The Different Parts of Medicare

When it comes to Medicare insurance, we all know that it can be confusing. This is exactly why we, at 1-800-MEDIGAP, are dedicating an entire page on the different parts of Medicare insurance. On this page you will find all of your questions answers on various topics like, Original Medicare, Medicare Advantage Plans, Medicare Prescription Drug Plans, and more. So, if you are like most of us and are confused when it comes to all of the different parts of Medicare insurance, continue to read on for a better understanding on Medicare insurance as whole.

If you have been doing some research, you have probably came across a few different terms. Terms like, Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. You may have even heard of Medigap insurance, or Medicare Supplemental insurance. Rest assured, we are going into great detail about each of these specific term.

First off, what is Medicare insurance? Medicare is a Government run program which offers health insurance specifically for senior citizens. There are two major parts of Medicare insurance: Medicare Part A and Medicare Part B.

Medicare Part A Insurance

Medicare Part A is your basic hospitalization insurance. Medicare Part A insurance will help cover:
•Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)
•Inpatient care in a skilled nursing facility (not custodial or long term care)
•Hospice care services
•Home health care services
•Inpatient care in a Religious Non medical Health Care Institution

However, in order to qualify for Medicare Part A insurance, you do have to meet a few qualifications. For instance, you must be 65 years or older in order to qualify for Medicare Part A insurance. However, if you are under the age of 65 and have a disability or were diagnosed with End Stage Renal Disease (ESRD), you may still qualify. Usually, upon reaching the age of 65, most senior citizens are automatically enrolled with Medicare Part A insurance. So, if you are currently 65 and not enrolled with Medicare, you may want to call 1-800-MEDICARE for assistance.

Keep in mind however, Medicare Part A insurance may not be free of charge. In most cases though, Medicare Part A is free. This is know as “Premium Free Part A”. Most seniors are eligible for “Premium Free Part A” if they or their spouse paid Medicare taxes while working. If you did not pay Medicare taxes while working, you may be still eligible to BUY into Medicare Part A insurance. In order to be eligible to buy into Medicare Part A, you must meet one of the following conditions:
•You’re 65 or older, you’re entitled to (or enrolling in) Part B, and you meet the citizenship or residency requirements.
•You’re under 65, disabled, and your premium-free Part A coverage ended because you returned to work.

Before enrolling with Medicare Part A insurance, you should know the amount of coverage you are receiving. You see, with Medicare Part A, you are not 100 percent coverage. Actually, you are only up to 80 percent coverage, and this is only in some cases. This is why so seniors are considering enrolling with a Medicare Supplemental insurance plan (also known as a Medigap Plan). But, we will get into more detail about Medicare Supplemental insurance later.

If you have any additional questions regarding Medicare Part A insurance, call 1-800-MEDICARE.

Medicare Part B Insurance

Medicare Part B is your basic medical insurance. Medicare Part B insurance will help cover:
•Doctor services
•Outpatient Care
•Home Health Services
•Medical Equipment and Supplies
•Some Preventive Services

However, like Medicare Part A insurance, in order to qualify for Medicare Part B insurance, you do have to meet a few qualifications. These qualifications are the same as the qualifications needed to enroll in Medicare Part A insurance. You must be 65 years or older in order to qualify for Medicare Part A insurance. However, if you are under the age of 65 and have a disability or were diagnosed with End Stage Renal Disease (ESRD), you may still qualify. Usually, upon reaching the age of 65, most senior citizens are automatically enrolled with Medicare Part B insurance. So, if you are currently 65 and not enrolled with Medicare, you may want to call 1-800-MEDICARE for assistance.

When it comes to Medicare Part B insurance, it is important to keep in mind that Medicare Part B is not free of charge. Unlike Medicare Part A who has a Premium Free option, Medicare Part B requires everyone to pay a monthly premium. Beginning in 2013, the new monthly premium for Medicare Part B insurance is $104.90. However, if you or your spouse make over a certain amount, you may be requires to pay a higher premium amount. If this applies to you, Social Security will be in contact with you. If you were determined to pay a higher premium amount by Social Security and you disagree, you should call Social Security at 1-80-772-1213.

Before enrolling in Medicare Part B insurance, you should know that you are not receiving full coverage. Like Medicare Part A insurance, you are only able to be up to 80 percent covered (in some cases) with Medicare Part B. This may be a problem for you depending on your income and your currently health status. More seniors now than ever before are looking for additional options. Many are considering Medicare Supplemental insurance, or Medigap insurance where the amount of coverage is not an issue. But again, we will get into further detail regarding Medicare Supplemental insurance later.

If you have any questions regarding Medicare Part B insurance, you can call 1-800-MEDICARE.

