What is Original Medicare?
Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them. When you get services, you’ll pay a deductible at the start of each year, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate drug plan (Part D).
Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S.
Who is the Medicare federal health insurance program for?
• People who are 65 or older
• Certain younger people with disabilities
• People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
What is Medicare Advantage?
Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Most plans offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more. Medicare Advantage Plans have yearly contracts with Medicare and must follow Medicare’s coverage rules. The plan must notify you about any changes before the start of the next enrollment year.
How do I get Parts A & B?
Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. It mainly depends on whether you’re getting Social Security benefits. Contact us to see which category you fall into.
What's not covered by Part A & Part B?
• Long-term care (also called custodial care )
• Most dental care
• Eye exams related to prescribing glasses
• Cosmetic surgery
• Hearing aids and exams for fitting them
• Routine foot care
What is Part B late enrollment penalty?
If you didn't get Part B when you're first eligible, your monthly premium may go up 10% for each 12-month period you could've had Part B, but didn't sign up. In most cases, you'll have to pay this penalty each time you pay your premiums, for as long as you have Part B. And, the penalty increases the longer you go without Part B coverage. Contact us to see if you meet a SEP period to avoid penalties.
What are the three Special Needs Plans (SNP)?
Chronic Condition SNP (C-SNP): You have one or more of these severe or disabling chronic conditions.
Institutional SNP (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home.
Dual Eligible SNP (D-SNP): You have both Medicare and Medicaid.
If you have any additional questions please contact us or go to medicare.gov.
Not affiliated with Medicare or any government agency.