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New to Medicare?

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Welcome!  You have made it!  You are joining millions of Americans who are benefiting from the Medicare health system.  There are many moving parts to Medicare and the more informed you are, the better you will feel about using the system.  Now is the time to really relax and let someone else do the heavy lifting.  You earned it!   

 

What is Medicare, and how does it all work together? 

Medicare is the US federal health insurance program created for those 65 or older, people younger than 65 with certain disabilities and people with ESRD (end stage renal disease).  The program is divided into 4 parts, and here is how they work together.

Part A:  Part A is hospital insurance. As well as post-hospital, skilled nursing care.  It also covers short-term home healthcare after a hospital stay.  Part A covers Rx in a hospital stay as well as blood transfusions and hospice care.  Medicare will not cover Long term care, such as nursing home care, or home health care.  Please call us for information on those services.

Part B: Covers doctors’ visits, services, and supplies necessary to treat your health condition.  This includes ambulance services, preventative care services, outpatient services and durable medical equipment. 

 Part C:   is the legal name given for the term Medicare Advantage. This is an alternative to original Medicare offered to people who are eligible for Medicare.  You do not sign up for Part C through social security but through a private insurance company.  Medicare Advantage companies receive a set monthly amount from Medicare to administer your care.  These plans usually have co-payments, and 20% co-insurance until an out of pocket max is met.  They usually are HMO’s with specific networks the member must use.  

Part D:  What is Part D?                                               

Part D also the Medicare prescription drug benefit is the program we to subsidize the costs of prescription drugs and prescription insurance plans over through Medicare contracted providers.  This program is voluntary and allows you access to medications at an affordable rate.