Key Takeaways

  • Medicare is a federal health insurance program.
  • Healthcare coverage is offered to adults over 65 or individuals under 65 with qualifying disabilities and/or ESRD.
  • Medicare has 4 parts that cover specific services.

Medicare is the federal government’s health insurance program for anyone 65 or older. Also covered are individuals under the age of 65 with qualifying disabilities and those suffering from End-Stage Renal Disease or ESRD (permanent kidney failure that requires dialysis or a transplant). Each of its four parts helps cover specific health-related services.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, skilled nursing home facility or hospice care, and some home healthcare.

Check with your Hospital.

Part B (Medical Insurance)

Part B covers certain physicians’ and preventive services, outpatient care, and medical supplies.

Check with your Doctor.

Part C (Advantage Plans)

This health plan is offered by private insurance companies that contract with the government to provide all Part A and Part B benefits. An Advantage Plan includes:

  • Health Maintenance Organizations (HMO)
  • Preferred Provider Organizations
  • Private Fee-for-Service Plans
  • Special Needs Plans
  • Medical Savings Account Plans

If you are enrolled in a Part C Plan, services are covered rather than being paid for under Original Medicare. Part C plans typically offer prescription drug coverage.

Part D (Prescription Drug Coverage)

Prescription drug coverage offered by Part D works alongside Original Medicare to provide coverage for prescription medications. These plans are offered by private insurance companies approved by Medicare. Part C Prescription Drug Plans may provide prescription drug coverage similar to what is offered through Part D Prescription Drug Plans.

Coverage Chart

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • 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
  • Offered by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

Which Type of Coverage Do You Have?

  • Check your red, white, and blue card.
  • Check other insurance cards you may use. For more information about what’s covered, dial the number on the back.
  • Visit the official site to check your health or prescription drug plan enrollment.
  • Call 1-800-MEDICARE (1-800-633-4227). TTY users should dial 1-877-486-2048.

Sources:

WRITE A COMMENT