ABC & D of Medicare
ABC & D of Medicare
Medicare is a federal health insurance program, administered by Centers for Medicare and Medicaid Services (CMS).
Who can get Medicare?
U.S. citizens and legal residents are eligible for Medicare if you fall into any of these categories:
- You are age 65 or older and eligible for Social Security or Railroad Retirement benefits
- You are 65 or older and married to someone eligible for Social Security or Railroad Retirement benefits
- You’ve been receiving Social Security disability benefits for at least 24 months
- Those with a diagnosis of End-Stage Renal Disease (ESRD/kidney failure) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s Disease)
What does Medicare cover?
Medicare Part A (Hospital Insurance) helps cover:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Medicare Part B (Medical Insurance) helps cover:
- Services from doctors and other health care providers
- 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)
What is NOT covered by original Medicare:
- Most dental care
- Eyeglasses
- Eye examinations related to prescribing glasses
- Acupuncture
- Hearing aids and exams for fitting them
- Transportation
Medicare Part C (Medicare Advantage Plans):
Only Medicare-approved private companies can offer Medicare Advantage (MA) plans.
Medicare Advantage plans are required to provide all benefits covered by Part A and Part B and offer additional benefits.
Most Medicare Advantage plans include vision, hearing, and dental coverage, and gym membership. Some also provide free transportation services for medical appointments and over-the-counter allowance. Furthermore, most plans include Part D prescription drugs benefits at no additional charge.
Medicare Part D (Prescription Drug Plans):
If you opt to have original Medicare, you must purchase a separate a Part D drug plan from a private company.
You can choose a standalone prescription coverage (Prescription Drug Plan).
Or you can choose a Medicare Advantage plan coverage that includes medical and prescription coverage.