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What is Medicare?
Medicare is a health insurance program for:
People age 65 and over
People under 65 with certain disabilities
People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)
Since 1965, Medicare has helped millions of Americans pay for the health care services they need. You likely have already paid into the program through Social Security.
Part A
Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care
Part B
Medicare Part B (Medical Insurance) covers, including doctor and other health care providers' services and outpatient care. Part B also covers durable medical equipment, home health care, and some preventive services.
Part C
Medicare Advantage sometimes called "Part C" – includes both Part A (Hospital Insurance)and Part B (Medical Insurance).
A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. Medicare Advantage Plans include:
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Health Maintenance Organizations
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Preferred Provider Organizations
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Private Fee-for-Service Plans
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Special Needs Plans
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Medicare Medical Savings Account Plans
If you’re enrolled in a Medicare Advantage Plan:
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Most Medicare services are covered through the plan
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Medicare services aren’t paid for by Original Medicare
Most Medicare Advantage Plans offer prescription drug coverage
Part D
Each Medicare drug plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.
A drug in a lower tier will generally cost you less than a drug in a higher tier. Your prescriber may think you need a drug that's on a higher tier. If so, you or your prescriber can sometimes ask your plan for an exception to get a lower copayment.
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Medicare Supplement (Medigap)
A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
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Copayments
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Coinsurance
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Deductibles
Medigap policies are sold by private companies.
Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:
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Medicare will pay its share of the Medicare-approved amount for covered health care costs.
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Then, your Medigap policy pays its share.
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