Understanding Medicare

What is Medicare?

Medicare is a national health insurance program in the United States. It began in 1966 under the Social Security Administration (SSA).  Centers for Medicare and Medicaid Services (CMS) now administers the plan.

It primarily provides health insurance for Americans aged 65 and older. Some younger people with disability status as determined by the Social Security Administration also receive benefits.  There are also some exceptions for people with end stage renal disease and ALS.

Who is Enrolled in Medicare?

According to the 2019 Medicare Trustees Report, Medicare provided health insurance for over 59.9 million individuals.  More than 52 million people aged 65 and older and about 8 million younger people.

What Are My Medicare Options?

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare:

1. Original Medicare

      • Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
      • If you want drug coverage, you can join a separate Part D plan.
      • Out-of-pockets costs like coinsurance apply to your care.  To help pay your out-of-pocket costs you can shop for and buy supplemental coverage.
      • You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

2. Medicare Advantage (Part C)

      • Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
      • Plans may have lower out-of-pocket costs than Original Medicare.• In most cases, you’ll need to use doctors who are in the plan’s network.
      • Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, dental, and more.

Medicare covers about half of healthcare expenses of those enrolled. Enrollees almost always cover most of the remaining costs by taking additional private insurance and/or by joining a public Part C or Part D Medicare health plan.

What is Medigap?

Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. These are “gaps” in Medicare coverage. A Medigap policy is an insurance policy that helps supplement Original Medicare and is sold by private companies. A Medigap policy can help pay some of the remaining health care costs that Original Medicare doesn’t pay for covered services and supplies, like copayments, coinsurance, and deductibles.

For more detailed information visit Medicare.gov to get started.

 

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