Original Medicare

If you have been searching around in the senior health insurance market, you have probably came across the term Original Medicare. Original Medicare is offered by the Government run program, Medicare. Basically, Original Medicare is a combination of Medicare Part A insurance and Medicare Part B insurance. As we mentioned previously, Medicare Part A is your basic hospitalization insurance and Medicare Part B is your basic Medical insurance. With Original Medicare, you can expect coverage for:
•Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)
•Inpatient care in a skilled nursing facility (not custodial or long term care)
•Hospice care services
•Home health care services
•Inpatient care in a Religious Non medical Health Care Institution
•Doctor services
•Outpatient Care
•Home Health Services
•Medical Equipment and Supplies
•Some Preventive Services

For Original Medicare insurance, you are usually only required to pay a low monthly premium for Medicare Part B, which is $104.90. Medicare Part A on the other hand, is usually free of charge. So, if you are eligible, you may be able to enroll in Medicare Part A and Medicare Part B for only $104.90 a month. Unfortunately, you will still not be fully coverage. You will only be up to 80 percent covered. This will leave you having to pay 20 percent or more. So, with that being said, you may want to consider additional options.

Medicare Part C, Medicare Advantage Plans

Medicare Part C, also known as a Medicare Advantage Plans, are offered by private insurance companies. These private insurance companies are in contract with Medicare. So, Medicare regulates and monitors every private insurance company out there. Basically, a Medicare Advantage Plan is a combination of Medicare Part A, Medicare Part B and Medicare Part D. Some Medicare Advantage Plans may offer additional coverage for: Dental, vision, hearing, etc.

Medicare Part A: Basic hospital insurance

Medicare Part B: Basic medical insurance

Medicare Part D: Prescription drug coverage

There are Different Types of Medicare Advantage Plans for you to choose from. These plans include:
•Health Maintenance Organization (HMO) Plans
•Preferred Provider Organization (PPO) Plans
•Private Fee-for-Service (PFFS) Plans
•Medical Savings Account (MSA) Plans
•Special Needs Plans (SNP)
•Point of Service (POS) Plans—Similar to HMOs, but you may be able to get some services out-of-network for a higher cost.
•Provider Sponsored Organizations (PSOs)—Plans run by a provider or group of providers. In a PSO, you usually get your health care from the providers who are part of the plan.

A Medicare Advantage Plan is not free of charge. Actually, in order to receive benefits, you will be required to pay a monthly premium in ADDITION to the Medicare Part B premium that you already pay. That’s right, in order to qualify for a Medicare Advantage Plan, you must be enrolled with Medicare Part A and Medicare Part B, or Original Medicare.

If you are looking for additional information on a Medicare Advantage Plan, you should contact 1-800-MEDIGAP.

Medicare Part D

Medicare Part D, also know as Medicare prescription drug coverage, is available to anyone with Medicare insurance. So, you must have Medicare Part A insurance or Medicare Part B insurance or both.

There are two types of Medicare Prescription Drug Plans:
•Medicare Prescription Drug Plans: These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
•Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.”

Keep in mind, each prescription drug plan will vary by price and the drugs coverage.

If you are looking for more information on Medicare Part D prescription drug coverage, you can call 1-800-MEDIGAP.

Medicare Supplemental Insurance, Medigap Insurance

Medicare Supplemental Insurance, also known as Medigap insurance, is a type of insurance offered by private insurance companies. These private insurance companies are in contract with Medicare and therefore are monitored and regulated. Medicare Supplemental insurance helps fill the “Gaps” left behind by Original Medicare. What gaps? Well, earlier we discussed Original Medicare insurance. If you remember correctly, Original Medicare Insurance only allows you to be up to 80 percent covered (in some cases). With that being said, with Original Medicare, you are expected to pay some out of pocket costs. Medicare Supplemental insurance covers “gaps” like these by offering more coverage. That’s right, Medicare Supplemental insurance, or Medigap insurance, offers more coverage than Original Medicare. There are 10 different Medigap plans available. Medigap Plan: A, B, C, D, F, G, K, L, M, and N. Each of these plans listed offer a different amount of coverage for a different price. Medicare Supplement Plan F for example, offers the most amount of coverage and benefits and therefore, usually costs the most out of all of the other plans as well. So, if you are looking for extra coverage, a Medicare Supplemental insurance plan may be the right plan for you.

However, you should know, in order to qualify for Medicare Supplemental insurance, you must be enrolled with Medicare Part A and B, or Original Medicare.

If you are looking for additional information on Medicare Supplemental insurance, or Medigap insurance, you can call 1-800-MEDIGAP.