Medicare and You
What is Medicare?
Medicare is health insurance for people 65 years or older, under age 65 with certain disabilities, and any age with end-stage renal disease (ESRD) or Lou Gehrig’s disease (ALS).
Medicare has four parts:
- Part A – Hospital insurance
- Part B – Medical/Doctor’s insurance
- Part C – Medicare Advantage Plans
- Part D – Prescription Drug Coverage
What does Medicare pay for?
Medicare covers certain medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance). If you have both Part A and Part B, these services and supplies must be covered as long as they are reasonable and necessary for your health, no matter what type of Medicare plan you have. A list of the covered services is found in the “Medicare and You” handbook.
What are my options?
Medicare offers a variety of coverage options:
The Original Medicare Plan
This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare.
Medicare Advantage Plans and Other Medicare Health Plans
These plans, which include HMOs, PPOs, and PFFS plans, may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. However, in some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals.
Medicare Drug Plans
Medicare prescription drug coverage started January 1, 2006. You can get prescription drug coverage no matter how you get your Medicare health care.