What is Medicare?

Medicare as the federal health insurance program for people age 65 and older, and certain younger people with disabilities like End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease. 

  • Medicare Parts A & B are funded by the government. 
  • Parts C & D are provided by private health insurance companies.

Over 61 million people are enrolled in Medicare, according to 2019 data from the Centers for Medicare and Medicaid Services (CMS).1

What Are the Parts of Medicare?

There are four parts of Medicare: Part A, Part B, Part C, and Part D. Each part covers different services.

Medicare terminology can get a little confusing. The different parts are also often referred to in the following ways:

    • Parts A & B combined: Original Medicare
    • Part C: Medicare Advantage
    • Part D: Prescription Drug Coverage

What does Medicare cover?

Each part of Medicare provides different health care benefits:

  • Medicare Part A covers hospital and other inpatient care. Most people qualify for “premium-free” Part A after having worked and paid taxes for a certain amount of time.  
  • Medicare Part B is optional and provides medical insurance that covers doctors visits, lab tests and many other outpatient services along with medical equipment. Part A and Part B together are referred to as Original Medicare.  
  • Part C is also known as Medicare Advantage, and is a set of private health insurance plans designed as an alternative to Original Medicare. These plans must provide at least the same minimum benefits as Original Medicare and may also offer additional benefits.  
  • Part D plans are private Medicare prescription drug plans.

 

Can Medicare Coverage Be Supplemented?

Medicare Supplement Insurance, also known as Medigap, is insurance that helps cover some of the out-of-pocket costs of Original Medicare.

There are generally up to 10 standardized Medigap plans to choose from in most states, and each plan provides a unique set of benefits.

What is a Medicare Supplement?

A Medicare supplement is a type of health insurance sold by private insurers to cover the gaps in Medicare. This is what we refer to the plans as “Medigap Plans.”

It serves to pay for the costs that normally Medicare would pass on to you. Medicare has gaps, like coinsurance, copayments, and deductibles. You must pay for these when accessing medically-approved services.

If you have a supplement policy, Medicare will first pay its share of your medical expenses. Then your policy will step in and pay its share. This is usually the remainder of your bill. However, it depends on which policy you choose from the standard offered plans.

Can I apply for Medicare Supplements without Medicare Parts A and B?

No. You must have Medicare Part A and be already enrolled in Medicare Part B.

What is Not Covered by Medicare Supplement Plans?

Medicare supplements only pay after Medicare has first paid its share. If Medicare approves a claim and pays the part that Medicare owes, it will forward the remainder of the bill to your Medicare Supplement.

Some things that are not covered by Medicare or your Medicare Supplement are:

  • Routine dental, vision and hearing exams
  • Hearing aids
  • Eyeglasses or contacts
  • Long-term care or custodial care
  • Retail prescription drugs

 

Does Medicare pay for Alzheimer’s care?

Medicare covers inpatient hospital care and some of the doctors’ fees and other medical items for people with Alzheimer’s or dementia who are age 65 or older. 

Medicare doesn’t have a special category of coverage for Alzheimer’s disease. And the single most important thing to understand about Medicare coverage for Alzheimer’s patients is that Medicare will pay for up to 100 days of skilled nursing home care under limited circumstances.  Medicare doesn’t pay for long-term care, whether in a nursing home, assisted-living facility, or at home.

Medicare Part D also covers many prescription drugs.

Is Medicare Advantage plan same as Medicare Supplements?

No, Medicare Advantage plan provides your Medicare Part A and B coverage with some additional benefits while Medigap supplements your Original Medicare by paying all or part of the Medicare-approved health care expenses that Medicare did not cover (Medicare excess or gap).

Patriot Medical Supplement will assist you learn more about as well as, what coverage is best for you.

Can I use my Medicare Supplement plan with a Medicare Advantage plan?

Medicare Supplement plans can only be used with Original Medicare (Part A and B). If you currently have Medicare Advantage plan and enroll in a Medigap, you will have to drop your Advantage plan before Medigap start its effectivity.

How to choose a Medigap supplemental policy?

Look at your needs first then check for the various benefits that each Medicare supplement plan offers. Comparing types of plans side by side and requesting a Medicare Supplement quotes will also help you compare and choose a Medigap policy.  

Patriot Medical Supplements provides this service at no cost for you! We help you find the company and Medigap policy perfect for your needs.