Medicare and You
Medicare is a federal government program that provides health insurance for people 65 and older. People under 65 with certain disabilities may also be eligible to get the Medicare coverage.
There are different parts for Medicare and there are different benefits that each of those parts provide and each of those parts has their own set of qualifying criteria. A lot of people are confused about the parts and the eligibility criteria and that is where we come in.
We can help you with your questions and we can provide you with clear and easy to understand answers to help you navigate this important aspect of your health and wellness.
Part (A) Hospital Coverage Insurance
Medicare Part A helps cover:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Part (B) Medical Insurance
Medicare Part B helps cover:
- Services from doctors/physicians/medical professionals and other health care providers
- Outpatient care
- Home health care
- Medical equipment like wheelchairs, walkers, hospital beds and more
- Preventative services like health screenings, shots or vaccines and annual wellness visits
Part (C) Coverage (Private insurance)
Medicare Part C is a little confusing and for good reason. Unlike other parts which cover specific medical benefits, Part C has no such stipulation. To understand Part C, you should think of it as a Private Medicare Insurance or Advantage Plans.
You need to have Part A and B to be able to even qualify for Part C of Medicare. These “Advantage Plans” usually have a network of providers that you visit. Think of them like “in network” providers.
Often but not always, Part C can have lower premiums that other Medigap plans.
Part (D) Drugs coverage
Medicare Part D helps cover all or some of the costs of “prescription” drugs. Plans that offer Part D coverage are often private insurance companies that must follow and adhere to the set of rules as laid out by Medicare.
What are my medicare options?
- Original Medicare coverage includes Part A (Hospital Insurance) and Part B (Medical Insurance)
- You can (and you should – in most cases) join a separate Part D to offset the Prescription drugs costs
- To help you pay some or all of your out-of-pocket expenses (like 20% co-insurance), you can buy additional supplement coverage.
- Since this is a federal program you can use any doctor in the US who accepts Medicare.
- Medicare Advantage is an “al;-in-one” alternative to Original Medicare Plans. These “bundled” plans usually include Part A, Part B and usually Part D too
- These plans may have lower out of pocket expenses than Original Medicare Plans
- In most cases, you are required to use the doctors and service providers who are in the plan’s network to get maximum benefits
- Most providers of these plans offer extra benefits that Original Medicare doesn’t cover – benefits like vision, hearing, dental and more
What is Medicare?
How is Medicare different from Medicaid?
I am on a limited income, how can I get help to pay for the premiums and out of pocket expenses?
What is the eligibility criteria?
Are there any costs associated with Medicare? I heard that its free. Is that really true?
What are the limitation of Medicare?
If I have Medicare, do I really need long term care plan?