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The Basics of Medicare

Medicare is health insurance for:

  • People age 65 or older
  • People Under 65 with certain disabilities
  • People with end-stage renal disease (ESRD)

The four parts of Medicare are Parts A, B, C and D.

Medicare Parts A & B are often referred to as Original Medicare. Medicare Part C refers to Medicare Advantage plans and Medicare      Part D covers prescription drug plans.

Medicare Part A (hospital insurance) helps cover:

  • Inpatient hospital care
  • Care in a skilled nursing facility
  • Hospice care
  • Home health care

Medicare Part B (medical insurance) helps cover:

  • Care from doctors and other healthcare providers
  • Hospital outpatient care
  • Home health care
  • Durable medical equipment (canes, wheelchairs, oxygen tanks etc.)
  • Some preventive services such as Diabetes screenings, Mammograms, flu shots etc.

Medicare Part C (Medicare Advantage plans)

  • Run by private insurance companies that are approved by Medicare
  • Include all the benefits and services covered under Part A and Part B
  • Sometimes cover extra benefits and services at extra costs
  • Usually, include a Part D prescription drug plan

With a Medicare Advantage Plan, you get your coverage through the plan and not Original Medicare.

Medicare Part D (Medicare prescription drug coverage)

  • Part D helps cover some of the cost of prescription drugs
  • Plans are provided by private insurance companies approved by Medicare

If you do not join Medicare Part D when you are first eligible and do not have other creditable coverage, you will pay a late enrollment penalty if you choose to join later.

Medicare Supplement (Medigap)

  • Offered by private insurance companies
  • Pays some or all of the copayments, coinsurance, and deductibles not covered by Original Medicare

Notes

Before choosing to enroll in a Medicare Advantage plan ensure your primary care physician, hospital as well as any specialist you see, are in the plan’s network.

When Medicare covers a service or item, either you or your plan will generally have to pay any deductibles, coinsurance, or copayments.

Unsure of the differences between a Medicare Supplement and a Medicare Advantage plan? Read my article here.

Medicare can be confusing. I will provide you with the information you need to make an informed decision and help you find the plan that will fit your budget and that meets your unique needs.

I make the complex simple by shopping the plans and rates for you. There is never a fee and you are under no obligation to use my services.

I specialize in Medicare products and represent all Medicare Supplement Plan types

Medicare Explained in Plain English