Medicare is a safety net for health insurance benefits for our seniors. It is divided into four sections, easily labeled A, B, C, and D. Sections A and B make up the original Medicare. This “Traditional Medicare” is administered by the Centers for Medicare and Medicaid Services (CMS) and is governmentally sponsored. The areas that Medicare A and Medicare B do not cover, commonly referred to as “medigap”, is usually filled with any supplemental insurance from private sectors that you may get.
Mostly covers costs of inpatient care
Covers up to 100 days of care at a nursing facility
Some hospice care covered
Some home health care covered
Medicare A has its eligibility at age 65. This is what you pay into through payroll deduction. There is a copayment ( the fixed amount you will pay for a visit or any medical service) and it has deductibles ( the amount you will pay before your plan will pay benefits).
Covers doctors office visits, both family and specialists
Covers outpatient care
Physical therapy covered by this sector
Occupational therapy covered by this sector
Some additional home health care provided
Some additions to the parts that Medicare A doesn’t cover
Medicare B you will have to apply for and pay a premium to have. This is not part of the Medicare you pay into through payroll deduction. You are eligible to sign up for this at age 65.
Must be in Medicare A and Medicare B to be eligible for Medicare C. Medicare C is from private insurers. This will replace Medicare A and Medicare B and will add more benefits than typical Medicare A & B. It can be either an HMO (a Health Maintenance Organization), PFFS (Private Fee For Service), or a PPO ( Preferred Provider Organization). There are many options to what services you can receive through Medicare C, you will have the option to pick what is right for you. The Medicare site has a good book to help you choose and plan your package. (www.medicare.gov)
Medicare D is the prescription drug plan that is handled through private insurance sectors. This was added in 2006 to give Medicare patients a plan to have discounted and reduced prescriptions, both formulary and generics. You will select it either separately or as part of your Medicare C plan.
For More Info
SHIP (State Health Insurance Assistance Program)