The Medicare Program
Medicare is a health insurance program for:
The Original Medicare Has Two Parts
Part A - Hospital Insurance. (see Medicare Part A)
Most people pay for Part A through their payroll taxes when they are working.
Part B - Medical Insurance. (see Medicare Part B)
Most people pay monthly for Part B.
You can elect to participate in a Medicare Advantage Plan Part C and Medicare Prescription Drug Coverage Part D
Medicare Advantage Plans(see Medicare Part C)
You can choose different ways to get the services covered by Medicare.
Depending on where you live, you may have different choices. In most cases,
when you first get Medicare, you are in the Original Medicare Plan. Or,
you may want to consider a Medicare Advantage Plan (like an HMO or PPO)
that provides all your Part A, Part B, and often Part D (Medicare Prescription
Drug) coverage. You make a choice when you are first eligible for Medicare.
Each year you can review your health and prescription needs and switch
to a different plan in the fall.
Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program, and sometimes called "Part C." When you join a Medicare Advantage Plan, you are still in Medicare. As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan (like an HMO or PPO).
Part D - Prescription Drug Coverage(see Medicare Part D)
Medicare Prescription Drug Plans are offered by insurance companies and other private companies approved by Medicare.
Medicare Health Plans
Today's Medicare is about choice. Your health plan choices include:
Medicare + Choice Plans are available in many areas.
The Medicare health plan that you choose affects many things like cost,
benefits (some have extra benefits like prescription drugs), doctor choice,
convenience, and quality.
What is Medicare Part A?(see Medicare Part A)
Medicare Part A (Hospital Insurance) helps cover your inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. You must meet certain conditions.
Medicare Part A Helps Cover Your Medically Necessary:
Skilled Nursing Facility Care
Home Health Care
What is Medicare Part B?(see Medicare Part B)
Medicare Part B (Medical Insurance) helps cover your doctors' services and outpatient hospital care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.
Most people will continue to pay the same premium they paid last year. The 2015 Medicare Premium for Part B is $121.80 per month. In some cases, this amount may be higher if you didn't sign up for Part B when you first became eligible. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but didn't sign up for it, except in special cases. You will have to pay this extra amount as long as you have Part B.
Medicare Part B Helps Cover Your Medically Necessary:
Medical and Other Services
Clinical Laboratory Services
Home Health Care
Outpatient Hospital Services
What is the Original Medicare Plan?
The Original Medicare Plan is a "fee-for-service" plan. This means you are usually charged a fee for each health care service or supply you get. This plan, managed by the Federal Government, is available nationwide. If you are in the Original Medicare Plan, you use your red, white, and blue Medicare card when you get health care. If you are happy getting your health care this way, you don't have to change. You will stay in the Original Medicare Plan unless you choose to join a Medicare + Choice Plan.
Your costs in the Original Medicare Plan
What you pay out-of-pocket depends on: