Medicare is composed of four basic elements. Parts A, B, C and D. Parts A and B together make up the Original Medicare Plan. Parts A and B cover much of the medical care you need but not all of it. Part C is better known as Medicare Advantage. I will cover that in some detail later in this blog. Part D is prescription drug coverage. You do not automatically qualify for Medicare Part D. It is available through private insurers that contract with Medicare. It can be either by itself or part of a Medicare Advantage Plan.
Part A helps cover medically necessary inpatient care in hospitals. It also helps cover hospice and home health care. You are responsible for copayments and a deductible when you use Part A services.
Part B helps cover doctor visits and outpatient care. It also helps pay for some services that Part A does not cover. Part B also covers limited preventive care services. You must sign up for and pay a premium and deductible for Part B.
Medicare Supplement plans are health insurance policies sold by private insurance companies to help fill the gaps in Original Medicare coverage. You pay a monthly premium to the private insurance company. These premiums vary based on the plan that you choose. They work only with Original Medicare. In most states, an insurance company may offer as many as 12 Medicare Supplement plans. These are plans A through L and they each offer various levels of coverage.
Medicare Part C is also called Medicare Advantage. These plans are also sold by private insurance companies. Your costs may be lower than the Original Medicare Plan and you may get extra benefits. Most of the Medicare Part C plans include Medicare Part D prescription drug coverage and the various plans may cover different drugs. Many of these plans are offered by private insurance companies at no extra premium cost to you. Your Part B premium may provide a sufficient amount enough to cover the Medicare Advantage plan you choose.
You make a Medicare Health Plan choice when you first become eligible for Medicare. Then each year you can review your health care and prescription drug needs. You can keep the same plan for the next year or you can change plans during the Annual Election period beginning on November 15th and ending on December 31st.
If you are turning 65 in 2008 you can enroll in a Medicare Supplement or Medicare Advantage Plan three months before your 65th birthday, the month in which you turn 65 and up to three months after your 65th birthday.
Remember, look at all of your health care options before you decide on which plan is best for you. Consider the cost - how much will you pay for premiums, deductibles and copayments? Does the plan include all Medicare benefits in part A and Part B and does it have prescription drug coverage? Do all of your doctors, hospitals, and pharmacies accept the plan? What are others saying about the plan you are considering.
I have given you a brief outline of Medicare Supplement and Medicare Advantage Plans. For more detailed information on specific questions that you may have, please contact our office. You may also request the publication “Medicare & You” by visiting the web site www.medicare.gov.