Understanding the Basics of Medicare Advantage

Do you know what Medicare is and who qualifies for it? Learn more about Medicare and how it may be beneficial to you.

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First things first, what is Medicare?

Medicare is a federal health insurance program that pays for several covered health services. Generally, you’re eligible for Medicare if you (or your spouse) worked for at least 10 years and contributed taxes to fund your Medicare benefits, are 65 years or older, and a U.S. citizen or permanent resident. If you’re younger than 65, you may qualify for coverage if you have a disability or End-Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or transplant.

Choosing the right plan is not only important, it’s personal. To sort things out, it is best to know all your options. So, what are the differences between Medicare Parts A, B, C and D?

Original Medicare—your government plan—is only PART A and PART B.

Part A is hospital coverage.

Part B is medical coverage, which most people will pay the standard premium amount for each month. This premium is set by the federal government, and your income determines how much you must pay.

Part C combines your hospital, medical, and typically even your drug coverage into one complete plan. You may need to pay an additional premium each month, depending on the plan you choose.

Part D is prescription drug coverage only.

Think of Medicare Advantage (Part C) as all-in-one coverage. You get hospital and basic medical care coverage, like preventive services and inpatient and outpatient care, plus many plans offer supplemental benefits for vision, dental, and hearing. You get all the benefits of Original Medicare, plus predictable copayments that make it easy to budget, a cap on your out-of-pocket maximum, and coverage for preventive screenings.

There are also Medicare Supplement or Medigap plans. These types of plans have an additional premium but only cover costs of some of the care Original Medicare doesn’t cover. These plans often don’t include any additional perks or optional benefits.

When it comes to Medicare, there isn’t a one-size-fits-all option. Give the SelectHealth Answer Team a call at 855-442-9940 (TTY: 711) or work with a licensed insurance agent to better understand your options and decide what’s right for you.

Related: Ready to Enroll