WHAT IS MEDICARE?
Medicare is the government sponsored health insurance coverage for people over 65. It also includes people who have social security disability for over two years as well as children and adults under 65 with disabilities.
WHAT ARE THE TWO PARTS OF MEDICARE?
Medicare covers medically necessary health related procedures.
WHAT IS MEDICARE SUPPLEMENT OR MEDI-GAP COVERAGE?
- Part A: Hospitalization: This is coverage for inpatient stays in a hospital. Part A has a deductible that applies to each stay in hospital, not an annual deductible. There are no monthly premiums for this coverage as long as you or your spouse is “vested” through the social security payments made while working.
- Part B: Doctors and outpatient procedures. This is the part of Medicare that covers outpatient procedures, doctors’ visits, labs, ambulance and all procedures that are done in a day surgery. This coverage has a monthly premium that varies based on individual income. An individual is responsible for an annual deductible and approximately 20% coinsurance for Medicare approved charges.
PART C OR MEDICARE ADVANTAGE
Medicare Advantage or Part C is where a private insurance company provides benefits equal to or greater than traditional Medicare. A patient transfers their benefits from the federal government program (traditional Medicare) to a private insurance company. They do not lose their Medicare benefits, they are transferred and administered by a private insurance company. These programs usually include the Part D prescription drug coverage as well. The cost for these programs can be as little as a $0 per month, (meaning that the client pays only the part B premium, and the plans receives no extra premium) to as much as $200 per month on top of the Medicare Part B premium. The cost and benefits are specific to each company. These programs are zip code specific and need to be reviewed carefully to make sure they fit your needs as a client.
These are your benefits that you are entitled to, let us help you understand them and get maximum benefit from them.