Medicare Explained
Medicare is a federal health insurance program that provides benefits to all U.S. citizens aged 65 and over. You can enroll up to three months before your 65th birthday and coverage can begin in your 65th birthday month. You can also qualify for Medicare at any age if you receive Social Security Disability Insurance or SSDI.
There are 4 parts of Medicare: Part A, Part B, Part C, and Part D.
PART A – HOSPITAL INSURANCE
Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facilities, hospice care, lab tests, surgeries, and home health care. You can use any doctor or hospital that takes Medicare, anywhere in the U.S.
PART B – MEDICAL INSURANCE
Medicare Part B covers medical services and supplies that are medically necessary to treat your health condition. This can include doctor visits, outpatient medical care, preventive services, ambulance services, and durable medical equipment.
PART C – MEDICARE ADVANTAGE
Medicare Advantage Plans (Medicare Part C) are offered by private insurance companies that are contracted by the federal government to administer them. These plans “bundle” the benefits of original Medicare parts A, B, and D into one coverage plan, administered by one company.
Medicare Advantage Plans are subsidized by Medicare so they usually have a very low or no premium at all. There are no extra premiums for prescription drug coverage with most plans and all preventative services are covered with no copay.
Out of pocket costs are based on usage instead of a monthly premium so most members with average healthcare usage save more money with a Medicare Advantage Plan than a Medicare Supplement.
Want to learn more about Medicare Advantage Plans?Schedule an appointment with Ron>>
PART D – PRESCRIPTION DRUGS
Unlike Medicare Part A and B, there is no public option for Medicare prescription coverage; all plans are provided by private companies. This allows participants to choose a plan that best meets their individual needs.
There are two ways to get Medicare prescription drug coverage:
- You can choose a Medicare Part C plan that includes prescription drug coverage (these are called Medicare Advantage prescription drug plans)
- You can purchase Medicare Part D as a stand-alone prescription drug plan if you are enrolled in Medicare Part A or B.
Out-of-pocket costs for prescriptions vary from plan to plan so please call Ron if you need help figuring out if your prescriptions are covered. (913) 707-2291
MEDICARE SUPPLEMENT INSURANCE
Original Medicare pays for much, but not all costs of covered health care services and supplies. Medicare Supplement Insurance can help pay some of your remaining health care costs, like copayments, coinsurance, and deductibles, and is also sold by private companies.