Medicare Basics
Ask most people to define Medicare and they’ll tell you that it’s health care coverage from the federal government for U.S. citizens age 65 and older. That’s certainly true, but it is also designed for younger individuals with disabilities. To be sure you’re getting the most from your coverage, it’s important to understand all of Medicare’s parts
UNDERSTANDING ALL THE PARTS OF YOUR MEDICARE COVERAGE
Medicare is split into four parts, A, B, C and D. Each part covers a specific set of health care services or expenses.
MEDICARE – PART A
Medicare Part A is often referred to as hospital insurance. You’ll need it if you’re ever admitted to the hospital, for any reason. However, Part A covers more than just hospital stays. You’ll also be covered for:
• Inpatient care at a skilled nursing facility
• Inpatient rehabilitation
• Home health care Hospice care
MEDICARE – PART B This is medical insurance for issues that don’t require hospitalization, including lab services. You’ll want Part B for coverage that extends to: • Doctor visits & outpatient treatment • Ambulance services • Preventive care services (screenings & check-ups) • Home health services • Durable medical equipment (including diabetes supplies)
MEDICARE – PART C Also known as Medicare Advantage, Part C refers to private health insurance plans that provide Medicare coverage. Private insurers who offer Medicare Advantage plans are required to provide the same benefits as Medicare Parts A and B, and some carriers provide even more benefits/services. Medicare Advantage plans: • Approved by the Centers for Medicare and Medicaid Services (CMS) • Must maintain a contract with CMS to provide Medicare coverage • Can offer prescription drug coverage (see Part D) as part of their plan offering
MEDICARE – PART D
Part D is Medicare prescription drug coverage. Sometimes referred to as MA-PD, Medicare prescription drug plans:
• Are provided by private health insurance companies
• Can be offered as stand-alone plans or as part of a Medicare Advantage plan
• May require you to use specific pharmacies or get some of your medications by mail
MEDICARE SUPPLEMENT (OR MEDIGAP)
Medicare Supplement plans cover many of the out-of-pocket expenses that original Medicare does not. Only private insurance companies offer Medigap plans, and 10 plans are available from which to choose. Keep in mind, however, that Medigap is not a Medicare Part C or Medicare Part D and does not cover services not covered by Medicare Part A or Part B.
WHO IS ELIGIBLE FOR MEDICARE? First off, let’s be clear about who is eligible for Medicare. Even if you’re not 65 yet, you may still be able to take advantage of Medicare. That’s because people of any age who are disabled, or have End-Stage Renal Disease (kidney failure), may qualify for Medicare. To determine if you’re eligible for Medicare, you can use the Medicare Eligibility Tool at Medicare.gov
HOW MUCH DOES IT COST?
Part A is free for most people, as long as you are already receiving benefits from Social Security. Part B requires you to pay a monthly premium. Individuals with high incomes may need to pay more for their Part B premium. If you have limited income, you may qualify for a special Medicare savings program from your state. Prices for Part C, Medicare Advantage plans and Medigap plans, as well as Part D, prescription drug coverage, vary based on your selected plan and insurance carrier.
STILL HAVE QUESTIONS? TALK TO AN EXPERT If you’re eligible for Medicare, it’s important to make sure you’re getting all the coverage you deserve. Fortunately, understanding your options doesn’t have to be complicated. When it comes to your health, you want to be sure you fully understand all of it. We work hard to ensure we provide you with the educational resources you need, the personal attention you deserve, and the commitment you want.