Medicare

Introduction to Medicare

Medicare is a federal program that pays for covered healthcare services of qualified beneficiaries. It was established in 1965 under the Social Security Act to provide health insurance to individuals 65 or older, and has expanded to include permanently disabled individuals under 65. The program is administered by the Department of Health and Human Services through the Centers for Medicare and Medicaid Services.

There are 4 distinct parts to Medicare:

Part A

Part A of Medicare is your hospital insurance. This helps you cover common hospital expenses for things such as the cost of a semi-private room for stays, hospice care, home healthcare and even skilled nursing facility stays. Part A also covers blood transfusions requiring more than 3 pints of blood.

Part B

Part B of Medicare is for outpatient services deemed medically necessary. Part B includes coverage for services like doctor's office visits, lab testing, diagnostic imaging, preventative care, surgeries, ambulance rides, chemotherapy and radiation, and even extensive dialysis care for people with renal failure. Many of these procedures occur in a hospital, but fall under Part B because physicians provide them. It's not always easy to determine what is inpatient vs. outpatient care, so we're here to help!

Part C

Medicare Part C, also known as a Medicare Advantage Plan, is different from Part A and B mainly because it is offered by private health insurance companies, not the government. Medicare Advantage plans combine coverage for Medicare Parts A and B and include additional medical services such as prescription drug coverage for those who want it.

Part D

Medicare Part D, also known as a Prescription Drug Plan, or PDP, provides help with the cost of prescription drugs. This can be provided through private insurance companies or select Medicare Advantage Plans that include drug coverage.

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