Medicare Basics

What is Medicare? Who is Eligible?

Medicare is health insurance that the US Government provides for people 65 and over, or for some disabled persons. Medicare is made up of four parts - Part A, Part B, Part C, and Part D.

PART A is hospital insurance that helps pay for things like inpatient hospital stays, skilled nursing care, hospice, and limited home health care. If you have worked a minimum of 10yrs and paid in at least 40 quarters of Medicare taxes, you are automatically enrolled in Part A with no monthly premium. 

PART B is medical insurance that helps pay for doctor visits, outpatient procedures, diagnostic tests, medical supplies, and preventive services including certain screenings. Most people have to sign up for Part B, and it typically comes with a standard monthly premium that is determined by income.

PART C is private insurance, known as Medicare Advantage. These plans act as primary insurance instead of Original Medicare. These plans cover the same Part B benefits as Original Medicare and many include coverage for prescription drugs, routine vision, hearing, dental, and even gym memberships.

PART D helps pay for prescription drugs. Each drug plan has a formulary that lists generic and brand-name drugs covered by the plan. Each drug is assigned a tier, which determines how much you have to pay.

MEDICARE SUPPLEMENT PLANS, also known as Medigap plans, act as secondary insurance to Original Medicare. These plans are designed to help cover some of the "gaps" not covered by Original Medicare, such as deductibles, copays, and coinsurance. With Medigap plans, you can also choose any doctor or provider who accepts Medicare. These plans don't cover things like vision, hearing, dental, long term care - and they don't cover prescription drugs so you may want to enroll in a stand alone Part D plan if you choose this option. 

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Everyone's situation and health is different, so it is very important to find the right coverage that fits you! Please don't make the mistake of picking what someone else has, if the coverage is not right for you. Drug coverage is very important because it impacts the price you will pay for the prescription drugs YOU take. We offer you our time and expertise at no extra cost to you! This is also not a one-time visit. We are there for you when you need us, whether that's answering questions or calling the insurance companies to review your claims and costs. We check in with you throughout the year and during enrollment periods to ensure you are satisfied with your coverage. We recommend to review competitive plans and premiums each year to ensure you are always getting competitive prices. 

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