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Need more help deciding?Jeff Skeesick can answer questions you may have. 866.696.3154 orjskeesick@aiin.net

Medicare coverage is provided to eligible US citizens at age 65, 66 or 67 (depending on the year you were born) as well as to those of any age who the Social Security Administration has determined to be disabled and to those who have end-stage renal (kidney) disease. Medicare, the nation’s largest health insurance program, is available to meet various needs. Basic healthcare needs are covered by four Medicare “parts” described below, as well as on the US Department of Health and Human Serviceswebsite.


Medicare Part A provides basic hospital cost coverage:

• Typically, people do not pay for Medicare Part A

• Helps cover hospital inpatient care for those who are Medicare-eligible

• Also helps pay for skilled nursing facility care following a hospital stay

• May cover certain hospice and home health care

Medicare Part B provides medical insurance

• Depending on income, most people pay monthly for Part B coverage

• Helps cover physicians’ services

• Participants can see any provider that is enrolled in Medicare and accepting new patients

• Helps pay for outpatient medical services and home healthcare

• Helps pay costs incurred for supplies not covered by hospital insurance

• Provides for some coverage of preventative health services

Medicare Part C (Medicare Advantage Plan)

• Part C is optional healthcare insurance provided by private insurance companies approved by and under contract to Medicare as a replacement for Part A and Part B 

• Most people who receive Medicare coverage also choose an optional Medicare Advantage Plan (such as a HMO or PPO) to fill in coverage gaps

• Also provides coverage for additional services which could include – for example – prescription drugs (Part D), vision, dental, hearing and/or wellness programs

• Part C plans, which may provide services with fewer out-of-pocket costs, are available in many but not all areas and are managed by private insurance companies

• If they wish, people with Medicare Parts A and B can choose to receive all of their healthcare services through one of these provider organizations instead of through Medicare

• To find out which plans are available in your area, visitwww.medicare.gov, and select “Compare Health Plans and Medigap Policies in Your Area.” You can also call 1-800-MEDICARE (1.800.633.4227). TTY users should call 1-877-486-2048.

• All people pay monthly for Part C, in addition to monthly premiums for Part B.  Of course, costs for services vary

Medicare Part D (Prescription Drug Coverage)

• Medicare Part D, is offered by private companies, to help pay for prescription drugs not covered under Medicare Parts A and B

• Part D is available to everyone with Medicare, by either joining a Medicare Prescription Drug Plan, which adds drug coverage to “Original Medicare” and certain Medicare Advantage Plans, or by joining a Medicare Advantage Plan that includes drug coverage

• Costs depend on the Medicare drug plan chosen as well as the drug taken, and most Medicare prescription drug plans have premiums, deductibles and copayments

• All people pay monthly for Part D, in addition to Part B monthly premiums

Medicare Choices

Before you enroll in Medicare and/or participate in any Medicare Advantage Plan, you’ll need to make several decisions about the kind of coverage you require:

Choice 1: Choose if you want to keep Part B:
When you enroll in Medicare, you will be automatically enrolled in Part B. If you don’t want to keep Part B, you will need to inform Medicare before the effective date on the Medicare card you’ll receive.

 

Choice 2: Choose how to obtain your Medicare coverage:
If you keep Part B, you can choose how you acquire your health coverage; e.i.: through the Federal government’s “Original Medicare” plan or a Medicare Advantage Plan offered through a private insurance company. NOTE: You may be able to delay joining Part B without a penalty if you or your spouse (or a family member, if you are disabled) is working and receive health insurance benefits from your employer.

Choice 3: Determine if you want or need Medicare prescription drug coverage:
If you choose “Original Medicare” and you would also like drug coverage, you will need to join a Medicare Prescription Drug Plan. (If you choose to join a Medicare Advantage Plan, the plan will generally include Medicare drug coverage.)

 

Choice 4: Decide if you want or need a Medigap (Medicare Supplement Insurance) policy:
If you choose “Original Medicare,” you may want to obtain a policy that helps pay some of the costs Medicare doesn’t cover. IMPORTANT: You don’t need and couldn’t use a Medigap policy if you choose a Medicare Advantage Plan.

 

Enrollment times are limited.
If you will soon turn 65, you have an opportunity to enroll in a Medicare plan. That opportunity begins three months before your birthday, includes the month of your birthday and continues until three months after your birthday month. If you wait to enroll beyond this seven-month initial enrollment period, you may have to pay more and may have fewer plan choices later.

Still have questions?
That’s normal. You can learn more on ourMedicare Frequently Asked Questionssection. Or an inova insurance specialist can help you determine what choices are best for your situation. Just give us a call. There’s no obligation.

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inova | 1206 N. Lincoln Suite 200 |  Spokane WA 99201-2559 | P: 509.777.2655 TF: 866.696.3154
Fx: 509.777.2675 | E: jskeesick@aiin.net

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