Medicare


OVERVIEW OF THE MEDICARE PROGRAM

Medicare is a National Health Insurance Program for: 

Medicare is not an entitlement program and should not be confused with Medicaid. The income and assets of a Medicare beneficiary are not a consideration in determining eligibility or benefit payment.

Medicare has four components: Part A, Part B, Part C and Part D

Part A covers inpatient hospital care, hospice care, inpatient care in a skilled nursing facility, and home health care services. Individuals have either paid into Medicare over the course of their employment and automatically become enrolled at age 65, or, if they have been a legal resident for five years or more, they can buy into Medicare.

Part B covers medical care and services provided by doctors and other medical practitioners, durable medical equipment, some outpatient care and home health care services. Individuals choose to become enrolled in Part B when they become eligible for Medicare and pay a monthly premium for that enrollment.

Medicare & You 2018 Handbook

2017 Part A, B & D Premiums and Deductibles

You can apply for Medicare online at:  Social Security Administration.

Part C also known as Medicare Advantage Plans are private insurance plans that contract with Medicare to provide healthcare coverage to Medicare beneficiaries in place of Medicare Parts A, B and D.

Part D is the prescription drug benefit  and covers some prescription drug expenses.

 

Medicare Health Plans include: 

 

Original Medicare

Original Medicare  is a “fee-for-service” plan. A beneficiary is usually charged a fee for each health care service or supply that he/she receives. The plan is managed by the Federal Government through the Centers for Medicare and Medicaid Services (CMS), is available nationwide & is available to ALL beneficiaries. If a beneficiary is in  Original Medicare, he/she uses their red, white and blue Medicare card when he receives health care services. Coverage under Original Medicare pays a portion of the cost of medical care. Often, deductibles and co-insurance (partial payment of initial and subsequent costs) are required of the beneficiary, unless the beneficiary chooses to buy a Supplemental or Medigap policy.

 

Medicare will pay for care that is medically “reasonable and necessary” for the treatment of an illness or injury. Medicare does not pay for services that are “routine or custodial” or inpatient care that can be provided by persons without professional skills/training. To find out what medical services & supplies that Medicare would cover under the Original Medicare, click on Medicare Coverage.

Preventive Visit and the Annual Wellness Visit

Medicare Advantage Plans (Part C)

Medicare Advantage Plans are private insurance plans that contract with Medicare to administer your healthcare costs. With Medicare Advantage, you may have a variety of choices that include Managed Care Plan (HMO), Preferred Provider Organization Plans (PPO) or Special Needs Plans (SNP).

For additional information on Medicare:

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