Medicare

The U.S. government offers a comprehensive health insurance program called Medicare to provide coverage for individuals aged 65 and older and younger individuals with disabilities.

Parts of Medicare

Medicare consists of four primary parts, including the following:

• Medicare Part A (hospital insurance) may help cover inpatient hospital care, skilled nursing facility care, hospice care, and home health care services. Most beneficiaries do not have to pay a premium for Part A.
• Medicare Part B (medical insurance) may help cover preventive care, doctor visits, medical supplies and medically necessary services. Most beneficiaries pay a monthly Part B premium, typically deducted from their Social Security benefits. There may also be an annual deductible and coinsurance.
• Medicare Part C (Medicare Advantage) offers an alternative way to receive Medicare benefits. Private insurance companies approved by Medicare offer these plans. Medicare Advantage Plans cover all services provided by Parts A and B. Some plans include additional benefits like prescription drug coverage (Part D), vision, dental and hearing. Beneficiaries may need to pay an additional premium, depending on the plan.
• Medicare Part D (prescription drug coverage) may help cover prescription drug costs. Private insurance companies approved by Medicare offer these plans. Beneficiaries pay a monthly premium and may have to meet a deductible and pay coinsurance or copayments for their medications.

Medicare Advantage vs. Medigap Plans

While Original Medicare (Parts A and B) helps provide essential coverage, it does not cover all health care expenses, such as prescription drugs. To fill these gaps, beneficiaries have two main options, including the following:

• Medicare Advantage Plans combine the benefits of Original Medicare into a single plan. Private insurance companies offer these plans and may include additional benefits such as prescription drug coverage, vision, dental and hearing. Medicare Advantage plans typically have network restrictions, requiring beneficiaries to use specific doctors and hospitals. They may also have cost-sharing in the form of copayments or coinsurance.
• Medigap Policies (Medicare supplement insurance) work with Original Medicare to help cover the out-of-pocket costs not covered by Parts A and B, such as deductibles, coinsurance and copayments. Private insurance companies also offer Medigap policies. They do not include prescription drug coverage, so beneficiaries can choose a separate Part D plan. Unlike Medicare Advantage Plans, Medigap policies allow beneficiaries to see any health care provider that accepts Medicare.

Contact Us

Contact Medicare Line in Colorado Springs, Colorado, to learn more about your Medicare options and get appropriate health care coverage to meet your needs.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.