Medicare 101

Its about that time to start looking at Medicare, yet feels like trying to solve a Rubik's cube… blindfolded, right? So many moving parts, plans, and acronyms is enough to drive anyone crazy! Not to worry, we at getMcare are here to help ease your confusion with the Medicare world and give you some clarity.

First things first: what is Medicare? Medicare is health insurance for those 65 and older from the federal government. It may also cover people under 65 with certain disabilities or conditions. This is the basic idea of who Medicare covers, yet there are several different plans that come with looking in which coverage is best for you. Let’s meet the main characters of Medicare:

Part A: The Hospital Hero (Think Inpatient!)

Imagine you're enjoying a peaceful afternoon, and suddenly, boom! You need a hospital stay. That's where Medicare Part A swoops in like a superhero. It helps cover your inpatient hospital care, skilled nursing facility care, hospice care, and even some home health services. Basically, if you're officially admitted to a facility, Part A is usually on the job. Good news: for most people, Part A is premium-free because you (or your spouse) paid Medicare taxes while working. Huzzah!

Part B: The Doctor's Best Friend (Think Outpatient!)

Okay, so Part A handles the "in-the-hospital" stuff. But what about your regular doctor visits, preventive screenings, lab tests, and durable medical equipment (like that snazzy new walker)? Enter Medicare Part B! This is your go-to for outpatient medical services. Unlike Part A, Part B usually comes with a monthly premium, which can vary based on your income. But hey, think of it as your VIP pass to keeping those check-ups regular!

Original Medicare: The Dynamic Duo (A & B Together!)

When you combine Part A and Part B, you've got what's called "Original Medicare." This is the classic, government-run Medicare program. With Original Medicare, you can typically go to any doctor, hospital, or supplier in the U.S. that accepts Medicare. The catch? It doesn't cover everything. You'll still have deductibles, coinsurance, and copayments to contend with. Which brings us to...

Part C: The All-in-One Adventure (Medicare Advantage!)

Feeling overwhelmed by all the separate parts? Medicare Part C, also known as Medicare Advantage, is like a bundled vacation package. These plans are offered by private insurance companies approved by Medicare. They include all the benefits of Part A and Part B, and often throw in extra goodies like prescription drug coverage (that's Part D, which we'll get to in a sec!), dental, vision, and even fitness programs. Think of it as a one-stop shop for your healthcare needs, often with a network of providers.

Part D: The Prescription Powerhouse (Drug Coverage!)

Let's face it, most of us will need prescriptions at some point. That's where Medicare Part D comes to the rescue! These plans are also offered by private insurance companies and help cover the cost of your prescription drugs. Each plan has its own "formulary" (a fancy word for a list of covered drugs), so it's important to find one that covers your specific medications. No more sticker shock at the pharmacy!

Medigap: The "Gap" Filler (Supplemental Insurance!)

Remember those out-of-pocket costs with Original Medicare (deductibles, coinsurance, copayments)? That's where Medigap, or Medicare Supplement Insurance, shines. These plans, sold by private companies, work with Original Medicare to help cover those "gaps" in coverage. They don't replace Original Medicare; they just make those unexpected bills a lot less shocking. Think of it as a financial safety net!

Navigating Medicare and its process may seem like a maze at first, but once you understand the basic “characters” and their roles, it becomes a bit easier to manage. At getMcare, we firmly believe that understanding your options should never be a headache. We are here to help you find the best plan that fits your specific needs like a glove.

If you are just beginning your journey with Medicare or just looking to make a switch, remember, you do not have to go through it alone. We are here to make Medicare easy for you! If you are ready to chat about your options, reach out to any one of our agents today- we’re always here to help!