Turning 65 is a milestone, and along with this momentous occasion comes lots of confusion surrounding Medicare.

Every time you’ve gone to the mailbox for the last 6 months, you have found something from the Medicare office or an insurance company, accumulating a very large stack of “I have no idea what to do.”   Maybe you are not even sure what exactly Medicare is.  Here are definitions of the different parts of Medicare to help you through the process

What is Medicare and what does it cover?

Medicare is a federal program that provides health insurance to retired individuals, regardless of their medical condition, and certain younger people with disabilities or end-stage renal disease. Medicare coverage consists of two main parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). These parts together are known as Original Medicare.

Medicare Part A (hospital insurance)

Generally known as hospital insurance, Part A covers services associated with inpatient hospital care. These are the costs associated with an overnight stay in a hospital, skilled nursing facility, or psychiatric hospital, including charges for the hospital room, meals, and nursing services. Part A also covers hospice care and home health care.

Medicare Part B (medical insurance)

Generally known as medical insurance, Part B covers other medical care. Physician care — whether you receive it as an inpatient at a hospital, as an outpatient at a hospital or other healthcare facility, or at a doctor’s office — is covered under Part B. Laboratory tests, physical therapy or rehabilitation services, and ambulance service are also covered. Medicare Part B also covers 100% of the cost of many preventative services and an annual wellness visit.

Other options:

In addition to the original Medicare benefits, there are other Medicare parts and supplements that are offered by insurance companies that are designed to enhance Medicare coverage and/or reduce out of pocket expenses.

Medicare Part C (Medicare Advantage)

A Medicare Advantage plan is a private healthcare plan that contracts with Medicare to provide Part A and Part B benefits. A Medicare Advantage plan covers all the services that Original Medicare covers except hospice care. Some plans offer extra coverage for expenses not covered by Original Medicare such as vision, hearing, dental, and other health expenses. Most also offer prescription drug (Part D) coverage. Several types of Medicare Advantage plans may be available, including health maintenance organization (HMO) plans, preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans, and special needs plans (SNPs).

Medicare Part D (prescription drug coverage)

All Medicare beneficiaries are eligible to join a Medicare prescription drug plan offered by private companies or insurers that have been approved by Medicare. Although these plans vary in price and benefits, they all cover a broad number of brand name and generic drugs available at local pharmacies or through the mail. Medicare prescription drug coverage is voluntary, but if you decide to join a plan, keep in mind that some plans cover more drugs or offer a wider selection of pharmacies (for a higher premium) than others. You can get information and help with comparing plans on the Medicare website, medicare.gov, or by calling a Medicare counselor at 1-800-Medicare.

Medicare Supplements (Medigap Policies)

Medicare Parts A and B provide insurance coverage for health-related expenses, but they don’t cover all the health care costs you may have. A Medicare Supplement plan, also called “Medigap,” is an insurance policy that can help pay for some of the health care costs that Medicare doesn’t cover. This usually includes out-of-pocket expenses like as copayments, coinsurance, and deductibles and you can see any provider that accepts Medicare.  There are several different plan options you can select, and cost vary depending on the coverage level you choose.

Our next few Blogs/Article will cover when and how to enroll in Medicare and how open Medicare open enrollment works

Searching for the right Advantage or Supplement plan can be confusing.  Call Cheryl Bujold at 480-263-0893 for expert guidance in deciding what policy is right for you.

Blog Post Written by Cheryl Bujold