Medicare Part A
Medicare Part A covers Hospital insurance. Most people do not have to pay for Part A, because they or their spouse paid Medicare taxes while working.
Medicare Part A covers:
- Inpatient hospital care
- Skilled nursing facility care
- Hospice care and
- Some home health care
- You can select the hospital you prefer
Medicare Part B
Part B covers Medical insurance. There is a monthly premium, which changes from year to year, and participation is voluntary.
Medicare Part B covers:
- Doctors’ services
- Outpatient hospital care and
- Medical services that Medicare Part A doesn’t cover (like some home health care including durable medical equipment)
- You can select the doctor you prefer
Medicare Part C
Part C is known as Medicare Advantage Plans. These are "managed care" plans providing health care under contract to Medicare, and you must continue to pay your Part B premium and may have to pay a Medicare Advantage premium. There are two types of plans available in many parts of the country:
- Medicare Managed Care (HMO and PPO) Plans
- Medicare Private Fee-for-Service (PFFS) Plans
Medicare Part D
Starting January 1, 2006, Medicare began offering Part D coverage for prescription drugs through Medicare prescription drug plans. Private companies are approved by Medicare to offer these plans. These plans help save money on prescription drug costs.
In order to get this prescription coverage, you must enroll in a Medicare prescription drug plan that meets your needs. If you have a limited income, you may qualify for assistance in paying for a Medicare prescription drug plan.
Consumers must pay a monthly premium for Part D coverage and, depending on the provider, may have to pay a yearly deductible and a copayment for part of the cost for prescriptions.
Who Pays for your Healthcare After Age 65?
What is covered by a Medicare Supplement policy?
While Medicare pays for some services needed as a result of illness or accident, it does not pay for all services. In addition, Medicare imposes certain deductibles and co-payments that are the responsibility of the individual.
Protecting yourself against these expensive gaps in Medicare coverage is what Medicare Supplement Insurance is all about.
All Medicare Supplement plans provide "core" benefits, which include:
- Medicare Part A coinsurance amount (does not include initial $1024 Part A deductible for days 1-60)*
- Cost of 365 extra days of hospital care during lifetime after Medicare coverage ends
- Medicare Part B coinsurance or co-payment amount (after you meet the $135 yearly deductible)*
- First 3 pints of blood each year
Other plan benefits vary and may include:
- Coverage for Medicare Part A and B Deductibles
- Foreign Travel Emergency
- Preventive Care
- At-Home Recovery
- Part B Excess Charges
For complete details about the plans available in many states, go to the Medicare Supplement Insurance Options section.
Who can buy a policy?
There are three categories of individuals who can purchase a Medicare Supplement Insurance policy.
Anyone over the age of 65 and enrolled in Medicare Part A and B
Persons under age 65, enrolled in Medicare Part A and B with End-Stage Renal Disease
Certain individuals who are under age 65, on disability (where required by state law), and enrolled in Medicare Part A and B
Medicare provides benefits for the most acute medical needs. However, it can still leave you with out-of-pocket expenses. Those expenses could be substantial if you experience a catastrophic illness or repeated hospitalizations.
If you want to help protect yourself from unexpected health care expenses, a Medicare Supplement plan can give you added health insurance coverage.
When is the best time to buy?
The best time to buy a Medicare Supplement policy is during the six-month open enrollment period.
The period lasts for six months and starts on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B. During this time, if a Medicare Supplement policy is requested, it must be issued. You cannot be denied coverage, have any conditions placed on your policy, or be charged more because of past or present health problems. If you miss the open enrollment period, you may be medically underwritten for a Medicare Supplement policy.
There may be other guarantee issue periods. These include:
- If employer Group coverage ends
- If you move out of the plan’s service area
- Other situations out of your control
- Medicare Advantage coverage is terminated
Some states have additional open enrollment periods and may have other guarantee issue requirements.
* These are 2006 deductible amounts which can change every year. Please consult the latest version of 2006 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
