Turning 65 is an exciting milestone! You’re at a stage in life where you can do what you like, with more time and freedom to do it. It also means it’s time to think about the Medicare coverage you’ll need to ensure you can stay healthy and live confidently. It goes without saying that there’s a lot to think about when it comes to finding the coverage that will work for you, so let’s start with the basics.
What is Medicare?
Medicare is a federal health insurance program for people who are ages 65 or older. It’s also available to certain younger people with disabilities and people with end-stage renal disease (kidney failure). Overall, it’s designed to help you afford good health care.
Medicare comes in four parts: Parts A, B, C and D. Parts A and B are called “Original Medicare” and are provided by the government. Parts C and D are available for purchase from insurance providers or other private companies. Medicare Supplement insurance is also available as a way to help pay for costs that aren’t covered by Original Medicare.
Below is a general overview of how each of these parts work.
Part A is considered hospital insurance. In general, it provides coverage for:
- Skilled nursing care
- Inpatient hospital stays
- Hospice care
- Some in-home care
Part B is considered medical insurance. In general, it provides coverage for:
- Doctor visits
- Preventive care
- Outpatient services
- Medical supplies
- Tests and X-rays
Part C is known as Medicare Advantage. This part is considered an alternative to Original Medicare (Parts A and B). By law, Medicare Advantage plans have to cover all of the services that Original Medicare covers, but that’s where the similarities end. Most Medicare Advantage plans include coverage for things like hearing, dental and vision. Those things aren’t covered with Original Medicare. Medicare Advantage plans may also include coverage for prescription drugs (Part D).
Part D is considered prescription drug coverage. You might be surprised to learn that the majority of prescriptions aren’t covered in Parts A and B. This is where Part D comes in. Just like non-Medicare insurance plans, Medicare Part D plans have a covered prescriptions list called a formulary that will tell you what drugs are covered by the plan. These plans are offered by private insurance companies approved by Medicare. They work in tandem with Original Medicare and Medicare Supplement plans. Prescription drug coverage is often included in Medicare Advantage plans.
Medicare Supplement insurance
These are plans sold by insurance providers like Blue Cross and Blue Shield of Kansas or other private companies. They can be purchased in combination with Parts A, B or D as a way to help bridge the gap in your Medicare coverage. They help pay for things like copays, coinsurance and deductibles. See our glossary of terms.
No matter how you sign up for Medicare, these parts are all designed to help cover specific services. There are a lot of choices and we want to help you get straight to enjoying the good life!
Blue Cross and Blue Shield of Kansas is not connected with or endorsed by the U.S. Government or Federal Medicare Program.
5 thoughts on “Learn the ABCs of Medicare”
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure.