Medicare Plan FAQs

Find the answers to common Medicare questions.

Medicare Plan FAQs

Get the Answers You Need

Whether you are a new member or you have been with us for a while, you may have questions about your coverage with Community HealthFirst. Use this page as a resource to find the answers to common questions.

Plan Frequently Asked Questions

What is a Medicare Advantage Plan?
Medicare Advantage plans combine Original Medicare Parts A and B and offer additional benefits, under one card. Private insurance companies, like Community HealthFirst, offer these plans. In addition, they offer extra coverage like dental, vision, hearing and prescription drugs. With an Advantage plan, you have more health care security. You have fixed copay or coinsurance amounts for things like routine doctor’s visits and yearly limits on your out-of-pocket health care costs. This means once you pay the maximum limit, you pay nothing more.  Original Medicare does not offer these limits. To be eligible for an Advantage Plan, you receive Original Medicare Parts A and B, and continue to pay your Part B premiums.  
Can anyone join a Medicare Advantage Plan?

Generally, anyone who is receiving Original Medicare Parts A and B is eligible for more coverage on an Advantage plan.  There are a few requirements if you wish to enroll in a Medicare Advantage plan. You must:

  • Be eligible for Medicare
  • Be enrolled in both Medicare Part A and Medicare Part B (if you are enrolled you would have received your red, white, and blue Medicare card)
  • Live within the plan’s service area (which is based on the county you live in – not your state of residence)
  • Not have end-stage renal disease (ESRD).
What is Medicare?

Medicare is federal insurance program for people age 65 and older, younger people with disabilities and those with End Stage Renal Disease. When you turn 65, you must enroll in Medicare coverage within the seven months surrounding your 65th birthday. If you do not enroll in coverage during that time but you are eligible for Medicare, you will have to pay a penalty. Learn more about enrollment here.

Do you lose your Original Medicare coverage when you enroll in an Advantage plan?

No. Your plan provider will take over some of the administrative processes to implement your Medicare benefits; however, you do not lose your Original Medicare. You must continue to pay your Medicare Part B premium. An advantage plan enhances your coverage. It works with Original Medicare, but does not replace it.

I need help choosing a plan, how can I find more information?

Before choosing a plan, you may want to consider the following things:

Costs, coverage, prescription drug coverage, doctor and hospital choice, quality of care, travel.

Make sure that the plan you choose works for your budget and your health care needs.

Browse the available plans we offer. If you still have questions, contact our licensed Medicare experts. They can help answer any questions you have about coverage and help choose a plan based on the coverage you need. For all other questions or information, please contact customer service by phone or email.

I’ve already picked a plan, but my health needs have changed. Can I change plan options?

Yes, but only during certain times of the year. During the Open Enrollment Period (from October 15 to December 7) you can switch from one Medicare Advantage Plan to another.

If you want to switch back to Original Medicare, you may do so between January 1 to February 14.

If you have questions about coverage, talk to one of our Medicare experts. They can help you find coverage that fits your health needs.

What are the different parts of Medicare and what do they cover?

Original Medicare covers two areas of your health care separately: Part A (hospital insurance) and Part B (medical insurance). Part D is optional and includes prescription drug coverage.

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Part D adds prescription drug coverage.

Medicare Advantage Plans are classified as Part C. These plans combine Original Medicare Parts A and B and offer additional benefits, all under one card. Most advantage plans also include Part D coverage. Advantage plans give you more coverage than Original Medicare alone.

Will anything change on my plan?

Any changes to the plan are described in the Annual Notice of Change (ANOC) which is mailed to you every year. Information can also be found on the plan detail page.

What if I’m planning to work beyond the age of 65?

If you are still working past the age of 65, you can delaying enrolling in Medicare. However, you must still have coverage through your employer’s health insurance.  You have the right to delay enrollment until your employment or insurance coverage ends (whichever happens first.) You have the choice to continue coverage on your employer’s plan or sign up for Medicare.

 

If you still have questions, please contact customer service for assistance at 1-800-942-0247. Our friendly and local team is available from 8:00 a.m. to 8:00 p.m., seven days a week.

DID YOU KNOW...?

Dental Coverage

Keeping your teeth and gums healthy is an important part of your whole health care plan. Dental coverage is included on select plans for yearly cleanings, x-rays, fluoride treatments, and other limited services.

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