Medicare 101

Medicare is designed to help different groups:

• Individuals aged 65 or older
• Certain younger people with disabilities
• People with End-Stage Renal Disease

It’s essential to know that Medicare itself only covers 80% of hospital and medical services, and the remaining 20% is the beneficiary’s responsibility. However, there are insurance plans you can obtain to help cover that cost. Also, coverage for dental, vision, and hearing services are not included in Original Medicare benefits.

Medicare is divided into separate parts.

• Part A: Covers hospital expenses (known as Original Medicare)
• Part B: Addresses medical services such as doctor’s visits, durable medical equipment, and some vaccines (also part of Original Medicare)
• Part C: Also called Medicare Advantage. These plans are offered by third parties, provides comprehensive coverage and often include prescription drug coverage.
• Part D: Provides standalone prescription drug coverage.

While not officially labeled with a Part in Medicare, supplemental plans, also known as Medigap plans, are a standard option for managing your Medicare health care coverages. These plans supplement the 20% cost share of Original Medicare. They do not cover prescription drugs, dental or vision.

Medicare has specific times that you can sign up for coverage. These are known as enrollment periods. There are two kinds of enrollment periods, ones that happen annually and ones that open for specific circumstances.

Enrolling at the proper time is important. Medicare does assign late enrollment penalties for Part A, Part B and Part D. These penalties can be permanent and can increase the cost of your medical expenses.

If you have financial constraints, you may be eligible for financial assistance with your prescription drug costs. If you already receive both Medicare and Medicaid, you may be able to enroll in a special plan designed to help you increase your preventative health services. Or if you have a chronic health condition, some areas have special plans to help you manage your health.

We look forward to helping you with all of your Medicare and healthcare related questions, plan selection and enrollment needs.