Medicare Advantage Plans ; If you have Part A and Part B, you can join a Medicare Advantage Plan, sometimes called “Part C” or an “MA plan.” This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). What should I know about Medicare Advantage Plans? · Insurance companies can decide if a plan will be available to everyone with Medicare in a state, or only in ce...
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private insurance company to help pay your share of costs in Original Medicare.
Part B helps cover: Services from doctors and other health care providers · Outpatient care · Home health care · Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment) · Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
If you have Medicare and other health insurance, each type of coverage is called a "payer." The "primary payer" pays up to the limits of its coverage, then sends the rest of the balance to the "sec...
The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs the Medicare Program. CMS is a branch of the Department of Health and Human Services. ; CMS also monitors Medicaid programs offered by each state. ; In 2023, Medicare covered over 66.7 million people. Total expenditures in 2023 were just over $1 trillion. This money comes from the Medicare Trust Funds.
Medicare coverage is based on 3 main factors: ; Federal and state laws. ; National coverage decisions Medicare makes. ; Local coverage decisions made by Medicare claims processing companies in each state. These companies decide if something is medically necessary and Medicare should cover it in their area.
With Original Medicare, you can: ; If you have other insurance, learn how Original Medicare works with your other coverage. ; If you're not lawfully present in the U.S., Medicare won't pay for your Part A and Part B claims, and you can't enroll in a Medicare Advantage Plan or a Medicare drug plan.
Medicare is health insurance for people 65 or older. More than 66 million people in the U.S. get their health coverage from Medicare.
What happens when I turn 65? ; You can choose to join a Medicare drug plan when you sign up for Medicare Part A and/or Part B. If you choose not to join a Medicare drug plan, you’ll need to have creditable drug coverage to avoid paying a Part D late enrollment penalty. Creditable drug coverage is coverage that provides the same value as Medicare drug coverage. If you’re not sure your retiree drug plan is considered creditable, ask your plan – they have to tell you. Your plan will also send...
Original Medicare, Medicare Advantage ; You can go to any doctor or hospital that takes Medicare, anywhere in the U.S., In many cases, you can only use doctors and other providers who are in the plan’s network and service area (for non-emergency care). ; In most cases you don’t need a referral to see a specialist., You may need to get a referral to see a specialist.