What is Medicare?
Medicare is a national health insurance for people 65 or older, people with disabilities, or ESRD (end stage renal failure). There are different parts to Medicare and it's important you understand what they are and how they work.
Medicare Part A & B
Part A
Inpatient services (Original Medicare)
Part A covers inpatient costs. In addition to hospitals, Part A covers skilled nursing facilities, hospice, and home health care. While Part A will cover the cost of your room, it does NOT cover treatments such as scans or surgeries. Those are under Part B.
It is free to most people at age 65 which is determined by work experience.
Part B
Doctor and outpatient services (Original Medicare)
Medicare Part B covers doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance services, and other outpatient services. It involves more costs than Part A which is adjusted yearly and has a deductible. You will want to check every year for determine your cost for the next year.
Medicare Part D
Drug Coverage
(Original Medicare)
Medicare Part D, the prescription drug benefit, is the part of Medicare that covers most outpatient prescription drugs. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with your Medicare Advantage Plan.
Unless you have creditable drug coverage and will have a Special Enrollment Period, you should enroll in Part D when you first get Medicare. If you delay enrollment, you may face gaps in coverage and enrollment penalties.
(For more detailed information about Medicare Supplement Insurance visit www.medicare.gov)
Medicare Part C -
Medicare Advantage Plans
Plans A, B, D all in one
A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA” Plans, are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). There are several types of Medicare Advantage Plans. Each of these Medicare Advantage Plan types have special rules about how you get your Medicare-covered Part A and B services and any supplemental benefits your plan covers.
If you join a Medicare Advantage Plan you’ll still have Medicare, but you’ll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare.
You must use the card from your Medicare Advantage Plan to get your Medicarecovered services. Keep your red, white, and blue Medicare card in a safe place because you may need to show your Medicare card for some services. Also, you’ll need it if you ever switch back to Original Medicare.
Medicare Supplement Insurance
(Or Medigap plans)
All Medicare supplement plans fully or partially pay for:
- Part A coinsurance
- Part B coinsurance
- Costs for 365 extra hospital days
- Hospice care coinsurance
May also pay for
- Parts A & B deductible
- Part B excess charges
- Foreign travel emergency care with limits
The coverage level varies from plan to plan. It's always good to ask about your plan. They do provide nationwide coverage.
How it works with Original Medicare
Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:
- Copayments
- Coinsurance
- Deductibles
For more detailed information about Medicare Supplement Insurance visit www.medicare.gov
