Module 1, Topic 1
In Progress

Day 4: What is Medicare and MedPAC

Petria September 3, 2020

What is Medicare?
Our National Health Plan

Medicare is a federal insurance program that provides medical and health-related services to specific groups of people in the United States. It was initially created to provide health care services for citizens of America who were 65 of age and older.

  • Part A
  • Part B
  • Part C
  • Part D

Different parts of Medicare – Part A

Medicare Part A (Hospital Insurance)Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care

Different parts of Medicare – Part B

Medicare Part B (Medical Insurance)Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Different parts of Medicare – Part C

Medicare Part C (Medicare Advantage Plans).  A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. Medicare Advantage Plans include:

  • Health Maintenance Organizations
  • Preferred Provider Organizations
  • Private Fee-for-Service Plans
  • Special Needs Plans
  • Medicare Medical Savings Account Plans
  • If you’re enrolled in a Medicare Advantage Plan:
  • Most Medicare services are covered through the plan
  • Medicare services aren’t paid for by Original Medicare
  • Most Medicare Advantage Plans offer prescription drug coverage

Different parts of Medicare – Part D

Medicare Part D (prescription drug coverage) Part D adds prescription drug coverage to:

  • Original Medicare
  • Some Medicare Cost Plans
  • Some Medicare Private-Fee-for-Service Plans
  • Medicare Medical Savings Account Plans

These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plan

Medigap

Medicare Supplement insurance, commonly referred to as “Medigap,” is a private form of medical insurance that can help cover the gaps left by Medicare. A Medigap plan can help pay for some of the out-of-pocket costs that Original Medicare (Part A and Part B) doesn’t pay for, such as deductibles, copayments, coinsurance and other costs.

What Do Medigap Plans Cover?

There are 10 standardized Medigap plan options to choose from in most states. (Minnesota, Massachusetts, and Wisconsin have different options.)
The basic benefits offered by Medicare Supplement plans are standardized by the federal government, but you buy the plans from private insurance companies, not the government.  You can use the 2019 Medigap plan chart below to compare the benefits that are offered by each type of plan.