Medicare

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What is Medicare?

Medicare is a federally run health insurance program for people 65 and older and with certain disabilities and health conditions under 65.
Medicare provides coverage for a wide range of medically necessary services, preventative services, and more.
You enroll in Medicare through the Social Security Administration.

What are the parts of Medicare?

Part A

Hospital Coverage

Part A is hospital insurance that assists you with the cost of inpatient care and skilled nursing facility stays. It also helps with things like hospice and home health care. In general, you should think of the inpatient hospital benefit as Medicare coverage for room and board in the hospital.

Part B

Medical Coverage

Part B is your outpatient medical coverage. Part B covers essentially all of your other medical services outside of your inpatient hospital care. Furthermore, without Part B, you would be uninsured for doctor’s visits (including doctors who treat you in the hospital). You would also not have Medicare coverage for lab work, preventive services, ambulance services, and outpatient surgeries.

Part C

Medicare Advantage

Part C refers to the Medicare Advantage program or private insurance. The cost of Advantage plans varies by carrier, county of residence, and plan selected.

To enroll in a Part C plan, you must first be enrolled in both Parts A and B. Even if you find a Part C plan with a very low premium, you will still pay for Part B. You must also live in the plan service area and apply during a valid election period.

Once you enroll, your Medicare coverage will come from the Advantage plan itself, not from the government.

Part D

Prescription Drugs

Medicare Part D is the newest part of our national health insurance program for people age 65 & up. For half a century, there was no Medicare coverage for prescription medicines. In 2006, our federal government rolled out Part D and tens of millions of Medicare beneficiaries signed up to get coverage for their outpatient drugs.

What is Medicare Supplemental Insurance? (Medigap)

Medicare supplements came into being shortly after Medicare was signed into law. Because you are required to pay for some things, like 20% of outpatient expenses, supplemental policies were created to pay those expenses for you. This allows people to feel less worried about how much each medical visit will end up costing them.

Some of the primary advantages of a traditional Medicare Supplement policy are:

Freedom to choose your own doctors and hospitals
No referrals are required to see a specialist
Predictable out-of-pocket expenses for Medicare-covered services (and zero out-of-pocket with Plan F)
Nationwide coverage – you can use it anywhere in the United States
Guaranteed renewability – the insurance company can never drop you or change your coverage due to a health condition

Supplemental insurance for seniors with Medicare is the most predictable back-end coverage you can buy. You will know exactly what’s covered for every inpatient or outpatient procedure based on which Medigap plan you choose.

Some other things to know about Medicare Supplement insurance:

You must have Part A and Part B to buy a Medigap policy.
Medicare Supplement plans cover only one person. Your spouse must have his or her own individual policy.
You can drop your supplement at any time. There is no annual election period for Medicare Supplement plans.
The Annual Election Period in the fall is for drug plans. It does not apply to Medicare supplements in any way.
Many carriers offer household discounts if two or more people enroll in Medicare supplemental plans from the same company.
Plans do not include Part D, so you’ll add a separate standalone Part D drug plan.

What are the parts of Medicare?

Part A

Hospital Coverage

Part A is hospital insurance that assists you with the cost of inpatient care and skilled nursing facility stays. It also helps with things like hospice and home health care. In general, you should think of the inpatient hospital benefit as Medicare coverage for room and board in the hospital.

Part B

Medical Coverage

Part B is your outpatient medical coverage. Part B covers essentially all of your other medical services outside of your inpatient hospital care. Furthermore, without Part B, you would be uninsured for doctor’s visits (including doctors who treat you in the hospital). You would also not have Medicare coverage for lab work, preventive services, ambulance services, and outpatient surgeries.

Part C

Medicare Advantage

Part C refers to the Medicare Advantage program or private insurance. The cost of Advantage plans varies by carrier, county of residence, and plan selected.

To enroll in a Part C plan, you must first be enrolled in both Parts A and B. Even if you find a Part C plan with a very low premium, you will still pay for Part B. You must also live in the plan service area and apply during a valid election period.

Once you enroll, your Medicare coverage will come from the Advantage plan itself, not from the government.

Part D

Prescription Drugs

Medicare Part D is the newest part of our national health insurance program for people age 65 & up. For half a century, there was no Medicare coverage for prescription medicines. In 2006, our federal government rolled out Part D and tens of millions of Medicare beneficiaries signed up to get coverage for their outpatient drugs.

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