Medicare is a federal health insurance program for individuals over the age of 65 or for people with certain disabilities. People with permanent kidney failure, called End-Stage Renal Disease (ESRD), or Lou Gehrig’s Disease (known as ALS), may also be eligible for Medicare at any age. Original Medicare includes Part A and Part B. With Original Medicare you can use any doctor or Hospital that takes Medicare, anywhere in the United States. Your Prescription Drugs can be covered by a Part D Medicare Prescription Drug Plan.
Coverage is broken down into parts to better understand how it works.
Part A (Hospital Insurance) and Part B (Medical Insurance) are both included in the original Medicare plan. You will typically pay a monthly premium for at least Part B. Most people eligible for Medicare do not have to pay for Part A as long as they paid into Medicare and are under a certain income threshold. Depending on your work history (or your spouse’s work history), you may have to pay for Part A.
Original Medicare coverage includes the following benefits:
Part A: (Hospital Insurance)
Note: Part A does not include long-term care.
Part B: (Medical Insurance)
There is typically a deductible amount that must be met before Medicare benefits are applied.
Medicare Part C, also known as Medicare Advantage, differs from Original Medicare in that it bundles Part A, Part B, and Part D, often including some of the necessary services listed in Part A and Part B, but also having other restrictions. Medicare Advantage is usually limited to a certain network of doctors or limited to a certain geographic area. This differs from Original Medicare, where you can obtain services from any provider, anywhere in the US, which accepts Medicare.
Finally, Medicare Part D offers prescription drug coverage for a set monthly premium. Recommended shots and vaccines are also covered by Medicare Part D. This plan is offered by private insurance companies, which must abide by strict rules set by the federal Medicare Program. Each state has numerous private insurers which offer this particular plan.
If you are nearing Medicare eligibility and would like to learn more about the different parts, reach out to The Benefit Link today! We will walk you through all of your options to ensure you get the Medicare coverage you need.
There is no charge to clients for our services. We would be honored to help walk you through this process!
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