MEDICARE 101
What is Medicare
Medicare is a federally administered health insurance program providing health coverage to nearly 55 million Americas above the age of 65 and other individuals who are eligible to certain illnesses or disabilities.
Medicare is a federally administered health insurance program providing health coverage to nearly 55 million Americas above the age of 65 and other individuals who are eligible to certain illnesses or disabilities.
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Who is eligible for Medicare
U.S. citizens and legal residents Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare You must also meet one of these following requirements: Age 65 or older Younger than 65 with a qualifying disability Any age with a diagnosis of end-stage renal disease or ALS |
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Original Medicare
Which includes hospital stays (Part A) and doctor visits (Part B)
Original Medicare pays for 80% of all services related to Parts A & B after the A & B deductibles are met.
You are responsible for the remaining 20%
There are 2 options to cover the 20% cost share you are responsible for.
Which includes hospital stays (Part A) and doctor visits (Part B)
Original Medicare pays for 80% of all services related to Parts A & B after the A & B deductibles are met.
You are responsible for the remaining 20%
There are 2 options to cover the 20% cost share you are responsible for.
Medicare Coverage Choices
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Medigap or Medicare Supplement
This is straight insurance, this is not a Medicare plan. Supplement plans are insurance plans that cover the 20% cost share Medicare doesn't. There is a monthly premium for this plan, Average price at 65 is $150 per month. There are "Alphabetic Letters" for the plan names most popular is G and N. These plans are all the same offered by different insurance companies and the prices vary by company.
Plan G will cover all your out of pocket copayments after the annual Part B deductible is met.
This is straight insurance, this is not a Medicare plan. Supplement plans are insurance plans that cover the 20% cost share Medicare doesn't. There is a monthly premium for this plan, Average price at 65 is $150 per month. There are "Alphabetic Letters" for the plan names most popular is G and N. These plans are all the same offered by different insurance companies and the prices vary by company.
Plan G will cover all your out of pocket copayments after the annual Part B deductible is met.
Medicare Part C: Medicare Advantage
Medicare Part C or Medicare Advantage. Medicare Advantage plans combine Part A and Part B benefits into one plan. Most include prescription drug coverage Part D and offer additional benefits (vision, dental, hearing etc) as well, often with no monthly premium. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Coverage and costs beyond the standards set by Medicare may vary from plan to plan.
Medicare Part C or Medicare Advantage. Medicare Advantage plans combine Part A and Part B benefits into one plan. Most include prescription drug coverage Part D and offer additional benefits (vision, dental, hearing etc) as well, often with no monthly premium. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Coverage and costs beyond the standards set by Medicare may vary from plan to plan.
Medicare Part D: Prescription Drug Coverage
You can get prescription drug coverage as a standalone Part D plan To go with your Supplement or with a Medicare Advantage plan that includes prescription drug coverage.
There is a $2000 Cap for all your drugs covered in the plans drug formulary.
There is a penalty for not signing up for Part D when it is first available to you.
You can get prescription drug coverage as a standalone Part D plan To go with your Supplement or with a Medicare Advantage plan that includes prescription drug coverage.
There is a $2000 Cap for all your drugs covered in the plans drug formulary.
There is a penalty for not signing up for Part D when it is first available to you.
D-SNP: Dual Special Needs Plans
Are designed for people with specific health care needs, including nursing home residents, those with chronic conditions and people who are eligible for both Medicare and Medicaid.
May provide care managers or nurse practitioners to help members get the care they need.
Usually have plan-specific eligibility requirements.
In Arizona if you are on AHCCCS or ALTCS and you are eligible for Medicare you would be able to qualify for one of these plans.
For More Info: CLICK HERE
Are designed for people with specific health care needs, including nursing home residents, those with chronic conditions and people who are eligible for both Medicare and Medicaid.
May provide care managers or nurse practitioners to help members get the care they need.
Usually have plan-specific eligibility requirements.
In Arizona if you are on AHCCCS or ALTCS and you are eligible for Medicare you would be able to qualify for one of these plans.
For More Info: CLICK HERE
