How Does Medicare Work?
What is Medicare Part A?
According to Medicare.gov, under Original Medicare, Part A generally covers:
Inpatient Care in a Hospital
Skilled Nursing Facility Care
Nursing Home Care (not custodial or long-term care)
Hospice Care
Home Health Care
What is Medicare Part B?
According to Medicare.gov, under Original Medicare, Part B covers two types of services:
Medically Necessary Services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards or medical practice.
Preventive Services: Health care to prevent illness (like the flu) or detect it at an early stage when treatment is most likely to work best.
According to Medicare.gov, under Original Medicare, Part B generally covers:
Clinical research
Ambulance Services
Durable Medical Equipment (DME)
Mental Health
Inpatient
Outpatient
Partial Hospitalization
Limited Outpatient Prescription Drugs
Comparative Analysis:
Medicare Supplement vs Medicare Advantage
Medicare Supplement
Under Original Medicare (Parts A & B), Medicare will cover 80% of the cost of covered services, leaving you, the patient, responsible to pay the remaining 20%. Medicare Supplements operate through private insurance companies that cover that 20% cost in exchange for charging you, the patient, a monthly premium and applicable deductibles and co-payments. Prescription drug coverage (Part D) is not included as part of a Medicare Supplement plan and will require additional enrollment in a Prescription Drug Plan (PDP).
If you'd like specific information about plans available in your area, please contact us today for a free consultation.
Medicare Advantage
According to Medicare.gov, Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services.
If you'd like specific information about plans available in your area, please contact us today for a free consultation.
Additional Coverages
Dental and Vision Insurance
According to Medicare.gov, under Original Medicare (Parts A & B), most dental care and eye exams related to prescribing glasses are not covered. As such, private individual plans are available for purchase for needed dental and vision services. These plans often require an initial fee, as well as monthly premiums, and pay-as-you-go co-payments.
If you'd like specific information about plans available in your area, please contact us today for a free consultation.
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