Here are some of the most common questions that we at the Sage PLUS Program (Hawai‘i SHIP) hear from individuals. If you have a general question, you can e-mail it to us at help@hawaiiship.org and we will address a couple of questions each Generations publication. For personalized help call 1-888-875-9229. AND if you really want to learn all about Medicare and also would like to help your community, become a Sage PLUS Volunteer. We have several exciting experiences waiting for you.

TEN MOST COMMON QUESTIONS:

Is Medicare only for people over 65 years old?

Medicare is for mostly for individuals over 65 years of age, but also for individuals with certain disabilities or those who have received Social Security Disability Income for 25 months. In Hawai‘i we have individuals with Medicare from ages 18 to 100+ years old.

What’s the best Medicare Health Plan in Hawai‘i?

The best plan is the plan that your providers will work with and covers the medication that you take. Medicare Health plans are very individual and you need to make sure you do your homework before you change plans. Understanding what your plan covers and what providers work with the plan will help you make the best use of your plan.

Does Medicare pay for long-term care?

Medicare pays for “skilled nursing” care on a limited basis. They do not pay for custodial or intermediate care.

What is the difference between Medicare and Medicaid?

Medicare is our federal health insurance and is available to those 65 years and older and to individuals with certain disabilities.

Medicaid is Hawai‘i’s medical assistance program. It is a needs based program and individual qualify depending on gross income and assets.

What is a “Medigap” policy?

Medigap policies are also called “Medicare supplements”. These plans pay second after Medicare, are sold by private companies and the benefits are regulated by the government, but premiums are not.

Does Medicare pay for dental?

Original/Traditional Medicare does not pay for dental care. Some Medicare health plans have some coverage or a dental rider(additional insurance) that can be purchased.

Do physicians have to take Medicare patients?

Providers do not have to take Medicare, but if they take you as a client by law they must bill Medicare. If they have “opted” out of the Medicare program, they must provide you with that information and then you will be responsible for all charges.

Is there a penalty if I don’t take Medicare Part D-drug coverage?

If you do not sign up when you are first eligible and you don’t have drug coverage as good as Medicare’s, then you could face a one percent penalty for each month that you don’t have coverage. But more important is that if something happens and you need that drug coverage, you may have to wait until the annual enrollment period. (October 15-December 7 of each year).

What is Medicare Part C?

Medicare Part C are Medicare contracted health Plans also known as Medicare Advantage plans. Private companies contract with Medicare to provide all your A & B benefits (hospital coverage, physician services, labs and X-Rays etc). Many of our Medicare Advantage plans also include drug coverage. These plans help you limit your out of pocket expenses, provide additional benefits not covered by Medicare and help with provider access.

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