![]() ![]() Medicare Part B (Medical Insurance) - Part B helps cover doctors' services and outpatient care. Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Beneficiaries must meet certain conditions to get these benefits. It also helps cover hospice care and some home health care. Medicare Part A (Hospital Insurance) - Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). Medicare has different parts that help cover specific services: People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).People under age 65 with certain disabilities.He has focused much of his career on health equity and improving access to care, and his expertise around these issues led Fernández to be included as a speaker at a White House Conference on Aging in 2015.Medicare is a health insurance program for: He has more than two decades of experience in management and executive-level positions in the healthcare industry, with an emphasis on the growth and expansion of Medicare and Medicaid products. ![]() You may be eligible to get Medicare earlier than age 65 if you have a disability, end-stage renal disease (ESRD), or ALS (also called Lou Gehrig’s disease).įrank Fernández leads Capital BlueCross’ government programs, including Medicare, the federal health insurance marketplace and the Children’s Health Insurance Program. This will ensure benefits begin on your birthday and you’ll have your Medicare coverage when you need it. A plan offering a zero or low monthly premium and higher out-of-pocket costs may end up costing more over time than a plan with a slightly higher monthly premium but lower out-of-pocket costs.īe sure to enroll in Medicare Parts A and B three months before you turn 65. An important reminder at this point: carefully consider the bottom line. This will help you assess what each plan offers and costs. Next, add a column for each plan you’re considering, and answer the questions from your list. Are prescription drugs covered? And are my prescriptions available as lower-cost generics?.What other benefits do I want/need? (Be specific and list everything, like hearing aids, certain dental services, eyeglasses, etc.).For this, it’s helpful to make a list of things you want from your policy and any questions you have, such as: Once you know the different parts and options, the next step is putting together coverage that suits your health and wellness needs. You cannot have a Medicare Supplement policy if you have Medicare Advantage plan. Medigap, or Medicare Supplement is extra coverage you can purchase to cover the costs original Medicare (Parts A and B) doesn’t cover (i.e., the remaining 20%). Prescription coverage is offered separately for those who have Parts A and B, but typically is included with Part C plans. Part D plans can have a deductible, copayments or coinsurance amounts due each time a prescription is filled at a pharmacy. Part D benefits, and the premium, could be included in a Part C plan. Part D (prescription drug coverage) offers insurance for prescription medications. HMO plans require you to use network providers for your care to be covered (except for emergency/urgent care). Health Maintenance Organization (HMO) – You select a primary care physician (PCP) who will assist you with coordinating your care. However, it may cost more to get care from out-of-network providers except for emergency/urgent care. Preferred Provider Organization (PPO) – PPO plans provide you with the flexibility to obtain care wherever you are since they include in-network and out-of-network coverage. If you choose a Medicare Advantage plan, you still have to pay your Part B monthly premium. They typically have a low or no-cost premium. They also can include additional services like, vision, dental, over-the-counter items, and fitness. Part C (Medicare Advantage) plans, offered privately through health insurance companies, must cover everything Parts A and B cover, and most include Part D prescription drug coverage. You pay an annual deductible and 20% coinsurance. Part B covers doctor’s visits, preventive services, urgent and emergency services, medical equipment and supplies, X-rays and outpatient care. There is typically no monthly premium if you’re eligible. Part A covers in-patient hospital care, skilled nursing care, home healthcare, and hospice care. Frank Fernández is the senior vice president of government programs at Capital Blue Cross. ![]()
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