What is Medicare?
Medicare (a federal program), is health insurance for people age 65 or older, people under 65 with certain disabilities, Amyotrophic Lateral Schlerosis (ALS) and people of any age with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a kidney transplant)
What are my medicare coverage options?
Original
Medicare
- Includes Medicare Part A and B.
- You can use any doctor or hospital that accepts Medicare in the US.
- Does NOT cover prescription drugs. You’ll need to purchase a drug plan. (Part D).
- Original Medicare pays 80% of your Medicare approved costs.
Medicare
Supplements
(Medigap)
- Medigap policies, sold by private insurance companies, can help pay some of the healthcare costs that Medicare doesn’t cover (like co-pays, deductibles and co-insurance).
- Does NOT cover prescription drugs (Part D).
- You’ll have to pay premiums for a Medigap policy.
medicare Prescription drug plan
(Part d)
- Helps cover the cost of prescription drugs.
- Sold by private insurance companies that follow rules set by Medicare.
- May help reduce your prescription costs.
- Part D plans usually have a premium.
- You may incur monetary penalties for not enrolling in Part D when first becoming eligible.
Medicare advantage
(part c)
- An “all in one plan” alternative to Original Medicare. These “bundled” plans include Part A, Part B and usually Part D.
- Plans may have lower out of pocket costs than Original Medicare.
- Medicare Advantage Plans must cover everything that Original Medicare does.
- Most plans offer extra benefits that Original Medicare doesn’t cover – like vision, dental, hearing, transportation and more.
Know your rights
your rights
No matter how you get your Medicare coverage, you have certain rights and protections. All people with Medicare have the right to:
- Be treated with dignity and respect at all times.
- Be protected from discrimination.
- Have your personal and health information kept private.
- Get information in a format and language you understand from Medicare, health care providers, Medicare Plans and Medicare contractors.
- Have questions about Medicare answered.
- Have access to doctors, specialists, other health care providers and hospitals for medically necessary services.
- Learn about your treatment choices in clear language that you can understand, and participate in treatment decisions.
- Get Medicare-covered services in an emergency.
- Get a decision about health care payment, coverage of services, or prescription drug coverage.
- Request review (appeal) of certain decisions about health care payment, coverage of service, or prescription drug coverage.
- File complaints (sometimes called “grievances”), including complaints about the quality of care.