Medicare is insurance for people who are 65 and older or certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant. These are the different types of plans.
- 1. What is Original Medicare:
Original Medicare – know as Medicare Part A & Medicare Plan B.
Part A – is Hospital Insurance. Free to most people who qualify for Medicare.
Part B – is Medical Insurance. Covers doctor visits, lab work, outpatient services and preventive care.
You don’t need referrals for specialists.
You pay a monthly premium for Part B that is set by the federal government not a private company based on income. Premiums are deducted from your social security check.
Original Medicare will only pick up about 80% of your medical costs.
Medicare does not cover long-term care (also called custodialcare). - 2. What is Part D:
Part D – is Prescription Drug Coverage.
Upon eligibility for original Medicare you can sign up for Part D.
It is recommended you enroll even if you don’t take prescription drugs. If you choose to wait, you will face late enrollment penalty for each year you were without prescription drug coverage. - 3. What is Medicare Advantage (MA) Plan:
Medicare Advantage referred to as Part C or MA Plan –
These plans replace Original Medicare Part A (Hospital Insurance) and Medicare Part
B (Medical Insurance) coverage.
MA plans are private insurance plans provided by a carrier that is approved by Medicare.
You do not need to get separate drug or supplemental polices in most Part C plans.
MA plans require you use their network. If they have out of network benefits you will have higher out of pocket expenses.
With most of these plans you need a referral to see a specialist. - 4. What is Supplemental Insurance Medigap Plan:
Medigap Plan –
Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel outside the U.S.
Medigap policies do not cover long-term care, dental care, vision care, hearing aids, eyeglasses, and private-duty nursing.
Most plans do not cover prescription drugs. You should purchase a Part D plan in conjunction with the Medigap plan.