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Getting Started with Medicare




For anyone who might not know, Medicare is a healthcare plan provider. It has 3 parts, Medicare Plan A, Medicare Plan B, and Plan D or commonly known as Original Medicare, Medicare Advantage Plan, and Prescription Plan. 

Original Medicare is usually applicable for in-patient hospital service, skilled nursing facility care, hospice, and home health care. It is also known as Hospital Insurance. While Medicare Advantage Plan or commonly known as Medical Insurance covers mainly your Outpatient and Physician Services, laboratory tests, wellness, and others.  And lastly, Medicare Plan D  or the Prescription Drug Coverage which covers the cost of your prescription drugs. This plan is usually run by private insurance companies that follow rules set by Medicare.

You have your options as to what Medicare Plan to get. Either you choose Original Medicare, Medicare Advantage, or you'll have Original Medicare and add on it a Medigap or Medicare Supplement Plan.


ORIGINAL MEDICARE ( Doctor and Hospital choice)

You can go to any doctor or hospital that takes Medicare, anywhere in the U.S. In most cases, you don't need a referral to see a specialist.

You usually pay 20% of the Medicare-approved amount after you meet your deductible. If you choose to buy prescription drug coverage, you'll pay that premium separately. 

There is no yearly limit on what you pay out-of-pocket unless you have supplemental coverage or a Medigap policy. This can help you pay your remaining out-of-pocket costs like your 20% coinsurance. 

It covers most medically necessary services and supplies in hospitals, doctors' offices, and other health care settings.

You can join a separate Medicare Prescription Drug Plan to get drug covered.

It doesn't cover care outside the U.S, however, you may be able to buy a Medigap policy that covers care outside the U.S.

MEDICARE ADVANTAGE

It is an "all-in-one" alternative to Original Medicare. This includes Part A, B and usually D. It can also have lower out-of-pocket costs than Original Medicare.

However, in most cases, you'll need to use doctors who are in the plan's network and you may need to get a referral to see a specialist. 

It also offers extra benefits that Original Medicare doesn't cover, like vision, hearing, dental and many more.

It has a yearly limit on what you pay out-of-pocket for Medicare Part A and B covered services. Once you reach your plan's limit, you'll pay nothing for Part A and B covered services for the rest of the year.

You can't buy or use separate supplemental coverage.

Prescription drug coverage is included in most plans.

Plans generally don't cover care outside the U.S. And plan usually doesn't cover non-emergency care you get outside o your plan's network.

Get the most out of Medicare

If you are still having a hard time choosing which Medicare Plan to get, you can get free, personalized counseling from your  State Health Insurance Assistance Program (SHIP). Just click this link for the  - contact numbers.

You can also call 1-800-MEDICARE (1-800-633-4227)
TTY Users can call 1-877-486-2048 or visit the Medicare Plan Finder at Medicare.gov/plan-compare.

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