What is Medicare?
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). Original Medicare covers many health care services and supplies, but there are many costs (“gaps”) it doesn’t cover.
The Different Parts of Medicare
Th e different parts of Medicare help cover specific services if you meet certain conditions. Medicare has the following parts:
Medicare Part A (Hospital Insurance)
• Helps cover inpatient care in hospitals
• Helps cover skilled nursing facility, hospice, and home health care
Medicare Part B (Medical Insurance)
• Helps cover doctors’ services and outpatient care
• Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse
Medicare Part C (Medicare Advantage Plans) (like an HMO or PPO)•
A health coverage choice run by private companies approved by Medicare • Includes Part A, Part B, and usually other coverage including prescription drugs
Medicare Part D (Medicare Prescription Drug Coverage)
• Helps cover the cost of prescription drugs
• May help lower your prescription drug costs and help protect against higher costs in the future
Your Medicare Coverage Choices
With Medicare, you can choose how you get your health and prescription drug coverage. Below are brief descriptions of your coverage choices.
Original Medicare
• Run by the Federal government. • Provides your Part A and Part B coverage. • You can join a Medicare Prescription Drug Plan to add drug coverage. • You can buy a Medigap (Medicare Supplement Insurance) policy (sold by private insurance companies) to help fill the gaps in Part A and Part B coverage (like coinsurance, copayments, and deductibles).
Medicare Advantage Plans (like an HMO or PPO)
• Run by private insurance companies approved by Medicare. • Provide your Part A and Part B coverage, but can charge different amounts for certain services. May off er extra coverage and prescription drug coverage for an extra cost. Costs for items and services vary by plan. • If you want drug coverage, you must get it through your plan (in most cases). • You don’t need a Medigap policy.
Other Medicare Health Plans
• Plans that aren’t Medicare Advantage Plans but are still part of Medicare.
• Include Medicare Cost Plans, Demonstration/Pilot Programs, and
Programs of All-Inclusive Care for the Elderly (PACE).
• Some plans provide Part A and Part B coverage, and some also provide
prescription drug coverage (Part D).
Note: If you have other health and/or prescription drug coverage from a former
or current employer or union, you may have other coverage choices. Th is
coverage may affect which Medicare coverage choice is best for you.
