We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
WHAT IS MEDICARE?
Medicare is health insurance for individuals:
-65 years and older
- Under 65 with certain disabilities
Medicare is administered by the government agency called the
Centers for Medicare and Medicaid Services
CMS = is a Federal Government agency and NOTconnected to private insurance companies!
There are 4 parts of Medicare:
Part A - Hospital insurance
- Hospital - Inpatient
- Skilled Nursing Facilities
- Home Health Care
*Most people do not have to pay for Part A
Part B- Medical insurance
-Doctor's visits
- Outpatient hospital services
- Clinical lab tests
- Preventive services
*You will pay a monthly premium for Part B
*Basic Medicare (Parts A & B) comes directly from the GOVERNMENT
Part C - Medicare Advantage Plans
- Requires participation in Medicare Part A & B
- HMOs and PPOs
HMOs - Health Managed Organization - very restrictive area of medical services
PPOs - Preferred Provider Organization - less restrictive area of medical services
- It may include Part D prescription coverage
- High exposure to out-of-pocket risk
- Offered by private insurance companies, but ultimately regulated and subsidized by CMS
Part D - Part D Prescription Drug Plans
- Requires participation in Medicare
- Medicare prescription drug coverage
- A "stand alone" insurance policy offered by private insurance companies
- Regulated by CMS
- CMS will impose a monetary penalty for not participating in a Part D plan when eligible
*You will pay a monthly premium for a "stand alone" prescription drug plan (PDP)
*Parts C & D are purchased and issued through private insurance companies, but are regulated by the Federal Government (CMS)
*Senior Assist will help you determine if a Part C Medicare Advantage Plan is your best option of coverage. We will also aid in your search for a Part D Prescription Drug Plan, if needed.
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