Medicare is a federal health insurance program that provides coverage for people who are 65 or older, some younger people with disabilities, and people with End-Stage Renal Disease. Medicare is a fee-for-service health insurance program that has two parts: Part A and Part B.
- Part A: Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
- Part B: Helps cover certain doctors services, outpatient care, medical supplies, and preventive services.
- Part D: Helps cover the cost of prescription drugs, including many recommended shots or vaccines. You can join a Medicare drug plan in addition to Original Medicare, or you can get it by joining a Medicare Advantage Plan with drug coverage.
Once you enroll in Medicare, you have options in how you get your coverage. There are two main ways: Original Medicare and Medicare Advantage.
- Original Medicare: Includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them. When you get services, you’ll pay a deductible, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate drug plan (Part D). Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that Original Medicare doesnt cover, like emergency medical care when you travel outside the U.S. .
- Medicare Advantage: Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D. Medicare Advantage plans may offer some extra benefits that Original Medicare doesn’t cover, like vision, hearing, and dental services. You join a plan offered by Medicare-approved private companies that follow rules set by Medicare. Each plan can have different rules for how you get services, like needing referrals to see a specialist. Costs for monthly premiums and services you get vary depending on which plan you join.
In summary, Medicare is a federal health insurance program that provides coverage for people who are 65 or older, some younger people with disabilities, and people with End-Stage Renal Disease. It has two main parts, Part A and Part B, and also includes Part D for prescription drug coverage. Medicare beneficiaries have the option to choose between Original Medicare and Medicare Advantage for their health coverage.