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Medicare 101

A

HOSPITAL COVERAGE

B

MEDICAL COVERAGE

d

RX COVERAGE

C

MEDICARE ADVANTAGE

Covers:

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  • Inpatient hospital

  • Skilled nursing

  • Home Healthcare

  • Hospice

 

Cost​:

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  •  No monthly premium

  •  Deductible / per day copays  

Covers things like:

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  • Docter Visit

  • Lab work / testing

  • Physical therapy

  • Outpatient services

  • Medical equipment

  • And More...

 

Cost​:

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  •  Monthly premium

  • Annual deductible

  • 80/20 coinsurance 

Parts A & B of Medicare are issued directly from the Federal Government and will show effective dates on your Medicare card.

Covers:

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  • Medications filled at the Pharmacy

 

Cost​:

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  •  Varies

  • Annual deductible

  • 80/20 coinsurance 

Covers:

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  • Part A

  • Part B

  • Many plans include Part D

 

Cost​:

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  • Possible monthly premium

  • Copays for service

  • Rx deductible / copays

 

 

Medicare Parts D & C are part of the Medicare program but are only available for enrollment through private insurance companies. 

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Premiums and cost shares (deductibles / copays) are set by the insurance companies but do follow Medicare guidelines and allowances.

"So... what are my options to help cover those costs?"

Medicare plans are not one size fits all. There are several different options available to you once you are a Medicare beneficiary. It is important to know what type of plan will work best for you.

MEDICARE SUPPLEMENT

MEDICARE SUPLLEMENT

  • Secondary coverage that you purchase to pay after Medicare pays

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  • Also called "Medigap" plans

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  • Supplements the parts A and B of Medicare

  • Part D Prescription Drug Plan is purchased separately

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  • 10 standardized plans to chose from                          A, B, C, D, F, G, K, L, M, & N  

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  • No provider network - can use any Medicare participating provider

MEDICARE ADVANTAGE

MEDICARE ADVANTAGE

  • Also known as Medicare Part C

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  • Plans are administered through private health insurance company's ​

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  • Offers all of the benefits covered under Medicare

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  • Available by county of residence

  • Also known as Medicare Part C

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  • Plans are administered through private health insurance company's ​

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  • Offers all of the benefits covered under Medicare

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  • Available by county of residence

MEDICARE PART D

MEDICARE PART D

  • Part of the Medicare Program to help cover medications

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  • Plans are administered through private health insurance company's ​

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  • Beneficiary must sign up for a plan to get coverage

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  • Plan enrollment is voluntary but penalties may apply if not enrolled

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  • Can be purchased as a stand alone drug plan or included in a Medicare Advantage health plan

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  • Formularies, pharmacy networks, and copay amounts may vary from plan to plan

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