Medicare insurance is a federal government-sponsored health insurance for people who are 65 years old and above. In some cases, it also covers people who have certain disabilities or health conditions.

Basically, there are two parts of Medicare insurance, namely Medicare A and Medicare B. Medicare A is also called hospital coverage and covers in-patient hospital services, skilled nursing care, home health care, and hospice care. Medicare B, on the other hand, is also called medical coverage and covers out-patient medical services, clinical laboratory expenses and medical expenses.

Medicare Insurance – What is not Covered

Generally, Medicare insurance covers 80% of the approved total cost of your medical expenses. However, there are also some medical services that are not covered by your Medicare.

• Long term care and skilled care, such as therapist or private nursing care

• Health care abroad

• Homemaker services

• Dental and Eye care

• Dentures, Eye Glasses, and Hearing Aids

• Cosmetic surgery

If you have received services or treatment that is Medicare-approved, you still will have to pay the remaining charges including the deductibles, copayments, and coinsurance. You can only use your Medicare insurance in medical institutions and doctors who are in the Medicare network. If you want to know which doctor or medical institution is part of the Medicare network, you can ask your doctor’s office.

Medicare Insurance – The Difference between Medicare Advantage

Although they sound the same, Medicare Insurance and Medicare Advantage are entirely two different insurance tools. Medicare Insurance, categorized as A and B, is sponsored by the government; while Medicare Advantage, also called Medicare C, is purchased from a private insurance company.

You can purchase Medicare Insurance as long as you meet the eligibility requirements set by Medicare. On the other hand, you cannot purchase a Medicare advantage plan if you are not enrolled in Medicare A or B.

Medicare Advantage plans work instead of Medicare.  You can get medical services from private medical institutions which are part of the Medicare Advantage network.

Medicare Insurance – Medicare Part D

Aside from Medicare Advantage, there is another kind of Medicare insurance called Medicare Part D or prescription drug coverage. This is offered by private insurers authorized by Medicare. This plan covers certain prescription drugs approved by Medicare.

Medicare Insurance Medicare Supplement

Medicare Supplements act as a supplement insurance for Medicare because it covers medical costs not covered by traditional or Original Medicare.

Medicare Insurance – Are You Eligible?

If you are 65 years above and a citizen of the United States, you are eligible for Medicare insurance Parts A and B. Once you turn 65, you are automatically enrolled in Medicare. Aside from this, here are other provisions that make you eligible for Medicare A and B.

• You are under 65 and permanently disabled. You should also be a recipient of the Social Security disability insurance for the last 2 years.

• You are under 65 and have end-stage renal disease. You and your spouse must meet the work requirements for Medicare.

Medicare Insurance – What Plan is Right for Me?

With so many options it can be hard to know which option to pick.  Here at Medicare Pathways our highly trained Benefit Advisors can review you rsituation and make a professional recommendation.  Please call 1-866-466-9118 or click here to request a quote.


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