Medicare Advantage Plans

Medicare basics

Medicare is a federally funded national health insurance program for those aged 65 and older or individuals with certain disabilities or health conditions. Medicare consists of 4 different parts. Parts A & B together are also called “Original Medicare”.

Medicare Part A

Medicare Part A is also known as Hospital Insurance. Many individuals are eligible for Part A at no premium. If not, Part A is also available to purchase for a monthly premium. There are deductible and coinsurance costs associated with Part A. Some benefits of Part A may include:

• Hospital stays
• Skilled nursing care
• Hospice care
• Does not include long term care

Medicare Part B

Medicare Part B is also known as Medical Insurance. There is a monthly premium for Medicare Part B. It is important to enroll in Part B when first eligible to avoid a late enrollment penalty. There is an annual deductible and coinsurance expenses. Services that may be included under Part B are:

• Physician services
• Outpatient hospital services
• Some home health care
• DME – Durable Medical Equipment
• Preventative care

Medicare Part C – Medicare Advantage

Medicare Advantage Plans are an alternative to Original Medicare (Parts A & B) and are offered by private insurance companies. Plans costs and benefits vary by carrier and may have premiums, deductibles and networks of doctors and hospitals.

• All of the benefits of Original Medicare are included
• May offer additional benefits such as dental or vision
• Prescription drug coverage may be included

Medicare Part D – Prescription Drug Coverage

Prescription Drug Coverage provides coverage for prescription drugs not covered by Original Medicare. Part D may also be included in some Medicare Advantage Plans.

• Part D plans have a formulary of covered drugs
• There are premiums, coinsurance and copayments with Part D Plans
• Purchasing a Part D plan is optional, however, there may be penalties if enrollment is delayed