Medicare Basics
This article was updated on: 10/01/2016
Medicare is a federal program, managed by the Centers for Medicare & Medicaid Services.
It provides health insurance to eligible United States citizens and permanent residents of five or more years.
You’re eligible for Medicare if you’re 65 or older, or under 65 with certain disabilities. You may also qualify for Medicare, regardless of age, if you have amyotrophic lateral sclerosis (also known as Lou Gehrig’s Disease) or end-stage renal disease requiring a kidney transplant or dialysis.
Medicare Overview
Medicare beneficiaries can generally get their health coverage in two ways: through Original Medicare, or through a private Medicare Advantage plan.
Original Medicare comes in two parts:
This covers inpatient hospital, skilled nursing facilities, hospice, and home health care.
This covers outpatient medical care, including (but not limited to) doctor visits, durable medical equipment, lab tests, and preventive services.
Certain types of Medicare coverage are only available through private insurance companies.
Medicare Advantage plans provide Original Medicare benefits through private insurance companies. There are many types of Medicare Advantage plans, such as Preferred Provider Organization (PPO) plans and Health Maintenance Organization (HMO) plans. In addition to what’s covered under Original Medicare, some plans offer other benefits, such as routine dental and vision, health wellness programs, and prescription drug coverage.
Original Medicare doesn’t include prescription drug benefits, except in certain situations. You can sign up for prescription drug coverage through a separate Medicare prescription drug plan, or through a Medicare Advantage Prescription Drug plan.
Medigap helps pay for out-of-pocket costs not covered in Original Medicare, such as copayments, coinsurance, deductibles, and overseas health coverage. These plans can only be used for Original Medicare and cannot be used with a Medicare Advantage plan.
If you’re enrolled in, or will soon be eligible for Medicare, and are considering whether one of the Medicare plans could be a good option for you, we can help you compare your options. We’re happy to walk you through your options by phone or email you information. If you’d like to get personalized assistance, you can talk to a licensed insurance agent today.
Call a UIA licensed insurance agents at 1-888-725-7955, Monday through Friday, 10AM to 7PM EST
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