Medicare has been in existence since 1955, and much of the original program is still active today. Medicare is typically for people aged 65 years and older; however, it is possible to qualify for Medicare prior to age 65 if someone has been disabled for at least 24 months or has certain ailments. Upon reaching age 65, eligible individuals are given the option to enroll in Medicare. If the individual is already drawing Social Security benefits, this may happen automatically. “Original Medicare,” as it is known, is comprised of just Medicare Parts A and B, although there are four Parts to Medicare (Parts A, B, C, and D).
Medicare Part A
Medicare Part A, also known as Medicare Hospital Insurance, provides basic coverage for hospital care, surgery, skilled nursing and some home health care.
Medicare Part B
Medicare Part B, also known as Medical Coverage for Medicare recipients, provides coverage for doctor visits, lab services, outpatient care, ambulance rides and other healthcare provider services.
Original Medicare (Parts A and B) covers roughly only 80% of most people's medical expenses with no maximum out-of-pocket. The remaining amount either comes out of pocket (which can be significant as age and health ailments increase) or from private insurers with additional options and features offered to the consumer. The two most common plans are Medicare Supplement and Medicare Advantage.
Medicare Supplement Plans
Medicare Supplements, also known as Medigap Plans, are plans offered by private insurance companies and are designed to fill in the “gaps” of Original Medicare to help mitigate costs. With a Medicare Supplement plan, Original Medicare (Parts A and B) is your primary coverage, and it allows you to continue to receive federal health care benefits. This offers considerable flexibility as Medicare does not require referrals and allows you to go to any doctor or hospital in the United States that accepts Medicare. Medicare Supplements do not include prescription drug coverage. In this case, prescription drug coverage is obtained separately through Medicare Part D. To speak to a licensed insurance agent about Medicare Supplement options click here or enter your zip code at the bottom of this page.
Medicare Advantage Plans
(Medicare Part C)
Individuals eligible for Medicare typically have two options to help mitigate the costs of Original Medicare; either a Medicare Supplement (as referenced above) or Medicare Advantage plan. Medicare Advantage Plans, also called Medicare Part C, are commonly known as all-in-one health care solutions. Medicare Advantage plans are also offered by private insurance companies and are used as a replacement to Original Medicare. It is still required to maintain Medicare Parts A and B; however, these plans are designed to help reduce out-of-pocket costs and provide additional benefits that Original Medicare does not offer. At a minimum, all Medicare Advantage Plans are required to cover the same basic services as Original Medicare. Unlike Medicare Supplement Plans, Medicare advantage plans can include services such as prescription drug coverage, dental, vision, hearing, fitness memberships, and much more with no additional cost. The addition benefits beyond the basic services of Original Medicare will vary depending on the plans available in your service area and the plan you choose. To speak to a licensed agent about Medicare Advantage plans available in your service area click here or enter your zip code at the bottom of this page.
Prescription Drug Plans
(Medicare Part D)
Since Original Medicare does not cover prescription drugs, the Medicare Modernization Act was signed into law in 2003 to help Medicare eligible individuals afford prescription drugs and premiums. In 2006, the new outpatient drug coverage was created and is now called Medicare Part D, also known as a Prescription Drug Plan (PDP). These plans are approved by the Centers for Medicare and Medicaid Services (CMS) and offered by private insurers. Each plan will vary based on its formulary for covered medications. Note: this makes it very important to check which plan may suit your needs based on the medications you take. Medicare Part D plans can be obtained through a stand-alone Prescription Drug Plan or included as part of a Medicare Advantage plan. To speak to a licensed agent about Prescription Drug coverage click here or enter your zip code below.
Other Health Related Products
Hospital indemnity plans were created to help supplement health insurance coverage and mitigate costs associated with hospitalization. Eligible individuals can purchase these plans and they will provide them with cash payments to help pay for the added expenses that may come while recovering from a hospital stay. Typically, plans pay based on the number of days of hospitalization. To learn more about these plans and speak to a licensed insurance agent in your area, click here or enter your zip code below.
Cancer plan insurance was created as an affordable option to help mitigate out-of-pocket expenses individuals may incur when diagnosed and treated for cancer. These costs can include medical plan deductibles, co-payments, and co-insurance. It can also include non-medical expenses such as loss of income, transportation to treatment centers, groceries, rent or mortgage payments, childcare, or hiring help to complete daily chores. These plans are typically lump sum payouts, which are tax free, and can be used for just about anything. To learn more about these plans and speak to a licensed insurance agent in your area, click here or enter your zip code below.
Heart and Stroke Plan
Heart and Stroke insurance was created as an option to help mitigate out-of-pocket expenses individuals may incur when diagnosed and treated for certain heart conditions or stroke. These costs can include medical plan deductibles, co-payments, and co-insurance. It can also include non-medical expenses such as loss of income, transportation to treatment centers, groceries, rent or mortgage payments, childcare, or hiring help to complete daily chores. These plans are typically lump sum payouts, which are tax free, and can be used for just about anything. To learn more about these plans and speak to a licensed insurance agent in your area, click here or enter your zip code below.
Dental insurance is designed to lower the out-of-pocket expenses associated with the upkeep and repair of your teeth. Dental plans can vary greatly, and many factors should be considered when purchasing the right dental coverage. Some factors to consider are negotiated rates, network of dentists, waiting periods, co-payments/co-insurance, and cost. Dental insurance can be purchased as a stand-alone plan or can be added to certain Medicare advantage plans with no additional cost. To learn more about your options, speak to a licensed insurance agent in your area by clicking here or entering your zip code below.
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