What is Medicare?
This blog will attempt to answer “what is Medicare?” by providing a basic understanding of the Medicare program and how it works. In addition, it will detail the other parts of Medicare such as C and D. First of all lets start with the official definition: Medicare is the federal health insurance program for people who are 65 or older. It is also for certain younger people with disabilities and with End-Stage Renal Disease. Most people are eligible for Medicare at age 65.
Medicare is made up of four components which can cause confusion. Original Medicare (Red, White and Blue care with a Medicare ID on it) is Medical coverage with parts A and B. This is what provides basic medical coverage for those on the program. Medicare Part C is different than Original Medicare. Part C is a Medicare Advantage Plan and is something a member can enroll in if they want. Medicare Part C replaces Medicare A and B for those that enroll in it. Another part of Medicare is part D which is prescription drug coverage (Also called a PDP). You can enroll in Medicare part D using a stand alone drug plan or access Medicare part D through the drug benefits on an Advantage plan.
Medicare Part A (Hospital Coverage)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and also some home health care.
Medicare Part B (Medical Coverage)
Part B covers certain outpatient doctors services, outpatient care, medical supplies, and preventive services.
Medicare Part C (Medicare Advantage Plans)
A type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your benefits including Part A, B and D. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans (MSA’s). Therefore, if you’re enrolled in a Medicare Advantage Plan, services are covered by the insurance company/plan and not Medicare because Medicare is not the primary insurance. Most Medicare Advantage Plans offer prescription drug coverage.
Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. In addition, Medicare Advantage Plans may also offer prescription drug coverage. They follow the same rules as Medicare Prescription Drug Plans.
What is Medicare: Overall
People often become confused over Medicare. Therefore they confuse Medicare Supplement plans and Medicare Advantage plans with Original Medicare A and B. A Medicare supplement (also called Medigap) is a plan that helps cover the Medical benefits Medicare A and B do not cover entirely. It is secondary to Original Medicare A and B. A Medicare Advantage plan (often called part C) is a plan from a private insurance company. Especially relevant is a person with a Medicare Advantage plan does not use Original Medicare as their insurance. Instead , they use the Advantage plan. As a result, it is not possible to have both plans at the same time.
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