UNDERSTANDING MEDICARE

Medicare is federal government sponsored health care coverage. It’s health care coverage for people 65 and older as well as those under 65 who have been on Social Security disability insurance income for at least 24 months. Medicare is the federally-backed health insurance program for people 65 and over, regardless of your income, medical history, or current health status.

What Medicare covers and how benefits are applied is as follows:

MEDICARE (PARTS A & B) is provided by the federal government. Part A helps pay for hospital stays and inpatient care. Part B helps pay for doctor visits and outpatient care. Everyone who enrolls in Medicare gets Part A and Part B first.

MEDICARE PART C, or Medicare Advantage, is an alternative way to get Part A and Part B coverage benefits. Medicare Advantage plans are "all in one" plans that are offered by private insurance companies. With Medicare Advantage plans, you still enroll in Part A and Part B through the federal government, but then you will enroll in a Part C plan with a private insurance company. Most Medicare Advantage plans also include Part D prescription drug coverage, as well as other benefits such dental, vision, and hearing. There are several kinds of Medicare Advantage plans, with benefits (and costs) varying from plan to plan.

MEDICARE PART D is prescription drug coverage. This coverage comes from private insurers in one of two ways: (1) as a stand-alone plan, or (2) as part of a Medicare Advantage plan that includes prescription drug coverage. Again, what drugs are covered varies from plan to plan.

Although the benefits of each of these is substantial, there are gaps in coverage, often for services important to older patients. Items like long-term services, dental and vision services, and hearing aids. To cover these gaps, you would need a supplemental insurance program through your retirement program, through Medigap (Medicare’s “gap”insurance), Medicaid, or via a Medicare Advantage program mentioned earlier.

At the end of the day, the best way to understand your options, and piece together the best combination of plans, is to give Leslie a call for a no-charge consultation.