The Essential ABCs (and D!)
of Medicare
The
Medicare program was designed in four parts, each part covering a different
benefit category. As a Medicare eligible person, you will likely need and use a
combination of these services depending on your health and as you get older.
Part A – Hospital Coverage
Most
people who qualify for Medicare automatically get Part A coverage without
having to pay a premium. Part A includes inpatient hospital care, long-term
care in hospitals and treatment in a critical access hospital.
Part B – Medical Coverage
Part
B covers your medically necessary doctors’ services and outpatient care. A
premium for Part B is deducted from your social security check each month to
help pay the cost of this coverage.
Part C – Medicare Advantage
Plans
If
you have part C, your coverage is provided by a private health plan called a
Medicare Advantage plan. The health plans are contracted with Medicare. The
coverage includes everything covered under Part A and Part B, except hospice
care (original Medicare continues to cover hospice care). Often, the plans include Part D
prescription benefits at no extra costs. The plans may include
additional benefits not available with Original Medicare, such as vision, gym membership,
transportation and more.
Part D – Prescription Drug
Coverage
This coverage is available as a stand-alone plan
or may be included in a Medicare Advantage plan. To learn more and have your
questions answered, contact your local licensed insurance agent. You may also
desire to attend an upcoming Medicare 101 session taught by local area licensed
insurance agents. To find an
event near you, click here.
Choosing Coverage Based on
Your Health Needs
Choosing Original Medicare
Only. This
means that you have Medicare Part A and/or Medicare Part B only. Keep in mind,
Medicare does not cover 100% of your medical and hospital costs, which will
require you to meet a deductible and then pay a percentage of the cost of your
care. Original Medicare also does not provide coverage for prescription drugs.
For this, you need an additional standalone plan that may charge an expensive
monthly premium.
Purchasing a Medicare
Supplement. The supplement provides additional, variable
coverage to fill in part or all the gaps or costs not covered by Original
Medicare, but the cost to you may be an expensive monthly premium.
Selecting a Medicare
Advantage plan. A Medicare Advantage plan
(Medicare Part C) includes all the healthcare benefits you are entitled to
under Original Medicare, and may include additional coverage like vision, hearing, dental
and prescription drug coverage or provide monies toward over-the-counter
supplies. Some Medicare Advantage plans
may come with a $0 premium. Medicare
Advantage plans can, however, choose not to cover the costs of services that
are not medically necessary under Medicare. Medicare Advantage plans contract with the federal government to provide
coverage to you, so you are still in the Medicare program, but you don’t need
to use your Medicare card when you obtain medical services.
To
learn more and have your questions answered, contact your local licensed
insurance agent. You may also desire to attend an upcoming Medicare 101 session
taught by local area licensed insurance agents. To find one near you, click here.
Why Medicare Advantage May
Be A Good Choice for Patients Who Are Over 65
Many
Medicare Advantage plans offer benefits that are ideal for helping you afford
good healthcare coverage for current and future healthcare needs.
If
you find that you spend a lot of money on healthcare for things like specialist
visits, prescriptions and testing, a Medicare Advantage plan can help lower
these costs with affordable copays on these services. A copay is a set, fixed
amount of money that you pay as your share of the cost of care. You are still
required to pay a monthly Part B premium as part of a Medicare Advantage plan
but may find Medicare Advantage plans with premiums as low as $0 per month.
Buffalo
Medical Group participates in a special program called Senior Care Advantage
ONE in partnership with
Medicare Advantage plans. When
you select one of these plans, you have access to a new approach to care delivery
that focuses on keeping you healthy and helping coordinate care resources when
you need them.
To
learn more and have your questions answered, contact your local licensed
insurance agent. You may also desire to attend an upcoming Medicare 101 session
taught by local area licensed insurance agents. To find an event near you, click here.
What is Included in a
Medicare Advantage Plan?
Medicare
Advantage plans offer a variety of benefits designed to help members save on
their healthcare spending. An experienced advisor can help review the benefits
of each plan and help find the right one for you. One way to do this is to make
an appointment with a licensed agent, who can help you compare plans and
understand which providers belong in the network and what the cost of any
medications you are currently taking would be. If you see a healthcare provider
that doesn’t belong to the plan, your services may not be covered, or your costs
could be higher.
To
find a plan that is right for you and continue receiving care from your Buffalo
Medical Group primary care physician, contact your local licensed insurance
agent. You may also desire to attend an upcoming Medicare 101 session taught by
local area licensed insurance agents. To find an event near you, click here.
Medicare Advantage: Saving
on Hospital Care, Prescription Drugs and other Health Care Expenses
Receiving
health care at a hospital can be very costly. However, many Medicare Advantage
plans offer low copays on physician visits and include a limit on how much you
pay for these services.
Each
Medicare Advantage plan can charge different out-of-pocket costs, making it
even more important to compare benefits and find the plan that is right for
your needs and budget. Original Medicare does not cover prescriptions and
adding a supplemental prescription plan can often cost you more in monthly
premiums. However, many Medicare Advantage plans include prescription coverage
for no additional cost.
Medicare
Advantage plans can offer a number of additional benefits for you that are not offered in Medicare Parts
A and B (Original Medicare). They may include dental, vision and hearing
coverage, as well as extra benefits designed to help members save money and
stay healthy including:
- Gym membership
- Nutritional programs
- Transportation to and from medical appointments
- Over-the-counter medical supply allowances
To
find a plan that is right for you and continue receiving care from your Buffalo
Medical Group physician, contact your local licensed insurance agent. You may also desire to
attend an upcoming Medicare 101 session taught by local area licensed insurance
agents. To find one near you, click here.