What is Medicare?

All about Medicare and its options

by Amy De Vore+ on May 13, 2014 | 1 Comment

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with permanent kidney failure requiring dialysis or a transplant. What does this mean for you? Many people don’t fully understand what Medicare is and what their options are. We get that, so we have broken down what Medicare is and how it works best for seniors.

What Medicare Covers

Medicare is broken down into two parts:

  • Medicare Part A
  • Medicare Part B

Alright, so that isn’t saying much. We’ll explain each separately below.

Medicare Part A

This is also known as hospital coverage. Most people do not pay a premium for this coverage. Part A, in general,covers the following:

  • Hospital care*
  • Skilled nursing facility care*
  • Nursing home care (as long as custodial care isn’t the only care you need)*
  • Hospice*
  • Home health services*

*All Medicare Part A are subject to a deductible and annual and lifetime limits.

Medicare Part B

Medicare Part B is medical coverage. Most people pay $104.90 a month for their premium. You can opt out of Medicare Part B if you like, however if you want to cover the basics you will want the combo of the two. Medicare Part B, generally, covers the following:

  • Clinical research** 
  • Ambulance services**
  • Durable medical equipment (DME)**
  • Mental health**
  • Getting a second opinion before surgery**

**Medicare Part B coverage is subject to a deductible, copay, coinsurance, and excess charges.

To sign up for Medicare go to our Medicare Overview Page.

Medicare Options

There are two types of Medicare options: Medicare Advantage and Medigap.

Medicare Advantage is a low-cost way to get all of your Medicare Part A and Part B coverage with added benefits like drug coverage, dental, vision, and gym memberships. With Medicare Advantage you are still usually responsible for Original Medicare’s deductibles, coinsurance, and excess charges, but will have meet an out-of-pocket max each year -to protect yourself. However, Medicare Advantage can still leave financial gaps.

Medigap works with Original Medicare by filling in the gaps that it leaves open. Medigap can cover coinsurance, deductibles, excess charges, up to three pints of blood for a blood transfusion, foreign health care, and what is most important is extends hospitalization coverage. Medigap does not cover drug plans, you will need a stand-alone Part D plan.

Click here to compare Medigap and Medicare Advantage.

Next Steps

Make sure you enroll in Medicare Part A and B when you are first eligible. Then decide if you want an MA or Medigap plan. The deciding factor really depends on your budget. If you can afford it, Medigap offers the greatest financial protection from a major medical issue, but if you can’t Medicare Advantage usually offers better coverage than just having original Medicare.

For any questions call the number above or click here to get an instant Medigap quote.

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Reader Comments and Questions

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By Estelle Russell on December 27, 2016

Does Medicare pay for a mammogram in full or do I pay a cost?

Estelle,
Here is an article that explains how Medicare covers mammograms. If you need help finding a Medicare Health Plan to help cover any costs, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


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