Course 2: Medicare and Hospital Discharge Planning

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• Course 1: Health Insurance Terms

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  This course marks the beginning of your journey in navigating the world of Medicare. First you will become familiar with health insurance terms and concepts that are essential to understanding Medicare. You will use this vocabulary to access and describe more complicated topics as we move through the MI Pro core curriculum. Terms and concepts we’ll cover include premiums, deductibles, coinsurances, copayments; distinctions between private and public health insurance; the three categories of providers for Original Medicare; differences between in-network and out-of-network for Medicare Advantage Plans; non-doctor types of health care providers; differences between hospital inpatients and outpatients; kinds of Medicare-covered therapy and types of care; and important notices that Medicare beneficiaries will receive before or after receiving a health care service or item.

• Course 4: Medigaps

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  This course focuses on Medigaps, also known as supplemental insurance plans or policies, which work with Original Medicare and pay some or all of the costs that Medicare does not cover, such as deductibles, coinsurance, and copayments. You will learn about the 10 different standardized Medigap policies, labeled A through N, and explore how different lettered plans may offer different levels of coverage, but all plans under the same letter—regardless of the insurer issuing them—must offer the same level of coverage. You’ll see how premium costs can vary widely from insurer to insurer, depending on if the plan uses community-rated, attained-age-rated, or issue-age-rated pricing. Finally, you will find out when an individual can purchase a Medigap and learn about the guaranteed issue right.

• Course 3: Medicare Options

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  In this course, you will learn how to make an informed decision about Medicare coverage, first by learning the two different ways that Medicare benefits are offered: through Original Medicare administered directly through the federal government and through Medicare Advantage Plans offered by private insurance companies that contract with the federal government. We will talk about the broad categories of care, program costs, and excluded services under Original Medicare, and then see how Medicare Advantage Plans must cover all the same services, but may do so with different costs, restrictions, and additional benefits. You will also learn about Medigap supplemental policies and public benefits available to help those with lower incomes afford care.

• Course 4: Medicare Late Enrollment Penalties and IRMAA

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  Many beneficiaries have questions about late enrollment penalties and Medicare Income-Related Monthly Adjustment Amounts (IRMAA), and this course will help people with Medicare avoid penalties wherever possible. You will learn that penalties are incurred if individuals do not enroll in Medicare Parts A, B, and/or D when they are first eligible to do so, and we will explore how these penalties may be eliminated. The course reviews all key IRMAA considerations: what IRMAA is, when it must be paid and who is likely to pay it, and how to appeal or request a new initial determination if there is disagreement with Social Security’s IRMAA decision.