Medicare explained

Medicare is the federal government’s health care program for older adults and people with disabilities. It is designed to provide people in certain categories with health care benefits that can be used to pay for regular health care. If you are going to be eligible for Medicare soon, this is what you need to know about the program.

What Is Medicare

Medicare is administered by the Social Security Administration. To enroll, you must submit an application to them and wait for approval. Once you enroll, you will have the opportunity to enroll in Part A, Part B, Part C, or Part D benefits.

Medicare Part A

Medicare Part A is the hospital insurance portion of the Medicare program. It pays for treatments administered in hospitals, skilled nursing facilities, and hospices. Part A also covers home health care services in some situations. Medicare Part A does not cover all hospital treatments, so consult with your doctor to learn if the procedure you need is a Medicare approved treatment.

Medicare Part B

Medicare Part B is the medical insurance component of the Medicare program. It covers a variety of medically necessary services as well as some preventive services. For most preventive services, you will have no out-of-pocket costs if you choose to get the services from a health care provider who accepts Medicare assignments. Medicare Part B covers the following health care costs:

  • Clinical research
  • Ambulance services
  • Purchase of durable medical equipment
  • Inpatient, outpatient, and partial hospitalization mental health care
  • Limited outpatient prescription drugs

Medicare Part C (Medicare Advantage)

Part C of Medicare is a bit different from the other parts of the program. This portion of the program is not health care insurance, instead it is a program that administers Medicare Advantage insurance plans. These plans are provided by private insurance companies that have been approved by the Social Security Administration.

Medicare Advantage plans are not like Part A and Part B of Medicare. With Parts A and B, which is commonly referred to as Original Medicare, you are getting your hospital and medical insurance through the government. With a Part C plan, your benefits are administered by a private company that has been approved to offer Medicare Advantage products.

Because Part C plans are sold by private companies, they are allowed to include supplemental benefits that would be otherwise unavailable with the Original Medicare plan. These benefits are designed to make the plans competitive, and include options like prescription drug coverage, transportation benefits, and low or $0 premiums. To find the best Medicare Advantage plan possible, you should work with an insurance agent in your area.

Medicare Part D

Medicare Part D is the component of the Medicare program that provides prescription drug coverage to people that are enrolled in a Medicare plan. Like Part C plans, Medicare prescription drug coverage plans are sold by private insurance companies that are licensed to sell such plans. Each plan covers a specific list of prescription drugs. The drugs that are covered will be listed within their formulary. All Part D plans are required to offer several commonly needed categories of drugs.

They include:

  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • Immunosuppressants
  • Antiretrovirals
  • Antineoplastics

Learn More About Medicare

The Medicare system is complex, and it can be difficult to enroll and shop for plans on your own. For help navigating Medicare, contact Weinstein Wealth Insurance Solutions to schedule a free consultation. We will help you plan your benefits and choose a plan if necessary.