Most people turn to Medicare, the federal insurance program for people over 65, and some people under 65 with certain disabilities.
First, you must learn about how Medicare is structured. Medicare has 4 parts, lettered A, B, C, D.
Part A (hospital insurance) does not have a premium for eligible individuals, but does have cost sharing amounts (deductibles, coinsurances) that are paid by the beneficiary when care is received.
Part B (medical insurance) of Medicare is optional coverage and charges a premium, which is adjusted each year by the federal government to cover costs. Premiums for Part B are means tested higher incomes translate to a higher premium based on an established table of values. Part B also uses cost sharing in the form of deductibles, coinsurance, and excess charges.
Medicare pays for medical care based on reimbursement schedules determined by the federal government for all approved medical care.
Another part of Medicare is Part C. This allows private insurance companies to offer plans that cover all Medicare-covered services, and more benefits that may not be covered by Medicare. Many Part C plans are structured like HMOs or PPOs.
Part D of Medicare pays for outpatient prescription drugs, a benefit not included with Original Medicare. Multiple plans are available, with varying benefits and premiums. Part D is also means tested.
As Medicare does not pay full compensation for care, the beneficiary is responsible for cost sharing out of their own pocket. To address this, Medicare beneficiaries can seek to improve their benefits using additional coverages Medicare Supplement (Medigap) plans or Medicare Advantage plans.
Our 2021 Medicare Overview pamphlet is now available.
Please fill out the simple form below to download this informative PDF.
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The costs of non-Medicare covered health care costs (ie. dental, vision, hearing etc) must also be considered, and we will examine and can suggest coverages in these areas as well.