What is Medicare?
Medicare is a fee-for-service health care program for seniors or those who qualify for disability, in which the government pays health care providers directly for services that fall under Parts A and B of Medicare benefits (see below).
Medicare is divided into four categories. This allows you to customize your personal coverage when shopping for a comprehensive policy.
- Part A (hospital insurance): Covers hospital care, nursing home care, home health services and hospice.
- Part B (medical insurance): Covers doctors visits specialty visits as well as medically necessary services and supplies used for diagnosing and treating medical conditions, and preventative services for illness prevention and/or early detection. Examples include ambulance services, mental health care, outpatient procedures and clinical research.
- Part C: Combines Parts A and B benefits and often part D through a private insurance carrier.
- Part D: Offers prescription drug coverage.
What Medicare options are available?
Original Medicare offers coverage for services and supplies that are considered to be medically necessary, such as doctor visits, lab tests and wheelchairs. However, Medicare has exposure left to the insured that can change each year. There is also no maximum out of pocket. Because of this there are several alternative plans you can choose from for additional coverage.
- Medicare Advantage Plans. These are also known as Part C. They combines Part A and Part B as a replacement to Medicare for more comprehensive health care coverage. These plans must provide as good and better benefits then Medicare does by itself. These plans can be customized with additional coverage, such as a prescription drug program (Part D), vision and dental. These plans can also be found with low premiums because they receive a certain amount of premium from Medicare.
- Medicare Supplemental Plans. These are also known as Medigap. These plans do not replace Medicare, they supplement it. They act as a secondary to their Medicare program. They can have a higher premium, but they also can provide very low or no exposure.
What are Part D Plans?
These plans are to provide prescription benefits. These plans are governed by Centers of Medicare and Medicaid Services, and must follow a set of specific requirements. To know which plan works best for you, is based on the prescriptions you are taking as well as the pharmacy you purchase them at. We can easily assist you in finding the plan that works best for you.
Contact us today to learn more about coverage options. We are happy to work with you to determine which Medicare options are best for you.