Medicare FAQ

HealthTN Medicare

Q: How does Medicare pay for my health services?
A: Medicare is financed by federal taxes taken out of every paycheck issued in the United States. All workers in the United States pay into the Medicare system during their years of employment, and are eligible to receive those benefits when they reach 65 years of age.

Q: How much will Medicare cover, and how much will I have to pay?
A: Medicare Part A and B typically cover around 80% of treatment costs during a hospitalization. The rest is deferred to the patient in the form of co-payments. Part B requires a yearly deductible, but provides coverage for routine doctor visits. Again, co-payments may still be due at the time of treatment even with Plan B. Medigap policies (or Medicare Supplements) can often cover these co-payments entirely.

Q: What types of outpatient treatment can I receive with Medicare coverage?
A: Medicare Part B covers most routine doctor visits as well as most emergencies, including X-rays, stitches, treatment of broken bones and emergency room visits.

Q: I’m a Knoxville resident who is 65 or older and I’m still working – should I sign up for Medicare?
A: Yes. Medicare Part A is free to all United States citizens 65 and older who have been employed for at least 10 years. Even if your health insurance is provided through your place of business or union, you should still enroll as it may help offset certain costs your current plan doesn’t cover.

Q: What is a Medicare HMO?
A: A Medicare HMO is a privatized version of Medicare. Most Medicare Advantage plans are considered Medicare HMOs and they are offered by private insurance companies in Knoxville and across the U.S. They are designed to work with the federal government to provide treatment, but it is important to understand that they operate on a more restrictive network of doctors and hospitals. In exchange for the restrictions, some HMOs offer extra benefits, including prescription drugs, vision care

Q: Will my prescription drugs be covered under Medicare?
A: With the introduction of Medicare Part D in 2006, most commonly prescribed drugs are now covered under Medicare. This is only applicable if you are actually enrolled in Medicare Part D, as Part A and B do not cover this. However, some drugs are not covered even under Part D, including weight loss drugs, some painkillers and any drug that is designed for cosmetic use.

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