MEDICARE PLANS
What’s Medicare?
Medicare is health insurance for people 65 or older, certain people under 65 with disabilities, and people of any age with End‑Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)
Medicare is the federal health insurance program for:
● People who are 65 or older
● Certain younger people with disabilities
● People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
What are the parts of Medicare?
The different parts of Medicare help cover specific services:
1. Medicare Part A (Hospital Insurance)
● Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
2. Medicare Part B (Medical Insurance)
● Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
3. Part B Medicare Advantage Plans
● Private plans licensed By Center for Medicare & Medicaid Services.
Medicare Advantage Plan
Medicare Advantage plans or “Medicare Part C” type plans are contracted with Medicare to deliver the administration of Medicare through a private insurer. Some of these types of plans include prescription drug coverage and can have some additional benefits original Medicare does not include.
Medicare Advantage plans are contracted with Medicare each year and can and often change year to year, that is One reason why a Medicare Advantage plan is subject to the annual Enrollment period each year from October 15th through December 7th. Medicare Advantage plans are mostly HMO based network type plans with Service area restrictions. Many Medicare Advantage plans have Prescription plans included and also have some additional benefits that are not Part of original Medicare like gym memberships or vision and dental.
Medicare Advantage plans are offered by private insurance companies that contract with Medicare to help with the cost left behind by Medicare Part A and B with smaller co-pays and a maximum out of pocket. These plans have the following features and benefits:
● No or Low monthly Premiums
● Network - based care
● Maximum Out of Pockets
● Some Additional Benefits Available
● No Deductibles
● Multiple Plans to Choose from
● Many have Part D drug plans included
A Medigap policy is different from a Medicare Advantage Plan (like an HMO or PPO) because those plans are ways to get Medicare benefits, while a Medigap policy only supplements the costs of your Original Medicare benefits.
A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.