ABC's of Medicare

Medicare made easy:  Original Medicare covers hospital and medical insurance (known as Part A & Part B) and these parts come from the federal government

There are 2 ways to get Part D prescription drug coverage 1 a stand alone prescription drug plan (PDP) or a Part C (Medicare Advantage plan) that includes prescription coverage.  To get a stand alone Part D plan you must be enrolled in either Part A or Part B.  To get a Part C plan you must be enrolled in Part A & Part B

Part A & B doesn’t cover everything i.e. it doesn’t cover prescriptions, routine dental, vision or hearing.

Your healthcare cost can vary always review your premiums, copay and coinsurance before selecting a plan

Medicare Supplement Plans may help cover some of the cost original Medicare doesn’t cover

Part C plans

Note: you may have to pay more for Part A, B & D if you don’t enroll when first eligible or if you don’t qualify for a special enrollment period.

Medicare Part A

Medicare Part A is often referred to as ‘hospital insurance.’ In-patient hospital care, home health care, hospice care, skilled nursing home care (not long-term or custodial) are all covered under Medicare A.

Medicare Part B

Medicare B covers non-hospital healthcare. Routine Dr. visits, preventative services (check-ups, screening, vaccinations, etc.), outpatient services, clinical tests and some diagnostic tests, durable medical equipment, home health visits, preventative care and services, mental health care, equipment or tests administered during outpatient services, clinical research, ambulance services, and some outpatient prescriptions.

Medicare Part C

Medicare C is also commonly known as Medicare Advantage (MA) is an all-in-one solution offered by private insurance companies. They cover the same services as A and B, and many also include part D (prescription drug coverage). Different plans offer different benefits and incentives. Medicare C also gives the added benefit of being able to compare rates, plans, and benefits annually (known as AEP or Annually Enrollment Period). Examples of Medicare C plans are:

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • HMOPOS (HMO Point-of-Service Plans)
  • SNP (Special Needs Plans)
  • PFFS (Private Fee-for-Service Plans)
  • MMSA (Medicare Medical Savings Account)

There is also Medicare D, which we will cover on the following section. For any questions or details concerning Medicare A-C, please reach out to one of our specialists. We realize there is a lot to know, and these are basic outlines- having a specialist on your side can give you the peace of mind of knowing you have an expert on your side to help you find the perfect coverage for you and you loved ones.