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Medicare Part A
Hospital Coverage
Medicare Part A is also known as Hospital Insurance. In general, it covers inpatient care in a hospital, care in a skilled nursing facility, home health services, and hospice care. It is health insurance for qualified Americans aged 65 and older or to those of any age who have received at least 25 months of disability benefits through Social Security or the Railroad Retirement Board. You must also be a United States citizen or legal resident who has lived in the U.S. for at least 5 consecutive years.
Medicare Part B
Doctor Visits & Outpatient Care
Medicare Part B covers medical services and supplies that are medically necessary to treat your current health condition. This can include preventative care services such as routine physicals, mammography, bone density, and flu shot just to name a few. It also includes outpatient care, ambulance services, durable medical equipment, lab and x-ray services.
Medicare Part C
Medicare Advantage Plans
Medicare Part C is a type of insurance option that offers traditional Medicare coverage plus more. It is known as Medicare Advantage. Most of these plans cover inpatient care in a hospital, medical costs, prescription drugs, vision care, and hearing care. Some Medicare Advantage plans offer additional health benefits, such as a gym membership, dental benefits, and transportation services.
Medicare Part D
Pick the Right Prescription Drug Coverage
Medicare Part D offers prescription drug coverage to anyone who is enrolled in Medicare. If you decide not to get Medicare drug coverage when you are first eligible, you may pay a late enrollment penalty if you choose later. Generally, plans can choose which specific drugs are covered in each drug category.
Facts about Medicare Part D:
- Medicare prescription drug coverage is available only through private health insurers that are approved by Medicare.
- You can purchase a stand-alone plan, or your prescription drug coverage can be included with your Medicare Advantage plan (Part C), but you must have Medicare Part A and Medicare Part B to join a Medicare Advantage plan.
- Prices and coverage may vary from plan to plan. Each insurance carrier has their own drug formulary.
- If you don’t sign up for prescription drug coverage (or have some other form of creditable prescription drug coverage) as soon as you’re eligible, you may be charged a late enrollment penalty.
Medicare Advantage
Ramp Up Your Coverage with Medicare Advantage
Medicare Advantage plans may offer additional benefits that may not be available through Medicare Parts A and B. Medicare Advantage plans are offered through private insurance companies. There are different types of Medicare Advantage plans:
- HMO/POS (Health Maintenance Organization)
- PPO (Preferred Provider Organizations)
- Special Needs Plan (SNP)
HMO/POS
Health Maintenance Organizations (HMO/POS) have a network of pre-approved service providers that will be covered on your plan. Most carriers require you to select a primary care physician. This primary care physician acts as your personal doctor, but also as your health care coordinator. If you ever needed to see a specialty doctor, your primary care physician could offer you a referral if the plan requires one.
PPO
A Preferred Provider Organization means that there is a network of preferred facilities and physicians that are pre-approved for coverage with your plan. As long as you stay within this network, you will not incur any unexpected costs from covered procedures and examinations. Medicare Advantage Plan you choose can also make a difference in your out-of-pocket costs and have may have different rules for how you receive certain services.
Special Needs Plan
Special Needs Plans (SNPs) are a type of Medicare Advantage Plan offered to those who have specific needs relating to a medical condition such as a disease or characteristic. Medicare tailors these plans for those who have certain health conditions to meet their specific needs, helping them to get the best provider choice, benefits, and drug coverage.
Medicare Supplement
Choosing A Medicare Supplement
Medicare Supplement Insurance, also known as “Medigap” helps to fill in the gaps in original Medicare and is sold by private insurance companies. It can help to pay some of the remaining health care costs such as copayments, coinsurance, your Medicare deductibles, hospital costs after you run out of Medicare-covered days, and skilled nursing facility costs once you have run out of Medicare-covered days. Medigap policies cannot be obtained with Medicare Advantage. A Medicare supplement policy must follow Federal and state laws. In most states, there are 10 different, standardized Medigap plans available, labeled with letters: A, B, C, D, F, G, K, L, M, and N.
