When Calling Porter Group
Do I have to get a plan when I age into medicare?
Not if you (or your spouse) are still working and have employer coverage. However, if you do not have adequate employer coverage, you will need to enroll in Medicare Part B and Part D to prevent additional lifetime charges in the future.
What plan do I have?
You can find what plan you have listed on your health insurance card itself.
What are my benefits?
Your specific plan benefits are outlined in your enrollment book. You can also call the member service number on your card or call our Medicare Resource Center where we will be happy to help you get all the benefits offered with your plan.
Do I qualify for the “Extra Benefits” the tv/people calling me/radio/letter I got in the mail?
Many of these ‘Extra Benefits’ advertised on television and in the fliers you receive by mail are for individuals who financially qualify for both Medicare and Medicaid. Even if you don’t financially qualify, we can help you evaluate your current plan as there are many benefits available that you might not be currently receiving.
How do I know if I get extra help?
You will need to apply for extra help at SSA.GOV. We can help with that but it’s a financial threshold that you will need to meet in order to qualify.
If you do qualify, you will also need to apply through your state’s Medicaid site. We can help you with both of these steps through our Medicare Resource Center.
Am I on the right plan?
We would be happy to meet with you to evaluate your current coverage and, if necessary, help you change to a plan that is better suited to meet your needs.
Is Dr. _______ in the network? (specialist, dentist, optometrist)
Call the member service number on your card or our Medicare Resource Center. We have the ability to look up network providers for most all plans.
What is the difference between a Medicare Supplement and a Medicare Advantage plan?
Medicare only covers 80% of your medical and hospital costs (your Part A and Part B). With a Medicare Supplement, you pay a premium every month and it takes care of the other 20%. These plans don’t offer any other benefits Medicare doesn’t offer. You will still need a Part D drug plan which you will also pay a monthly premium for and you’ll have a copay when you go to the pharmacy.
With a Medicare Advantage plan your Part A, Part B, and Part D is all bundled together. You’ll pay a copay at the Dr., when you go to the hospital, and at the pharmacy. These plans also offer dental, vision, and hearing benefits as well as OTC cards. A lot of those plans have a $0 premium.
Medicare Supplement plans do not work in conjunction with Medicaid assistance. You should not carry both at the same time.
Where do I find my Medicare number?
It’s listed right below your name on your red, white and blue card and it will include numbers and letters, it will no longer be your social security number.
Which card do I use when I go to the doctor?
If you have a Medicare Advantage plan, you will need to show that card at the doctor and at the pharmacy as the drug plan is included. If you have a Medicare Supplement, use that card when you go to the doctor and if you have a separate drug prescription card, use that when you go to the pharmacy.
Why did I get bill for a preventative procedure?
It depends on how the facility codes the billing. If the doctor finds something on your test that is sent for further testing, the coding changed from preventative to diagnostic, and then there would be an additional charge for that service.