The
essential ABCs (and D!) of Medicare
The Medicare
program was designed in four parts, each part covering a different benefit category.
As a Medicare-eligible person, you will likely need and use a combination of
these services depending on your health, and as you get older.
Part A –
Hospital Coverage
Most people
who qualify for Medicare automatically get Part A coverage without having to
pay a premium. Part A includes inpatient hospital care and home health after
the hospital stay.
Part B –
Medical Coverage
Part B
covers your medically necessary doctors' services and outpatient care. A
premium for Part B is deducted from your social security check each month to
help pay the cost of this coverage.
Part C –
Medicare Advantage Plans
If you have
part C, your coverage is provided by a private health plan called a Medicare
Advantage plan. These health plans are contracted with Medicare to care for
you. The coverage includes everything covered under Part A and Part B, except
hospice care (original Medicare continues to cover hospice care). Often, the
plans include Part D prescription benefits at no extra costs. The plans may
include additional benefits not available with Original Medicare, such as
vision, gym membership, transportation, and more.
Part D –
Prescription Drug Coverage
If you choose Part D coverage, it can help lower
your prescription drug costs. This coverage is available as a stand-alone plan
or may be included in a Medicare Advantage plan. To learn more and have your
questions answered, contact your local licensed insurance agent. You may also
desire to attend an upcoming Medicare 101 session taught by local area licensed
insurance agents. To find an event near you, click here.
A Quick Look
at Medicare: Click here to download a simple guide about Medicare.
Choosing Coverage
Based on Your Health Needs
Choosing
only Original Medicare means that you have Medicare Part A and/or Medicare Part B only. Keep in
mind. Medicare does not cover 100% of your medical and hospital costs. You will
be required to meet a deductible and then pay a percentage of the cost of your
care. Original Medicare also does not provide coverage for prescription drugs.
For this, you need an additional stand-alone plan that may charge an expensive
monthly premium.
Purchasing
a Medicare Supplemental Policy: The supplement policy, also known as Medi-Gap policy,
provides additional, variable coverage to fill in part or all the gaps or costs
not covered by Original Medicare, and cost to you may be an expensive monthly
premium.
Selecting
a Medicare Advantage plan: A Medicare Advantage plan (also called as Medicare Part C) includes all
the healthcare benefits you are entitled to under Original Medicare and may
include coverage like vision, hearing, dental and prescription drug coverage,
or provide monies toward over-the-counter supplies. Some Medicare Advantage plans may come with a
$0 premium. Medicare Advantage plans
can, however, choose not to cover the costs of services that are not medically
necessary under Medicare. Medicare
Advantage plans contract with the government to provide coverage to you, so you
still have Medicare. To obtain medical services, you will present an insurance
member card instead.
To
learn more and have your questions answered, contact your local licensed
insurance agent. You may also desire to attend an upcoming Medicare 101 session
taught by local area licensed insurance agents. To find one near you, click here.
Why
Medicare Advantage May Be A Good Choice for Patients Who Are Over 65
Many
Medicare Advantage plans offer benefits that are ideal for helping you afford
good healthcare coverage for current and future healthcare needs.
If you find
that you spend a lot of money on healthcare for things like co-insurance, specialist
visits, prescriptions, and tests, a Medicare Advantage plan can help lower
these costs with affordable copays on these services. A copay is a set, fixed
amount of money that you pay as your share of the cost of care. You are still
required to pay a monthly Part B premium as part of a Medicare Advantage plan
but may find Medicare Advantage plans with premiums as low as $0 per month.
Answer Health participates in a special program called Answer Health Senior Care Advantage in partnership with participating Medicare Advantage plans. When you select one
of these plans, you have access to a new approach to care delivery that focuses
on keeping you healthy and helping coordinate care resources when you need
them.
To
learn more and have your questions answered, contact your local licensed
insurance agent. You may also want to attend an upcoming Medicare 101 session
taught by local area licensed insurance agents. To find an event near you,
click here.
What is Included in a Medicare
Advantage Plan?
Medicare
Advantage plans offer a variety of benefits designed to help members save on
their healthcare spending. An experienced advisor can help review the benefits
of each plan and help find the right one for you. One way to do this is to make
an appointment with a licensed agent who can help you compare plans and
understand which providers belong in the network and what the cost of any
medications you are currently taking would be. If you see a healthcare provider
that does not belong to the plan, your services may not be covered, or your
costs could be higher.
To
find a plan that is right for you, and continue receiving care from Answer Health, contact your local licensed insurance agent. You may also desire to attend an
upcoming Medicare 101 session taught by local area licensed insurance agents.
To find an event near you, click here.
Medicare Advantage:
Saving on Hospital Care, Prescription Drugs and other Health Care Expenses
Receiving
health care at a hospital can be very costly. However, many Medicare Advantage
plans offer low copays on physician visits and include a limit on how much you
pay for these services.
Each
Medicare Advantage plan can charge different out-of-pocket costs, making it
even more important to compare benefits and find the plan that is right for
your needs and budget. Original Medicare does not cover prescriptions, and
adding a supplemental prescription plan can often cost you more in monthly
premiums. However, many Medicare Advantage plans include prescription coverage
for no additional cost.
Medicare
Advantage plans can offer a number of additional benefits for you that are not
offered in Medicare Parts A and B (Original Medicare). They may include dental,
vision, and hearing coverage, as well as extra benefits designed to help
members save money and stay healthy, including:
- Gym membership
- Nutritional programs
- Transportation to and from medical appointments
- Over-the-counter medical supply allowances
To
find a plan that is right for you, and continue receiving care from your
physician at Answer Health, contact your local licensed insurance agent. If you don't have an insurance agent, you may
call (616) 201-4002 in the greater Grand Rapids area or (231)225-9301 in the greater Traverse City area to
speak with an independent licensed insurance broker who is familiar with our
practice and the plans that we are contracted with. You may also desire to attend an upcoming
Medicare 101 session taught by local area licensed insurance agents. To find
one near you, click here.