Understanding Medicare

Medicare Part A – Hospital Coverage

Original Medicare: Part A and Part B

Part A of Medicare pays for hospital expenses. If you have been employed and have paid into the Medicare program through payroll taxes for a certain period of time (approximately ten years), you don’t pay a premium for Part A coverage.

 

What does Medicare Part A provide coverage for?

 

 

 

Medicare Part B – Medical Coverage

Original Medicare: Part A and Part B

Part B of Medicare pays for medically necessary care you receive on an outpatient basis. While you may not pay a premium for Medicare Part A, you do have to pay a premium for Medicare Part B.

 

What does Medicare Part B provide coverage for?

 

 

 

Medicare Part C – Medicare Advantage

Medicare Part C, also known as Medicare Advantage plans, combine Medicare Part A, Medicare Part B and often Medicare Part D into one plan. All Medicare Advantage plans are required to offer benefits that are equal to or better than Original Medicare. Many Medicare Advantage plans provide coverage for things that Original Medicare does not, including prescription drugs, vision and dental care.

In order to enroll in a Medicare Advantage plan, you must first enroll in Original Medicare (Part A and Part B). You would then enroll in a Medicare Advantage plan through an insurance company.

Eligibility Requirements:

• Must have Medicare Part A and Part B to enroll
• Must continue to pay Medicare Part B premiums (in addition to your Medicare Advantage premium)
• Must reside in the plan’s service area

 

See Nebraska Blue Medicare Advantage options

 

 

Medicare Part D – Prescription Drug Plans

Medicare Part D is an optional program to help you cover prescription costs. Prescription drug coverage is available to you in one of two ways: either through a Prescription Drug (Part D) plan or by enrolling in a Medicare Advantage plan that offers drug coverage. Both are available and delivered through private insurance companies that contract with Medicare. You must be enrolled in Medicare Part A and/or Part B to enroll in a prescription drug plan.

Individuals who choose to enroll in a Part D plan generally pay a monthly premium. Some plans may require a deductible. Part D covers drug prices at different tiers.

 

How Medicare Part D plans price drugs:

 

 

 

See Nebraska Blue Prescription Drug plans

 

 

Medicare Supplement

If you choose Original Medicare, Medicare Supplement plans (also known as Medigap plans) cover some of the health care costs left after Original Medicare pays. These plans are standardized, meaning the plan benefits do not change from year to year. These plans are sold by private insurance companies.

 

See Nebraska Blue Medicare Supplement plans