An essential guide
to your Medicare options
Want to make smart Medicare choices? Start here.
If you are ready to
enroll in Medicare now, or soon will be, it is important to understand what it
does and does not cover. This booklet from Blue Cross and Blue Shield of
Texas, a Division of Health Care Service Corporation, tells you more
about Medicare. You’ll learn about your options for coverage. This booklet can
help you get ready to select the Medicare health plan that is right for you.
How Medicare works:
Original Medicare doesn’t cover everything.
Original Medicare doesn’t cover everything.
Original Medicare was
not designed to cover all of your health care costs. It covers only about 80%
of your hospital and medical costs. You may be responsible for paying the other
20%.*
Most prescriptions
aren’t covered by Original Medicare. You must get that coverage in a separate
plan.
Introduction to Medicare
There are four parts
to Medicare, each providing coverage for different types of health care
services.
Part A is hospital coverage.
Part A helps cover your inpatient care in
hospitals, including critical access and long-term care hospitals, skilled
nursing care and hospice. Most people automatically get Part A without having
to pay a monthly premium.
Part B is medical coverage.
Most Medicare beneficiaries pay a premium
for Part B coverage. Part B helps cover medical services like doctors’ office
visits and outpatient care when they are medically necessary. You pay the Part
B premium each month.
Part A and Part B are considered Original Medicare.
Part C is Medicare Advantage.
Medicare Advantage is managed care that
combines Part A, Part B, and usually Part D.† Medicare
oversees private insurers who manage your coverage. These plans may offer
benefits beyond Original Medicare. The plans are usually Health Maintenance
Organizations (HMO) or Preferred Provider Organizations (PPO) with provider
networks to help manage costs.
Part D is prescription drug coverage.
Part D coverage is designed to help lower
your prescription drug costs. Part D coverage is available as a stand-alone
plan or may be included as part of a Medicare Advantage plan.
Medicare Supplement Insurance Plan ‡^
A Medicare Supplement Insurance Plan is
designed to help fill the gaps in Original Medicare. It does not include
prescription drug coverage so you may want to add a Part D plan to complete
your coverage if you choose this option. Medicare Supplement Insurance Plans
are generally accepted by any provider that accepts Medicare. The best time to
buy a Medicare Supplement insurance policy is around the time you turn 65. You
have guaranteed acceptance during the six-month Open Enrollment Period that
begins on the first day of the month in which you turn 65 and are enrolled in
Medicare Part B. If you are under age 65, have Medicare Part A and are within
the six months following your enrollment for Medicare Part B, your acceptance
is guaranteed for Plan A. If you are under age 65 and on Medicare, you will
also have a six-month Open Enrollment Period when you reach age 65, beginning
on the first day of the month in which you turn 65. In any scenario, you must
have Medicare Part B to be eligible for a Medicare Supplement insurance policy.
You cannot have a Medicare Advantage Plan
and a Medicare Supplement Insurance Plan at the same time.
* Source:
Medicare 2019 costs at a glance; Medicare.gov.
† Medicare
Advantage plans usually require you to use network hospitals and doctors for
maximum coverage and in non-emergency medical situations.
‡ You are free to
use any hospital or physician that is a Medicare contracted provider.
^ Not connected with or
endorsed by the U.S. Government or Federal Medicare Program.
No comments:
Post a Comment