201 What is Medicare Health Insurance?

 

 

Revised 03/01/2021

Policy

Medicare is a Federal health insurance program that is available to most US citizens and legal residents who are:

·        Age 65 or over;

·        Persons of any age with permanent kidney failure; and

·        Certain individuals with disability.

 

The Medicare program has four benefit packages:

·        Hospital Insurance (Medicare Part A);

·        Supplementary Medical Insurance (Medicare Part B);

·        Medicare Advantage (Medicare Part C); and

·        Medicare Voluntary Prescription Drug Coverage (Medicare Part D).

The local Social Security Administration offices take applications for Medicare and the Part D Extra Help program.

 

Definitions

Term

Definition

Medicare Part A

Medicare benefit that assists with inpatient care including critical access hospitals, hospice care, some home health care and skilled nursing facility services.

More information on what is covered by Medicare Part A can be found on Medicare.gov.

Medicare Part B

Medicare benefit that assists with doctor’s services, outpatient care and some medical services not covered by Part A.

More information on what is covered by Medicare Part B can be found on Medicare.gov.

Medicare Part C

Medicare Advantage Plans are health plan options approved by Centers for Medicare & Medicaid Services . They are sometimes called “Part C” or “MA Plans”. Medicare Advantage plans provide both Medicare Part A and Part B covered services.

More information on Medicare Advantage plans can be found on Medicare.gov.

Medicare Part D

Medicare Part D is a voluntary program that provides prescriptions drug coverage. Part D covers most classifications of prescription drugs.

Medicare offers prescription drug coverage (Part D) for everyone with Medicare. A beneficiary who is entitled to Medicare Part A or enrolled in Part B is entitled to Part D. To get Medicare drug coverage, the beneficiary must join a plan run by an insurance company or other private company approved by Medicare.

More information on Medicare Part D plans can be found on Medicare.gov.