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What Is Medicare?

What Is Medicare?

If you or a loved one is eligible for Medicare soon, now is the time to understand how Medicare works. Choosing Medicare coverage is an important decision and there are many things to consider when finding a plan that meets your individual health insurance needs. Understanding all of the different parts of Medicare and options can be complicated, but ABC Insurance Agencies is here to help! By uniting with the Medicare experts at Medicare.org, we’re making it easy for you to research, compare, buy, and enroll in the right health insurance plan at the right price. Start comparing Medicare plans today and call 1-844-961-9452 – TTY 711 to speak with a licensed sales agent to learn more.

Medicare is a federal health insurance program for qualified individuals age 65 and older, and for some people under the age of 65 with certain disabilities or those who have permanent kidney failure.

Medicare has four primary parts: Part A, B, C, and D. Whether you decide to get your benefits through Original Medicare or a Medicare Advantage Plan, understanding the benefits of each can help you make these important choices. Here is some basic information to help get you started:

Medicare Part A

Medicare Part A is often referred to as “hospital insurance.” Medicare Part A helps cover the costs of hospital care, skilled nursing facility care, nursing home care, hospice, and home health services. Most people who paid taxes while working are eligible for premium-free Part A. If you aren’t eligible for premium-free Part A benefits, you may be able to purchase Part A coverage.

Some people are automatically enrolled in Part A, including:

  • Individuals already getting benefits from the Railroad Retirement Board (RRB) or Social Security
  • Individuals under the age of 65 with a disability
  • Individuals with ALS (also known as Lou Gehrig’s Disease)
  • If you are automatically enrolled, you will receive your Medicare card in the mail three months before your 65th birthday, or your 25th month of disability

Some people need to sign up for Part A, including those who are still working and do not receive Social Security or RRB benefits, and those who qualify due to ESRD.

Medicare Part B

Medicare Part B is also known as “medical insurance.” Part B covers medically necessary services and supplies that meet accepted standards of medical practice and are needed to diagnose or treat a medical condition. Part B also covers preventive care, which can include important vaccinations, screenings, and annual wellness visits.

Part B provides benefits including coverage for:

  • Durable Medical Equipment (DME)
  • Ambulance Services
  • Clinical Research
  • Mental Health Services (including inpatient and outpatient care)
  • Second Opinions (before surgery)
  • Most people pay a monthly premium for Part B, as well as an annual deductible. If you do not sign up for Part B when you are first eligible and decide to enroll later, you may have to pay a late enrollment penalty.

Medicare Part C

Part C, also known as a “Medicare Advantage Plan,” is health insurance offered by private companies that contract with Medicare in order to provide you with your Part A and Part B benefits. Medicare Advantage Plans include:

  • Health Maintenance Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Private Fee-for-Service Plans
  • Special Needs Plans (SNPs)
  • Medicare Medical Savings Account Plans
  • Medicare Advantage Plans must include the same Part A and Part B coverage offered by the federal program, but many offer additional benefits, including vision and dental care, hearing exams, fitness club memberships, and prescription drug coverage.

Medicare Part D

Part D, or prescription drug coverage, is an essential component to your Medicare health care coverage. Prescriptions are not covered by Part A or Part B, or by Medicare Supplement Plans (Medigap). Without any coverage, the cost of medications you require to maintain or improve your health could be financially overwhelming.

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP), runs for approximately seven weeks from October 15th through December 7th. During this period, Medicare beneficiaries can make changes to their existing Medicare plan or enroll for the first time if they missed their seven-month Initial Enrollment Period (IEP).

When you’re ready to take the next step, ABC Insurance can help you choose the best Medicare coverage for your needs. Call a licensed sales agent at 1-844-961-9452– TTY 711 with your Medicare questions, or visit the Medicare experts at Medicare.org to learn more! Standard call center hours of operation are Monday – Friday 5:00 am to 6:00 pm PT. During AEP, our extended hours are Monday – Saturday 5:00 am to 8:00 pm PT.

*Medicare.org is a non-government site and is operated by HealthCompare Insurance Services, a licensed health insurance agency certified to sell Medicare products. It contains information about and access to insurance plans for Medicare beneficiaries, individuals soon eligible for Medicare and those advising on behalf of Medicare beneficiaries. Medicare.org is not endorsed by the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency. If you’re looking for the government’s Medicare site, please navigate to www.medicare.gov. HealthCompare Insurance Services, Inc. is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and Medicare Prescription Drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1, of each year. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan’s nondiscrimination policy, please click on the carrier’s link below.

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