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What is Medicare?

Medicare is an insurance program administered by the Centers for Medicare and Medicaid Services in the United States. Medicare began in 1966 and was originally administered by the Social Security Administration. Over the past half-century, the program has adapted to meet the ever-changing needs of the modern world by adding new program options, and allowing for the introduction of supplemental plans.

Medicare insurance is a government-sponsored health insurance program available to most people aged 65 or older who have paid Medicare taxes while working. It is also available to some younger people with disabilities or end-stage renal disease. It’s divided into several sections with differing costs and choices. Rules concerning enrollment eligibility and timing must be considered.

Original Medicare Part A and Part BMedicare Advantage (Medicare Part C)Prescription Drug Plan (Medicare Part D)Medicare Supplement MedigapMedicare To-Do List

What are the benefits?

In addition to the expanded coverage noted above, there are other reasons a person may choose to enroll in an Advantage plan. While Original Medicare requires you to see a Medicare provider, some Advantage plans allow for out-of-network coverage, although this tends to cost more. Unlike Original Medicare, Advantage plans often have limits on out-of-pocket costs, which can take some of the guess work out of anticipating expenses for those on a fixed income. Here are more examples of benefits:

  • Plans may cost less.
  • Plans may offer more coverage options.
  • Plans may combine health and prescription coverage.

How do these plans work?

These plans contract with Medicare and also follow the Medicare rules and regulations. They are also reimbursed by the United States government. These plans can charge different premiums, copays, and deductibles than Original Medicare, and these will often differ from plan to plan. The plans are provided through private insurance companies, which allows someone who has Parts A, B, and D to have all their coverage managed by one company.

Medicare is divided into four sections referred to as Parts A, B, C, and D. Parts A and B are considered “Original Medicare.”

  • Part A: Medicare Part A covers hospital-related expenses, including inpatient stays in a traditional hospital, skilled nursing facility, or hospice. It may also include coverage for home health care.
  • Part B: Medicare Part B covers expenses that are not considered hospital-related. This can include some doctor visits and outpatient care, medical supplies, and preventive care services.
  • Part C: Medicare Part C is also known as Medicare Advantage. Medicare Advantage plans are an alternative to original Medicare. These plans typically follow Medicare rules, but they may have different out of pocket costs and may require an individual to use different channels to obtain care than original Medicare. They may also include coverage for prescription drugs.
  • Part D: Medicare Part D is designed to help cover the cost of prescription drugs for those who have both Medicare Part A and Part B. This is an optional coverage that is provided through private insurance companies.

We do not offer every plan available in your area. Currently we represent 12 organizations which offer 50 products in your area. Please contact, 800-MEDICARE, or your local State Health Insurance Program to get information on all your options.

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