There are three groups of Americans who are eligible for Medicare. The largest group are people who turn age 65, then followed by people who have been collecting Social Security disability benefits for two years. Lastly, if you have end stage renal disease (kidney failure), you will be also eligible for Medicare benefits.
Medicare has two options for eligible consumers. One option is to select Medicare Part A (hospital insurance and premium free) and Part B (medical insurance) to see your doctor(s) and for services like home care. The premium for Part B is based on your income from two years ago. Medicare Part D is used when you purchase prescription drugs; its premium is also based on your income. You can go to any doctor or hospital in the US that accepts payment under Medicare Parts A and B.
To cover the out of pocket expenses (deductibles and co-payments) under Medicare Parts A and B, you may also want to purchase a Medicare supplement insurance policy. These plans (also known as Medigap plans) are offered by private insurance companies. You must also enroll in Medicare Parts A and B.
The second option is to select one of the Medicare Advantage Plans under Part C. These are managed health insurance plans like a Health Maintenance Organization/HMO plans or Preferred Provider Organization/PPO plan. The Medicare Advantage plans are also sold by private insurance companies that offer the same basic services that are found in Medicare Part A and B. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage plans. Insurance companies are offering these plans today with low or no monthly premiums.
These plans are governed by the Medicare rules. If you enroll in one of these Part C plans, you must be also enrolled in Medicare Parts A and B. These plans may also offer additional benefits not found in Medicare Parts A and B like drug coverage, gym membership in some states, dental and vision plan services. Check to see if your provider (your doctor and hospital) is participating in these network plans. And there will be out of pocket expenses like co-insurances when you need medical care. You cannot purchase a Medicare Supplement plan if you are enrolled in a Medicare Advantage plan.
Call us or email us at Quinlan Care if we can help you choose the best Medicare plan(s).
