Medicare Coverage
Medicare is divided into several parts, each focusing on specific coverage for medical services:
-
Medicare
Part AOffers coverage for
hospitalization cost. -
Medicare
Part BOffers coverage for
medical care. -
Medicare
Part COffers additional benefits to Medicare parts A and B, inlcuding part D. -
Medicare
Part DOffers coverage for
prescription drugs.
Innovating Insurance Solutions
Medicare is a federal health insurance program that provides coverage to individuals aged 65+, as well as to certain younger people with disabilities, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS).
Also known as Traditional Medicare, it refers to Medicare Parts A and B.
- Part A helps pay for inpatient stays in hospitals, skilled nursing facilities, some home care and end-of-life hospice care.
- Part B covers doctors’ services, diagnostic screenings, lab tests, outpatient care, preventive services, plus some medical equipment and transportation. Medicare part B has a monthly premium which may vary per year, regulated by the CMS.
Original Medicare will only cover 80% of the total cost of the services mentioned above.
Best known as Medicare Advantage, this is an all-in-one alternative to Original Medicare. Offered by insurance companies, it bundles Medicare parts A, B and D, helping reduce the out-of-pocket expenses of the member while also adding additional benefits such as:
- Dental coverage
- Vision coverage
- Hearing coverage
- Fitness benefits
Also known as Medicare’s Prescription Drug Coverage, Medicare part D helps cover the cost of prescription drugs. Each Medicare part D plan will have a drug formulary detailing a list of approved drugs and their copays or coinsurance for the specific plan.
Medigap is private insurance that covers “gaps” in Original Medicare, such as copayments, coinsurance, and deductibles.
Benefits include:
- Supplementary Coverage: Covers additional costs not paid by Medicare Parts A and B.
- Flexibility: Allows beneficiaries to choose any doctor or provider that accepts Medicare.
Beneficiaries pay an additional monthly premium on top of the Medicare Part B cost. Prices and coverage vary depending on the policy.