height, weight, blood pressure 
  • Detection of any cognitive impairment 
  • Personalized health advice 
  • List of risk factors and treatment options for you 
  • Screening schedule (checklist) for appropriate preventive services 
  • Update personalized prevention plan to prevent disease and disability

NOT COVERED:

  • Medications are not prescribed or refilled during this visit 
  • If additional tests/services are performed, coinsurance and part B deductible apply

When: As needed

Cost: Co-Pay 20% of the Medicare-approved amount and part B deductible

COVERED:

  • Evaluation and management of acute or chronic illness or injury 
  • Medication management – prescriptions and refills

NOT COVERED:

  • Visit Medicare.gov for the most up-to-date Medicare plan coverage

  • Abdominal aortic aneurysm screening
  • Cardiovascular screening blood tests
  • Diabetes screening tests
  • Glaucoma screening
  • Bone mass measurement
  • Screening mammography
  • PAP test & pelvic examination
  • Colorectal cancer screening
  • Prostate cancer screening
  • Diabetes monitoring & education
  • Medical nutritional therapy
  • Smoking cessation services
  • Flu & H1N1 vaccination
  • Pneumococcal vaccination

If you are turning 65 soon or need a better understanding of Medicare, you may have a lot of questions. How do I sign up? What is the best option for me? What about prescriptions? What is an advantage plan? At CHI Health, we welcome individuals with Medicare coverage and want to help you understand how Medicare works and what your options are for coverage.

Eligibility for Medicare

Become eligible at age 65. You don’t have to be retired or collect social security to receive Medicare. You may also become eligible before age 65 if you have a permanent disability or end-stage renal disease.

Elements

Medicare includes parts A and B, C and D. These parts are grouped into original Medicare and Medicare advantage. Original Medicare covers much – but not all – of your care and has deductibles and coinsurance. Medicare advantage is considered an “all-in-one ” alternative to original Medicare and has separate premiums. It’s easy to get overwhelmed by the complexities of Medicare, but help is available. For more info, talk with a licensed insurance specialist from HealthMarkets, one of the largest independent health insurance agencies in the U.S. They can answer your questions and help you understand your choices. Visit them online or call (855) 962-1786.

Enrollment

It’s important to note that you wont be notified when it is time to sign up for Medicare. Follow these enrollment period guidelines:

Initial enrollment period - 3 months before or after your 65th birthday. This is when most individuals enroll in Medicare for the first time.

General enrollment period: Jan. 1 – March 31. If you didn’t sign up for part A and/or part B during the initial enrollment period, you can sign up during general enrollment. Your coverage won’t start until July 1 of that year, and you may have to pay a higher part A and/or part B premium for late enrollment.

Special enrollment period (SEP) - Medicare allows for enrollment anytime during the year when certain life events occur – some examples of such circumstances include leaving a current employer’s sponsored health plan, a relocation to a new area or your qualification for Medicare or extra help changes.

Annual election period (AEP): Oct. 15 – Dec. 7. Already have Medicare? Medicare’s annual election period is the time when all Medicare beneficiaries are able to change their Medicare participation options for the upcoming calendar year.