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Medicare Overview

 

 

Medicare provides protection against the costs of many health care services, but traditional Medicare has relatively high deductibles and cost-sharing requirements and places no limit on beneficiaries out-of-pocket spending for services covered under Parts A and B.

 

Medicare does not pay for some services that are important for older people and people with disabilities, including long-term services and supports, dental services, eyeglasses, and hearing aids.

 

The Medicare program consists of four different parts which are A, B, C, and D

 

Part A covers inpatient hospital stays, skilled nursing facility stays, some home health visits, and hospice care. Part A benefits are subject to a deductible. Beneficiaries are subject to coinsurance amounts for extended inpatient stays in a hospital or skilled nursing facility.

 

Part B covers physician visits, outpatient services, preventive services, and some home health visits. Part B benefits are subject to a deductible, and most Part B benefits are subject to coinsurance of 20 percent. No coinsurance or deductible is charged for an annual wellness visit or for preventive services that are rated A or B by the U.S. Preventive Services Task Force.

 

Part C refers to the Medicare Advantage program through which beneficiaries can enroll in a private health plan, such as a health maintenance organization (HMO) or preferred provider organization (PPO), and receive all Medicare-covered Part A and Part B benefits and typically Part D benefits.

 

Part D covers outpatient prescription drugs through private plans that contract with Medicare, including both stand-alone prescription drug plans and Medicare Advantage drug plans. Enrollment in Part D plans is voluntary. The benefit helps pay for enrollees drug costs after a deductible is met, and offers catastrophic coverage for very high drug costs. Enrollees pay monthly premiums and cost sharing for

prescriptions which vary by plan.

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This website is a private website and is not associated, endorsed or authorized by the Center for Medicare and Medicaid Services, nor do we claim to be. This site contains basic information about Medicare Supplement insurance for people with Medicare. If you would like to find more information about the Medigap program, please visit the Official US Government Site located at www.medicare.gov.