Medicare law was signed in 1965 to provide health insurance coverage for certain U.S. citizens or permanent U.S. residents. To qualify, one must be:
- Age 65 or older
- Under age 65 with certain disabilities*
- Any age, with end-stage renal disease (ESRD)
This program is administered by the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services.
*Includes disabled citizens, citizens having Lou Gehrig's Disease, or receiving SSDI for 2+ years.
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Medicare Law - Title XVIII of Social Security Act
This law defines different parts of Medicare, known as part A, B, C & D.
Here’s what each of these parts cover:
- Part A - Hospital Fees
- Part B - Medical Costs
- Part C - Medicare health plans, which must cover Part A and Part B benefits
- Part D - Prescription drug coverage
Medicare Part A & B, or Original Medicare, includes deductible and coinsurance.
Part C, Medicare Advantage (MA), combines parts A and B with a maximum out-of-pocket limit. MA plans may also offer extra benefits, such as free gym memberships, which original Medicare doesn’t offer. Some plans may include Part D (Prescription drug coverage).
Medicare Supplement - The Medigap Plan
In addition, the Medigap Plan, also known as Medicare Supplement, is a plan sold by private insurance companies to fill gaps in Original Medicare coverage. It helps pay all or a portion of Part A and Part B co-insurance, co-payments, and/or deductibles, when Original Medicare determines that a benefit is medically necessary. Some Medigap policies, also known as Medicare Supplements, cover benefits not covered by Original Medicare. Separate Part D (prescription drug plan) needs to be added, as it is not included in the Medigap plan.
Medicare & Medicaid
With Dual Special Needs Plans, with zero monthly cost you could get more benefits than Original Medicare (Red White & Blue Card) if you are a Qualified Medicare Beneficiary. These benefits may include (but are not limited to):
- $0 cost over the counter health products
- $0 cost Silver Sneakers membership (click here for nearby participating locations)
- $0 cost Transportation Assistance
- $0 cost Dental & Vision Coverage with no waiting period
- $0 copay Health Screening & Preventative Services
If you are looking for help understanding different parts of Medicare, Medicare Advantage, Medicaid, or Medicare Supplement, our knowledgeable agents are available for a free of charge personal consultation. Call 888-444-9020 for a free, no obligation appointment today!