Medicare is a federal health insurance program that covers a variety of health care expenses for qualifying individuals. The program is available to seniors who are 65 years or age or older as well as adults with certain qualifying medical conditions or permanent disabilities. At Horizon, we work closely with individuals and families to provide solutions for all their Medicare needs.
When you are eligible for Medicare, you can choose how to get your coverage by either going through Original Medicare (Part A and Part B) with a separate Prescription Plan (Part D) and the ability to purchase a Medicare Supplement Plan (Medigap) or you can purchase a Medicare Advantage Plan (Part C) that will take over for Original Medicare.
Let’s take a look at your options in more detail.
Medicare Part A is hospital insurance that covers inpatient hospital care, care in a skilled nursing facility, hospice care, and home health care services. There is no premium associated with this part of Medicare if you or your spouse have worked at least 10 years and have paid Medicare taxes during that time. If you do not meet these requirements, you can still qualify but you will need to pay a premium which will be determined by Social Security.
Medicare Part B is medical insurance that covers non-hospital related expenses. This includes doctor visits, outpatient care, blood tests, durable medical equipment, and various preventative services. There is a monthly premium that will be due for Medicare Part B. For those with low income, Medicaid can help cover these premiums. If you do not sign up when you are first eligible, you may face a penalty.
Medicare Part D is coverage for prescription drugs that can be added to Medicare Parts A and B. This coverage is available through private insurance companies approved by the Centers for Medicare and Medicaid Services (CMS). If you do not sign up when you are first eligible, you may face a monthly penalty.
Medicare Supplement plans (Medigap) help fill in the gaps on what Original Medicare doesn’t cover and is sold by private insurance companies. A Medicare Supplement plan can help pay for the remaining health care costs which can include deductibles, copayments, and coinsurance. Medicare Supplement plans offer the most flexibility on which doctors you can see (especially if you travel) and do not require a referral to a specialist.
Medicare Part D coverage is not included in a Medicare Supplement plan so you will need to purchase a separate prescription drug plan.
Medicare Part C, or Medicare Advantage, is Medicare coverage offered through private insurance companies. This is an “all in one” alternative to Original Medicare where all parts of Medicare are bundled together (Part A, Part B, and most of the time Part D) into one specific plan. Most Medicare Advantage plans will require you to stay within a specific doctor network to receive coverage for non-emergency care and you may be required to get a referral to see a specialist. These plans could be lower in premium compared to Medicare Supplements but may have higher out of pocket costs. Also, Medicare Advantage plans could offer extra benefits that Original Medicare does not cover such as dental, vision, and hearing.
No matter what type of coverage you may need, Horizon can help you find the Medicare plan that is right for you. If you need Medicare coverage of have any questions, feel free to contact one of our agents today!
"Horizon Insurance Agency, LLC is not connected with or endorsed by the United States government or the federal Medicare program"