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Medicare Plans
 * Medicare Programs By State

Medicare Resources
 * A Guide To Medicare Parts
 * What Can I Expect To Pay For Medicare?
 * Medicare Donut Hole
 * Medicare and Medigap Insurance: FAQ

Speak to an agent: (855) 458-1885


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A GUIDE TO MEDICARE PARTS


MEDICARE PARTS: WHAT YOU NEED TO KNOW


WHAT IS MEDICARE?

According to Medicare.gov, medicare is a federally funded health insurance
program for people who are 65 or older, those with disabilities (who qualify),
and people with lifelong, chronic major medical needs such as End-Stage Renal
Disease (ESRD), which causes permanent kidney failure requiring regular dialysis
or a transplant, which typically has a very long waiting list.  




MEDICARE PARTS BROKEN DOWN


Medicare comes in different parts: Part A, B, and D, that cover different
healthcare services.  Here is a simple breakdown: 


 * Medicare Part A – This covers more expensive, long-term, and specialized
   healthcare needs, such as hospital in-patient stays, the costs of nursing
   homes and hospice, and sometimes in-home care.  
 * Medicare Part B – This covers more routine care, such as doctors’ services,
   medical supplies, check ups, outpatient services, and preventative care.  
 * Medicare Part C – Medicare part C is a bit different, as it’s a Medicare
   Advantage plan. Medicare Part C is similar to a Medigap plan, but it includes
   a prescription drug plan and it usually comes at little or no cost (but it’s
   more limited in terms of doctors and coverage, and can be harder to qualify
   for).
 * Medicare Part D – This covers prescription drugs, as well as shots and
   vaccinations.




PREMIUMS 


While some people may be under the impression that Medicare is free for everyone
who qualifies, this isn’t true.  Medicare is usually less expensive than regular
insurance, but there are still premiums to pay. The cost of premiums can vary
wildly, and fluctuate from state to state and  year to year.  They can change
due to a variety of factors, including the beneficiary’s health, where they
live, whether the government or insurance providers have tinkered with price
increases, as well as what services and medications they choose to cover, the
amount they are willing to cover for these things, changes in income
requirements, and of course what plans and coverage they choose to get. 
Medicare also still comes with deductibles, copays, out-of-pocket costs and (for
some) the cost of coinsurance.  After adding everything up, the average Medicare
enrollee may find themselves reeling at the total sticker price.  But the bill
is still somewhat in the beneficiary’s control, as they can choose what plan
they get and how much coverage they want.  Premiums are also mainly
income-based, so what you can reasonably afford is also taken into consideration
by insurers and the federal government.  So how do these premiums apply?  They
typically break down as follows: 


 * Part A – For most people, Part A is fully covered and doesn’t cost anything.
   However, if you don’t qualify for Part A, you may be able to buy it.   
 * Part B – Everyone is subject to a premium of some kind for Part B.  While
   Medicare Part B is optional, you are likely to be enrolled automatically if
   you are auto-enrolled in Part A, but you have the option to drop it.  
 * Part C – Premiums for Part C are sold in the private marketplace, which means
   they vary by provider, plan, and location.  
 * Part D – Because Medicare Part D strictly covers prescription drugs only, it
   is sold by private insurance providers.  This means the premiums will vary
   plan to plan. In order to qualify for Medicare Part D, you will also need to
   enroll in a Medicare-approved plan.  That being said, all plans come with a
   standard amount of coverage set by Medicare.  

To get an idea of what your Medicare expenses might be, the Centers for Medicare
& Medicaid Services offers an Out-Of-Pocket Cost Calculator.  While this isn’t a
definitive guarantee of your actual cost, it can help you prepare for what you
might be looking at paying. 





WHAT IF I CAN’T AFFORD MEDICARE?  


As was stated earlier, the out-of-pocket costs (premiums, deductibles, copays,
coinsurance costs, etc) can be staggering for the average Medicare recipient. 
If you find yourself struggling to afford the cost of your healthcare, you may
qualify for federal and state subsidies.  This often comes in the form of
Medicaid. 


Medicaid is a program provided by the federal government for those who qualify
due to disability or low income.  It covers some or all of the costs of
Medicare.  If you qualify for both Medicare and Medicaid, you are know as having
“Dual Eligibility”.   




As healthcare costs continue to rise, lawmakers and insurance companies are
constantly working together to balance the cost of care for beneficiaries with
keeping the Medicare Trust Fund from going into bankruptcy.  It’s hard to know
what the future holds for both beneficiaries and taxpayers who fund their care. 
Doctors are constantly having to tailor their services to provide Medicare
recipients access to care while still fitting in to new rules, reforms, and
costs of service.  With all of these changes happening on a routine basis, it
can be difficult for beneficiaries to navigate as well, and for them to find
plans that best fit their medical needs while balancing affordability into the
equation. 



Oftentimes, recipients get hit with surprises in their bill and coverage when
they need it the most, and are unable to change it.  There are so many details
and difficulties to enrolling, navigating the system, and keeping up with what
plan will be right for you.  Opportunities to save money may go amiss, and
certain coverage needs may be overlooked.  Don’t go it alone.  Get a quote and
talk to an insurance specialist today. 


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Disclaimers: Outside of the Medicare Annual Enrollment Period, members can
enroll in a plan only if they meet certain criteria. A licensed insurance agent
can help you determine whether you are eligible. Plan availability varies by
region and state. Callers will be directed to a licensed insurance agent with a
third-party partner of MedicareGap.org who can provide more information about
Medicare Advantage plans offered by one or several Medicare-contracted
carrier(s). Enrollment in any plan depends on contract renewal. Medicare has
neither reviewed nor endorsed the information contained in this advertisement.
Not connected with, or endorsed by, the U.S. government or the federal Medicare
program. This information is not a complete description of benefits. For a
complete listing of Medicare plans, please contact 1-800-MEDICARE (TTY users
should call 1-877-486-2048), 24 hours a day, 7 days a week, or consult
www.medicare.gov.