What is Medicare? 

 

Medicare is the federal government program through which almost everybody who is age 65 and older receives their healthcare. Many people under the age of 65 also receive their medical coverage through Medicare if they have been determined to be disabled by the Social Security Administration.  Those with End-stage Renal Disease and ALS/ Lou Gehrigs Disease may also qualify for Medicare.

 

Although Medicare provides comprehensive in-patient and out-patient medical care, there are still significant out-of-pocket risks with Medicare alone. Medicare does not provide the protection of an out-of-pocket maximum for the cost of your medical care each year, and it does not provide any benefits for prescription medications at the pharmacy.

 

Most Medicare recipients will be interested in obtaining additional coverage to provide protection against the costs that Medicare does not cover.



 

Medicare Advantage VS. Medicare Supplement:

 

Medicare Advantage (MA) plans are Medicare health plans offered by private insurance companies contracted and overseen by the federal government.  Medicare Advantage plans provide Hospital (Part A) and Medical (Part B) coverage, and some plans include Medicare Prescription Drug (Part D) coverage. Medicare Advantage plans may also have additional benefits such as Vision, Dental, Gym Memberships, Acupuncture and Chiropractic services.  

 

Medicare Advantage plans may offer lower monthly plan premiums and some MA plans may have a $0 monthly plan premium.

 

All MA Plans must provide benefits equivalent to Original Medicare, and most plans also provide additional benefits


 

Medicare Supplement Plans fills in the gaps in Original Medicare coverage.

 

Original Medicare pays for much, but not all, of the cost for health care services and supplies.  Medicare Supplement or sometimes called Medigap policies, sold by private companies, can help pay some of the remaining health care cost for covered services and supplies, like copayments, coinsurance and deductibles.


 

Medicare Part D [Prescription Drug Plans (PDP)] is a government program that helps Medicare Beneficiaries cover some of the cost of prescription drugs. 


 

Medicare Extra Help/ Low Income Subsidy (LIS): Helps members with limited income and resources cover their part D premiums and Part D related out-of-pocket cost. Apply on the SSA website.

Click Here to apply.

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