Medicare is federal health insurance available for eligible individuals age 65 and over or individuals under 65 with certain disabilities or medical conditions. Medicare has different parts (referred to as Parts A, B, C and D) to cover all your healthcare needs depending your health, finances and lifestyle.
Your Initial Enrollment Period is when you first become eligible for Medicare. This is a seven-month window when you can enroll in Original Medicare (Part A and/or Part B). You can also enroll in a Medicare Prescription Drug (Part D) plan if you are already enrolled in Original Medicare.
Alternatively, you can enroll in a Medicare Advantage or Medicare Supplemental plan through a private insurer that covers all Parts A and B services and typically includes Medicare Prescription Drug (Part D) coverage.
Below is a brief summary on Medicare, Medicare Advantage, Prescription Drug Coverage and Medigap.
We can quickly help you understand all the benefits YOU are eligible for and enroll you in the best plan for your needs.
Medicare Part A (Hospital Insurance) covers most inpatient hospital stays, care in a skilled nursing home, some in-home health care and hospice care.
Medicare Part B (Medical Insurance) Outpatient coverage which includes pretty much everything else: doctor visits and services, equipment, lab-work, surgeries, durable medical equipment, diagnostic tests, etc.
Medicare Part A and Part B (Original Medicare) will not cover all medical expenses. Without additional coverage, you could be left with some out-of-pocket expenses.For example, Medicare Part A and Part B plans do not cover:
- Hearing aids
- Routine vision care
- Routine dental care
- Wellness services
- Prescription Drug Coverage
- Long-term care
- And more…
Medicare Advantage, Prescription Drug Coverage and Medigap can cover all of Original Medicare parts A and B as well as the additional benefits listed above you may need.
Medicare Advantage (Part C) plans offer all Medicare Part A and Part B benefits, plus additional services such as dental, vision, wellness and hearing services. These plans generally include prescription drug coverage as well. They tend to have lower cost sharing overall and a maximum that you would have to pay for out-of-pocket costs each calendar year. SeniorCare Benefits offers these types of Medicare Advantage plans:Health Maintenance Organization (HMO) Plans
- You choose an in-network Primary Care Physician (PCP) and use in-network providers, accept in an emergency.
- May or may not include prescription drug coverage, based on your needs.
- You are free to receive covered services from a network or non-network provider.
- Dual Eligible – Provides services if you have both Medicare and Medicaid.
- Chronic Care – These are available if you have certain severe or disabling chronic conditions such as diabetes, heart failure or cancer.
- Institutional – Provides services if you are in a long-term care facility or require long-term care.
Medigap (Medicare Supplement) is private insurance that supplements Medicare Parts A and B and helps pay for copayments, coinsurance and deductibles. A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage plans provide Medicare benefits, whereas Medigap policies supplement your Original Medicare benefits.
Medigap Plan F covers all out-of-pocket costs including deductibles, coinsurance, and copayments. Monthly costs for Plan F or any of the plans below are based on where you live, your gender and health status.
Specific information on Plan F as well as Plan A, G and N in the table below.
|Medicare Supplement Plans|
Medicare Part A Coinsurance plus coverage for 365 additional days after Medicare benefits end
|Medicare Part A Deductible|
|Skilled Nursing Coinsurance|
|Medicare Part B Deductible|
|Medicare Part B Excess Charge Beneﬁts|
|Foreign Travel Emergency|
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