Before you make a decision on purchasing any Medicare insurance products you should have a general idea of what the basics of Original Medicare are. Once you are familiar then you should contact us to discuss your options for additional coverage like Medigap insurance, prescription drug plans and Dental, Vision & Hearing plans. Medicare does not cover everything, so you may also need to learn about additional coverage options like Long Term Care, Personal and Custodial Care and Home Health Care.

Lets start with the four parts to Medicare. Part A, B, C & D. Easy right?

Medicare Part A

For most citizens and legal residents of the United States who are age 65 or older, Original Medicare Part A is Premium Free. This occurs when you have worked at least 40 quarters (ten years) and paid Medicare taxes while you were working. If you are not eligible for Part A you may be able to purchase it by paying a monthly premium. In 2017 the monthly Part A premium is up to $426 per month and you then must also sign up for Part B and pay an additional monthly premium of approximately $134 per month depending on your income level.

Medicare Part A covers services like hospitals, skilled nursing, hospice and home health services. In addition, Part A covers semi-private hospital rooms, meals, general nursing, drugs as part of your inpatient treatment and other hospital services and supplies. This includes the care you get in acute care hospitals, critical access hospitals, inpatient rehab facilities, long term care hospitals (time restrictions), inpatient care as part of a qualifying clinical research study, and mental health care.

Medicare Part B

Not everyone will have the need to sign up for Part B when they turn age 65. Some Medicare beneficiaries may choose to keep on working and are still active with their employer group health plan. This is OK and there is no need to pay the current $134 premium for Part B when this is the case. You will still have the right to enroll in Part B whenever you choose and that will then give you an Open Enrollment opportunity to purchase a Medicare Supplement (Medigap) plan that must be offered to you by any insurance company that sells these plans.

Medicare Part C – Medicare Advantage

Think of Medicare Advantage as a pre-packaged healthcare plan. You effectively replace your original Medicare and sign up for a plan from an insurance company that provides one in your area. These plans by law must include at a minimum the benefits of original Medicare both Part A and Part B. In most cases they will also cover prescription drugs meaning you have no need to sign up for the traditional Medicare Part D plan.  These plans are similar to group health plans provided by employers in that they have networks of doctors and hospitals that you must use. They also have co-pays for services and out of pocket costs that can change on an annual basis.

Medicare Part D – Prescription Drug Plans

Last but not least it Medicare Prescription Drug coverage. These plans will help cover some of the cost of your prescription medications. In other words when you doctor writes a prescription you then take that to your pharmacy and have it filled. Medicare drug plans are sold by private insurance companies, however they must abide by the rules and regulations set by the Centers for Medicare & Medicaid Services (CMS). They all have a basic structure that includes networks of pharmacy’s and drug formularies that include each class of prescription medication available under that plan. When it comes time to enroll into a drug plan you can go directly to the insurance company or go to Medicare via their website and enroll online.