Medicare is complex. We’re here to help simplify.
Whatever path you’re on in your Medicare journey, we’re here to help. If you’re just researching, below is a high level breakdown of Medicare basics. In need of immediate coverage? Give us a call today. We’ll break it down for you 1 and 1, and find a plan that’s best for you in no time.
What is Medicare?
Medicare is the federal health insurance program for those 65 or older, younger people with disabilities, or people with End-Stage Renal Disease. It can essentially be broken down into Original Medicare and Medicare Advantage or Supplemental plans.
- Original Medicare: Original Medicare includes three of the different Medicare parts A, B, or D. It is provided by the government through your social security, and will cover 80% of the cost of healthcare services and supplies when you decide to retire.
- Medicare Advantage – Medicare Advantage, also known as Part C of Medicare is offered through a private company and is Medicare-approved. Medicare Advantage or a Medicare Supplement Insurance Policy helps cover the additional 20%. These plans are usually yearly network plans such as HMO’s and PPO’s that must follow certain coverage rules.
What does it cover?
The different Parts of Medicare cover specific needs.
- Medicare Part A: Think of Part A as Hospital Insurance. It covers things like inpatient hospital stays, hospice care, care in skilled nursing facilities, and in some cases home health care.
- Medicare Part B: Part B can be referred to as Medical Insurance. It includes coverage for specific doctors’ services, medical supplies, outpatient care, and preventive services.
- Medicare Part C: Also called Medicare Advantage (MA or MAPD), includes prescription drug coverage along with other benefits such as vision, hearing, transportation, and dental, and Part B premium reduction.
- Medicare Part D: Part D is for Prescription Drug Coverage. It helps cover the cost of prescription drugs. This can include recommended shots or vaccines.
What about the cost?
Original Medicare
With Original Medicare, you pay for services as you get them. The government takes care of 80% of the cost. You will be responsible for the additional 20%. For example, if a deductible for a hospital bill was $10,000, you would have to pay $2,000 out of pocket.
Medicare Advantage
Each plan has different rules for how you receive services and pay for them. Out-of-pocket costs usually vary, but Medicare Advantage monthly fees are usually $0. We do offer Medicare Supplemental plans as well which do have higher monthly fees.