Understanding Medicare

Medicare is health insurance for people who are age 65 or older or people under age 65 with certain disabilities. Medicare is also available to anyone with end-stage renal disease, regardless of age.

There are several “parts” to Medicare. Each part provides coverage for specific services or items. Part A and Part B are often called “Original Medicare.”

  • Part A – Hospital Insurance
    • Helps cover inpatient care in a hospital or skilled nursing facility (following a hospital stay)
    • Covers home health care services and hospice care
  • Part B – Medical Insurance
    • Helps cover doctors’ services, outpatient care, home health services, and other medical services
    • Covers some preventive services
  • Part C – Medicare Advantage Plans
    • An alternative to Original Medicare
    • Includes Part A, Part B, and additional benefits (vision, dental, wellness programs, etc.)
    • Many plans cover Part D prescription drug coverage
  • Part D – Prescription Drug Coverage
    • Helps cover cost of prescription drugs
    • May lower prescription drug costs and protect against higher costs in the future

This is just a short summary – there is so much more to know. Find further details about each specific Medicare “part” by clicking the name in the list above.

Medigap Policies

A Medigap policy (also known as “Medicare Supplemental Insurance”) is private health insurance that supplements Original Medicare. This policy helps pay some of the health care costs that Medicare doesn’t cover – known as “gaps.” These costs may be co-payments, co-insurance, and deductibles, but prescription drug coverage is not included in Medigap policies.

Learn more on our Medigap Policies page.

Recent Medicare Changes

Health care reform helped strengthen the Medicare program by giving eligible seniors access to a range of preventive services with no out-of-pocket costs. Seniors also get discounts on prescription drugs when in the coverage gap (known as the “donut hole”). Plus, the health care law helps protect individuals from Medicare fraud and abuse.

Check out the specifics on our Health Care Reform Changes page.

Timing is Everything

Knowing when to sign up for Medicare is very important. If you miss certain enrollment periods, you may have to pay more for coverage and your start date can be delayed.

See the specific enrollment periods on our Medicare Enrollment page.

Finding Your Medicare Plan

There are a few things to consider when deciding what your Medicare coverage should be.

Step 1: Choose between Original Medicare and a Medicare Advantage Plan.

Step 2: Decide if you need to add prescription drug coverage.

Step 3: Decide if you need to add a Medigap policy.

Many people find Medicare confusing and want help walking through the decision process. We can help!

Learn more on our Choosing a Medicare Plan page.

Assignment

Each year, Medicare publishes a list of the amounts it will pay for hospital and medical services. This is known as “Medicare assignment.” When estimating your out-of-pocket costs, it’s important to know assignment details and if your doctor accepts assignment.

Get more information on our Assignment page.

In-depth Information

For in-depth information about Medicare, please visit the official Medicare website.

 

Medicare has neither reviewed nor endorsed this information.