Health Coverage

 Part A covers inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. 

 Part A is free of charge if you worked for a total of ten years or 40 quarters.

 Part B covers services from doctors and other health care providers including:

•  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)

 Part B of Medicare has a standard premium of $164.90/mo, but is determined by income.

 Original Medicare includes Part A and Part B. You can join a separate Medicare drug plan to get 

Medicare drug coverage (Part D).

You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

 To help pay your 20% coinsurance out-of-pocket cost in Original Medicare, you can also buy supplemental coverage, like Medicare Supplement Insurance (Medigap), or have coverage from a former employer or union, or Medicaid.

 Insurance you can buy from a private company that helps pay the 20% coinsurance not paid by Original Medicare. 

Policies are standardized, and in most states named by letters, like Plan G or Plan N. The benefits in each lettered plan are the same, no matter which insurance company sells it. 

 Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

 In most cases, you’ll need to use doctors who are in the plan’s network.

 Plans may have lower out-of-pocket costs than Original Medicare.

 Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.

 Helps cover the cost of prescription drugs (including many recommended shots or vaccines). You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.