What is Medicare and how many parts does it have?

 Today, I would like to clarify some frequently asked questions about Medicare. In this article I will discuss What is Medicare? What are various parts of Medicare? How much does it cost? What is covered and what is not covered by Medicare? And the difference between Medicare and Medicaid.

So, what is Medicare?

Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). 

Now, let’s take a look at various parts of Medicare:

     Part A (Hospital Insurance) covers your
 Inpatient care in hospitals
■ Skilled nursing facility care 
■ Hospice care 
■ Home health care

     Part B (Medical Insurance) covers  Services from doctors and other health care providers 
■ Outpatient care 
■ Home health care 
■ Durable medical equipment 
■ Some preventive services

     Part C (Medicare Advantage Plan) works like a health maintenance organization (HMO) or a preferred provider organization (PPO).

      ■ Includes all benefits and services covered under Part A and Part B 
■ Usually includes Medicare prescription drug coverage (Part D) as part of the plan 
■ Run by Medicare-approved private insurance companies 
■ May include extra benefits and services for an extra cost

     Part D (Medicare Prescription Drug Coverage) Part D is designed to help cover the cost of your prescription drugs.  
■ It is Run by Medicare-approved private insurance companies 
■ May help lower your prescription drug costs and help protect against higher costs in the future 

Medicare is not free!

Medicare premiums, deductibles, coinsurance and copayments for typical medical services must be paid by the policyholder and should be taken into consideration when estimating medical expenses in retirement.

Part A (Hospital Insurance): Typically, there is no premium charge for Part A if you ‘we worked and earned enough credits in your life time. There is an annual deductible and additional charges for hospital inpatient care

Part B (Medical Insurance): The premium varies by income, and is $134/month (for year 2018) (or higher depending on your income). There is also an annual deductible and typically there is a 20 percent copay.

There are various options that can help you manage these deductibles and coinsurance. Feel free to reach out and we will be glad to help you navigate the Medicare Supplements or Medicare Advantage Plans.

Part C (Medicare Advantage Plan): These plans charge additional premiums, and copays vary.

Part D (Medicare Prescription Drug Coverage): These plans charge additional premiums based on your income and choice of plan. There are deductibles and the copays vary.

Medicare Does NOT Pay For Everything.

Medicare doesn’t cover everything. If you need certain services that aren’t covered under Medicare Part A or Part B, you’ll have to pay for them yourself unless: 
■ You have other coverage (including Medicaid) to cover the costs. 
■ You’re in a Medicare health plan that covers these services. Even if Medicare covers a service or item, you generally have to pay deductibles, coinsurance, and copayments.

Some of the items and services that Medicare doesn’t cover include: 
✘  Most dental care. 
✘  Eye examinations related to prescribing glasses. 
✘  Dentures. 
✘ Cosmetic surgery. 
✘ Acupuncture. 
✘ Hearing aids and exams for fitting them. 
✘ Long-term care. 

Note: If you need help with coverage of the above items, please feel free to contact us. 

Medicare is not Medicaid.

Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, such as nursing home care and personal care services.

Each state has different rules about eligibility and applying for Medicaid.

I hope this information was useful to you. We have a few other videos on this topic on our YouTube channel. Please feel free to check it out!

 

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 Disclaimer:  Medicare has neither endorsed nor reviewed this information.
Not connected or affiliated with any United States Government or State agency.
Calling this number: 415-994-4121 will direct you to a licensed Agent/Broker. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. <Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance> may change on January 1 of each year.  You must continue to pay your Medicare Part B premium.