Medicare - Basics Explained

Questions come up all the time about what do I do when I hit age 65, and what are my options and what is the best option? Those aren't easy questions to just answer, but I will in this article explain the different options of Medicare and then we can dive into what is best for you when we get together or have a discussion.

First - Medicare part A - Hospital Insurance - this covers the very basics. And covers ONLY hospitals, skilled nursing home care and hospice care. This is what our Medicare taxes through the years paid for and paid into. If you, or your spouse worked and paid into this for 10 years total (40 quarters), this coverage is offered free to you.

Second - Medicare part B - Medical Insurance - this covers doctor visits, outpatient services, medical supplies, etc. This will require a monthly premium for this coverage.

Third - Medicare part C- Medicare Advantage - Private insurance alternatives to Original Medicare, offering "bundled" plans that include Part A, Part B, and often Part D (prescription drugs). These plans may offer extra benefits like dental, hearing, and vision.

Fourth - Medicare part D - Prescription Coverage - A separate, optional plan provided by private insurance to cover costs of medications. With this coverage you want to be sure and look up - or go through - your current prescriptions to be sure they are covered when choosing the correct plan for you.

Then there is also the option of purchasing Medi-Gap Insurance - which as it states in the title will cover the gaps in your insurance coverage. Private plans that cover the 20% of costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles. 

Medicare Comparison

Feature	Original Medicare (A & B)	Medicare Advantage (Part C)
Provider	Federal Government	Private Insurance
Drug Coverage	Must buy separate Part D plan	Often included
Doctor Choice	Any doctor who takes Medicare	Usually limited to networks
Extra Benefits	No (e.g., Dental/Vision)	Often included

• Note: You cannot have both a Medi-gap plan and a Medicare Advantage plan at the same time. 

• For financial advice, consult a pro- give us a call