Medicare is a federal health insurance program for people 65 years old or over and
for certain disabled people under 65 years of age. You are automatically enrolled
in Medicare hospital insurance (Part A) when you apply for Social Security benefits
— usually upon reaching 65 years of age. Part A covers inpatient care in a
hospital or a limited stay in a skilled nursing facility. Part B covers physician
and outpatient hospital services.
The premium you pay for Part B is deducted from your Social Security benefits. Medicare
pays for many health care services and supplies, but it doesn't cover all of your
health care costs. For example, you pay a deductible for each hospital stay and
coinsurance anytime you use the services of a physician or surgeon. Also, drug coverage
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company
that contracts with Medicare to provide you with all your Part A and Part B benefits.
This type of health
plan is an alternative to Original Medicare and was created by the Balanced Budget
Act of 1997 and the Medicare Modernization Act of 2003. Some examples of Medicare
Advantage plans are:
- Medicare Health Maintenance Organization plans (HMO)
- Medicare Preferred Provider Organization plans (PPO)
- Medicare Private Fee-for-Service plans (PFFS)
- Specials Needs Plans (SNP)
- Medicare Medical Savings Account Plans (MSA)
Medicare Advantage plans can feature prescription drug benefits, have fixed costs, limits
on out-of-pocket expenses, and worldwide coverage for emergency and urgent care.
An HMO is an alternative to Original Medicare and features specific lists of doctors,
hospitals, and other providers that you must use to receive benefits. HMOs often
provide additional benefits not found in Original Medicare, including coverage for
deductibles, steep reductions in coinsurance when you use doctors, a drug benefit
plan and wellness or fitness programs. If you select a Medicare Advantage HMO, it
replaces your Original Medicare coverage. However, you can return to Original Medicare
down the road if you wish.
For additional information on Medicare click on their link: www.medicare.gov