Types of Medicare Coverage – How to Handle the Medicare Maze (3 of 5)

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Four Parts to Medicare – How to Handle the Medicare Maze (3 of 5)

Open Enrollment begins a little earlier this year. Change your Medicare health or prescription drug coverage for 2013. Open Enrollment: October 15 – December 7, 2012.

The four parts of Medicare are covered in depth in the third entry from the “How to Handle the Medicare Maze” video series.

– Part A: Hospital Insurance
– Part B: Medical Insurance
– Part C: Medicare Advantage
– Part D: Prescription Drug Coverage

  1. Medicare Part A (Hospital Insurance)

    PART A helps cover medically necessary inpatient care in hospitals. It also helps cover skilled nursing facility, hospice care and home health care.

    However, you must meet certain requirements to get these benefits. One way you become eligible for Part A is just by turning 65, even if you’re still working. During your working years, you have probably paid for Part A through payroll deductions.

    Part A doesn’t cover all your expenses – you are responsible for copayments and a deductible when you use Part A services.

  2. Medicare Part B (Medical Insurance)

    Medicare Part B helps cover doctor’s services and outpatient care. It also helps pay for some preventative services and services Part A doesn’t cover including physical and occupational therapy and some home health care – if these services are medically necessary.

    It’s important that you sign up for Part B when you become eligible. If you don’t, your Part B premium may be higher.

    Parts A and B together cover much of the medical care you need, but not all of it. For example, Part A and B (called Original Medicare) do not cover prescription drugs. This is where Parts C and D come into play.

  3. Medicare Part C (Medicare Advantage Plans)

    Medicare Advantage plans are health plan options approved by Medicare and administered by private health insurance companies like Humana.

    These plans include all the benefits of Original Medicare and more like prescription drug coverage and annual physical exams that Medicare doesn’t cover.

    In addition, some plans offer extra services like wellness programs and fitness center memberships at no additional cost. Finally, Medicare Advantage plans may reduce out-of-pocket expenses.

    Several types of Medicare Advantage plans are available:

    • HMO – Health Maintenance Organization
    • PPO – Preferred Provider Organization
    • PFFS – Private Fee-for-Service

    You must be enrolled in both Medicare Parts A and B to join a Medicare Advantage plan, which then acts as a alternative for Parts A and B.

  4. Medicare Part D (Prescription Drug Coverage)

    Medicare Part D helps cover prescription drugs and like Medicare Advantage, Medicare Part D is available only from private insurers that contract with Medicare.

    This coverage may help lower your costs and protect against higher costs in the future.

    Remember, you don’t get Part D automatically – you have to select it. You can enroll in a stand-alone plan or enroll in a Medicare Advantage plan that includes prescription drug coverage.

    You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

    • 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;
    • The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office

Looking for information on health care in Canada? Click here to view the entire “How to Handle the Canadian Health Care Maze” video series.

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