MEDICARE
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Medicare doesn't have to be confusing and overwhelming. We'll help you weed
through the mass of paperwork you've received and show you your options. Don't
waste your valuable time. Let us help you understand it all. You're not alone,
contact us now at (562) 420-7104
What is
Medicare?
Medicare is a government health insurance program administered by the Centers
for Medicare & Medicaid Services (CMS). Medicare is the largest health
insurance service in the country, with approximately 40 million Americans
participating. To be eligible you must be a citizen of the United States and
meet certain requirements. If you are not a citizen of the United States,
you can contact your local Social Security office to learn if you are eligible.
Medicare Benefits: A Brief Summary
Medicare is basically broken down into two main categories: "Original
Medicare Plan" and the "Medicare Advantage Plan." Each category
is made up of four sub-categories: Part A, Part B, Part C and Part D.
The Original Medicare Plan
The Original Medicare Plan consists of Part A. You do have the option of adding
Part B and D. You will automatically be enrolled in the Original Medicare
Plan unless you specifically choose to join a Medicare Advantage Plan (Part
C).
The federal government manages the Original Medicare Plan. It operates on
a fee-for-service plan. Most people pay a deductible and then a co-pay or
co-insurance.
Medicare Advantage Plan
The Medicare Advantage Plan or Plan C combines your Part A and B coverage,
but is provided by private insurance companies. You have the option of adding
Part D if coverage is not already included. Medicare Advantage Plans include
HMO, PPO, private fee-for-service plans, and Medicare special needs plans.
Part A Overview
Part A is hospital insurance provided by Medicare. Most people do not pay
a premium for this coverage. Part A covers inpatient care in skilled nursing
facilities, critical access hospitals, and hospitals. Hospice and home health
care are also covered by Part A.
Part B Overview
Part B is medical insurance to pay for medically necessary services and supplies
provided by Medicare. Most people will have to pay a premium to receive this
coverage. Part B covers outpatient care, doctor's services, physical or occupational
therapists, and additional home health care.
Part C Overview (Medicare Advantage Plan)
Part C is the combination of Part A and Part B. The main difference in Part
C is that it is provided through private insurance companies approved by Medicare.
With this program, you may have lower costs and receive extra benefits.
Part D Overview
Part D is stand-alone prescription drug coverage insurance. Most people do
have to pay a premium for this coverage. Plans vary and cover different drugs,
but all medically necessary drugs are covered. You can choose what drug plan
will be best suited to your needs.
How Can I Cover Additional Expenses?
Original Medicare Plans do not cover everything. Costs that you may incur
include co-insurance, co-pays, deductibles, etc. Also, medicare DOES NOT have
a "stop-loss" or "out of pocket maximum", so you may be
responsible for 20% of charges to an unlimited amount. To help cover these
costs you'll want to consider a Medigap/Medicare Supplement policy.
CONTACT US AT (562) 420-7104 to discuss these options and/or to enroll in
a plan today.
