There’s a lot of information out about federally ran Medicare, and we’ve found out the things you’ve always wanted to know.
With Medicare you can see any doctor, but it may cost you
Yes, it’s true you can see any doctor, healthcare provider, hospital, or other facility that accepts Medicare and is taking on new clients. However, Original Medicare has negotiated a rate with the doctor, and you will have to pay out what is not negotiated. This rate is capped at 15% above the Medicare rate. But this can add up. If you have a Medigap Plan F it covers this excess charge.
Medicare does not cover prescription drugs
There are few exceptions to this, but Medicare does not cover prescriptions. Medicare Part D is insurance that you pay a monthly premium to cover a percentage of your prescription costs.
You do not need a primary doctor or need a referral with Medicare
As long as your doctor or specialist are enrolled in Medicare you can see them. Just remember to check what their rates are.
There’s no yearly limit for out-of-pocket costs with Medicare
You initially pay the deductible, but are also responsible for co-insurance (the amount you pay after you meet your deductible, usually 20%), co-payments (price you pay at time of visit to doctor or facility). These costs can add up, especially with an extended hospital stay, and there is not a ceiling for these costs.
Medigap fills in the gaps of Medicare
Medigap (AKA Medicare Supplemental) fills in the gaps where Medicare leaves off. Medigap will help with co-insurance, deductibles, and extended hospital visits. To read more about the financial protection of Medigap go to our Medicare Supplement Overview.
Next steps
If you have any further questions about Medicare, please contact Senior 65 or call the number above.