Seniorsurance

What is Medicare?

Medicare is a vital federal health insurance program designed to cater primarily to individuals aged 65 and older, as well as those with disabilities or specific medical conditions. Administered by the Centers for Medicare & Medicaid Services (CMS), it offers coverage for a wide range of healthcare services and associated expenses.


The Medicare program is divided into distinct parts, each with a specialized focus on healthcare services. Original Medicare, the fundamental coverage provided by the federal government, comprises Part A and Part B. In addition to these, there are supplemental options available to enhance coverage, including Part C (Medicare Advantage), Part D (prescription drug coverage), and Medicare supplement insurance (Medigap).


This multi-part structure ensures that individuals can tailor their Medicare coverage to suit their specific healthcare needs and preferences.

Medicare Parts A, B, C, & D

Medicare Part A (Hospital Coverage)

Part A covers mostly any time you would spend at the hospital. This includes inpatient care, skilled nursing, as well as needs required in a nursing home or for home health care needs.


Part A does not cover long term care, like longer periods of time in a nursing home. A good option is to purchase long-term care insurance in case you think you will use a nursing home down the road.


For most people, you will not have to pay a premium for Part A (you already paid into it during your time in the workforce.)


It is important to know that Part A is not totally free however. Medicare will charge a deductible any time you need to be admitted into a hospital. Supplemental insurance can help cover this.


If you have any questions regarding how to enroll in Part A, or what is covered, we are happy to help you!

Medicare Part B (Doctors + Outpatient)

Part B of Medicare will cover your doctor visits, tests and screenings, any medicare equipment you need, ambulances, and other services.


This can include cancer treatments (radiation/chemo), imaging, and dialysis.


Included also in Part B are things like flu shots, mammograms, colonoscopies, and more.


You should know, Part B will generally cost more than Part A. For some, it may be an idea to delay signing up for Part B. We can help you do this, and avoid any penalties.


If you already are taking Social Security benefits at age 65, you will be automatically enrolled. Otherwise, you will need to enroll at age 65. It is important to apply for coverage before you will need it to ensure you don't have a gap in your insurance.

Medicare Part C (Medicare Advantage)

Medicare Part C is an alternative to traditional Medicare, and you should know they are optional. A Part C Medicare plan is a private Medicare plan - one that pays instead of normal Medicare.


What you get with a Part C (Medicare Advantage, or MA) plan, is coverage that includes Parts A, B, and likely D into one plan.


You will still enroll in Part A and Part B, as well as Part C. MA Plans sometimes pay for things not included in original Medicare, like dental and vision.


For these plans, you will likely choose and HMO or PPO. With an HMO, you will choose a primary care provider. With a PPO, you will have a network of doctors and facilities to choose from.

Medicare Part D (Prescription Drug Coverage)

Part D of Medicare will pay some of your retail Rx drug costs. These plans have premiums, out-of-pocket costs, and copays. Some plans also have an annual deductible.


It is important to choose the right plan depending on what prescription drugs you are taking regularly.


Part D differs to Part A and B in that you will not enroll through Social Security. To enroll in Part D, you will choose from private insurance plans offered in your county.


Please note, these plans are optional, and there are rules for when you can enroll (and dis-enroll) from Part D.

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