Medicare Coverage You Can Count On

Medicare is a federal health insurance program for people age 65 and older, as well as certain younger individuals with disabilities or specific health conditions. It helps cover many essential health care services, but there are different parts and plan types to understand.

The Parts of Medicare

Part A – Hospital Insurance

  • Helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.
  • Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working.

Part B – Medical Insurance

  • Helps cover doctor visits, outpatient care, preventive services, lab tests, and durable medical equipment.
  • Part B has a monthly premium, which may vary depending on income.

Part C – Medicare Advantage

  • An alternative to Original Medicare, offered by private insurance companies approved by Medicare.
  • Combines Part A and Part B, and most plans also include Part D (prescription drug coverage).
  • Many Medicare Advantage plans may offer extra benefits like vision, dental, hearing, fitness programs, and more.

Part D – Prescription Drug Coverage

  • Helps cover the cost of prescription medications.
  • Plans are offered by private companies approved by Medicare, and each plan has its own list of covered drugs (called a formulary).

Medicare Supplement Insurance (Medigap)

  • Sold by private companies, these plans help pay for costs that Original Medicare does not cover, such as copayments, coinsurance, and deductibles.
  • You can use Medigap with Original Medicare, but not with a Medicare Advantage plan.

Key Things to Know

  • Enrollment: Most people are first eligible at age 65. There are specific enrollment periods when you can sign up or make changes.
  • Costs: While some parts of Medicare are premium-free, others include monthly premiums, deductibles, and copayments.
  • Provider Access: Original Medicare is accepted nationwide. Medicare Advantage plans may have provider networks.

Why Medicare Matters

Medicare provides peace of mind by helping cover the cost of health care as you age. Understanding your options ensures you can choose the coverage that best fits your health needs and budget.