guide to senior communities

“Just turned 64 this month, so I need to start studying up on Medicare. It seems so complicated right now. I need to make the right decision.” – Robert

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Guide to Medicare Plan Types Part A-B-C-D

Overview of Medicare Health Insurance

Medicare was created as part of the Social Security Act of 1965 that was signed by former President Lyndon B. Johnson. The first enrollees were former President Harry Truman and his wife Bess, who both received their Medicare cards at the bill singing ceremony held on July 30, 1965.

Medicare plans vary and can be confusing for seniors to understand. Medicare health insurance is a government program, and is the largest health insurance coverage plan in the United States with over 50 million people participating. The eligibility requirements to qualify for Medicare benefits include being able to answer yes to one of the following questions:

· 65 years of age or older
· Under 65, but with certain disabilities
· End stage Renal Disease

Medicare has four different parts – Parts A, B, C, and D. Part A. Part A involves hospital insurance, Part B is insurance coverage, Part C is advantage plans, and Part D includes prescription drug plans.


The Medicare Open Enrollment period for Medicare Advantage Plans (Part C) and Prescription Drug Coverage Plans (Part D) is from October 15th through December 7, 2014. Any change you make during the Open Enrollment period will take effect on January 1st, 2015.

Thanks to the new health care reform tax credit making healthcare easier, there are more options available.

Medicare Part A

Medicare Part A plans cover overnight hospital stays that include physician services, tests, food and supplies. Part A also covers brief patient visits to a skilled nursing facility. Skilled nursing facility coverage under Part A lasts for a length of 100 days. The first 20 days are covered in full with the 80 remaining days consisting of a co-payment of $142 a day. Many individuals and families opt to have supplemental coverage to make up for the delta in coverage after the first 20 days.

Medicare Part B

Medicare health insurance Part B plans cover some services that are not covered via Part A. It also provides health coverage for many outpatient needs and services. Part B coverage consists of medical equipment, x-rays, laboratory tests, mental health services and medication and outpatient services provided in an outpatient setting. Most people have to pay a premium to receive Part B coverage. Between Part A and B, most services and supplies are covered, including preventative services and home health. Some people may qualify for Part B subsidies depending on income level. People should keep in mind that Part B is not a 100% insurance coverage plan.

Medigap or Supplement insurance is designed to enhance and supplement original Medicare and is a good idea to have to cover what could be a financial disaster for you if you suffer a major accident or serious illness not covered by Medicare. Supplement insurance is private health insurance from an insurance company like Aetna, Humana or United Health Care to name a few. For more information about Medicare Supplement insurance check these sources:

medicare part b

Medicare Part C

Medicare Part C is referred to as Medicare Advantage plans. Part C plans combine Parts A and B coverage, but are offered by private insurance companies. In many cases, Part C plans are more affordable than original Medicare plans and have better coverage. Put away your Medicare card if you have Advantage - you only need one card to give to your Doctor. Experts say the care coordination is often better with an Advantage plan and the prices are often much more stable.

Part C plans include:

· Medicare Preferred Provider Plans
· Medicare Health Maintenance Organization
· Private Pay
· Special Needs
· Medicare Savings Accounts

Medicare Part D

Medicare prescription drug coverage Part D is an important part of any health plan because of the rising cost and increased use of prescription medication. Part D coverage provides prescription drug benefits by private insurance companies approved by Medicare. Many people who are on Medicare Advantage (Part C) plans probably already have Part D coverage. For those who do not have Part C coverage, you typically have to pay a separate premium.

Some Advantage Plans also include coverage for Part D.

For additional information on a specific term related to Medicare visit our Glossary of Medicare Terms page, which explains terms used in the Medicare program.


Shop Around to Find the Medicare Plan for You

Your needs are unique and to find a health care plan that is best for you, you need to compare the benefits and costs. Experts advise that you really need to begin with a needs assessment. What is important to you. Obtain a complete description of benefits of each plan and see how they match up with your needs. Key things to consider are monthly plan premium, annual maximum out-of-pocket, annual deductible for medial services, prescription drugs co pays, inpatient hospital coverage, skilled nursing facility coverage, primary care physician and specialist visits, emergency care, preventive services, dental and visions services and fitness benefit.

As you approach age 65 there you will be invited to group meetings that can be a good source of information about various plans. AARP, senior centers, insurance brokers and other groups also have resources available. Some of the top insurance companies offering Medicare Supplement or Advantage plans are Unitedhealth Care, Wellpoint, Kaiser Foundation, Humana, Aetna, HCSC Group, Blue Cross/ Blue Shield, Coventry Heath Care, Highmark Group and Cigna Heatlh Group.

Medicare Basics