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Medicare and Supplemental Health Insurance for Beneficiaries

If you are a person who is now eligible for Medicare and supplemental health insurance for beneficiaries, you have come to the right website. Health Plans of America has the tools, resources and information you need to make smart decisions about supplemental insurance coverage. But first, let’s learn more about Medicare...

What is Medicare?

Medicare is a Social Security benefit for which individuals age 65 and older or individuals under age 65 that have certain disabilities (such as permanent kidney failure (ESRD) or ALS), may be eligible. Essentially, Medicare is a federally-funded health insurance program that covers treatment of acute medical conditions or those conditions from which individuals usually recover. Medicare attempts to provide reasonably priced, quality healthcare to the segment of the population that generally lives on a restricted income. Medicare is provided in four parts, Parts A-D, and each part covers specific services. Most people eligible for Medicare are covered under the Original Medicare Plan. Individuals covered by this plan pay a portion of their health care costs as well as an additional premium, referred to as a deductible and coinsurance, for Parts A and B.

About Medicare Part A

Medicare Part A is commonly referred to as the Hospital Insurance and covers services considered to be medically necessary such as inpatient hospital care, critical access care, short-term care in skilled nursing facilities, hospice and home health care. Medicare usually does not pay for long-term care at home, in assisted living facilities, or at nursing homes. Medicare Part A is free to most Medicare beneficiaries if the beneficiary or their spouse paid Medicare taxes while they were working 40 quarters/10 years or more. Even if an individual is not eligible to receive Part A free-of-charge, the individual may be eligible to purchase Part A coverage if they meet eligibility requirements.

About Medicare Part B

Medicare Part B is referred to as Medical Insurance, and Part B covers medically necessary services such as doctor and outpatient care. Part B does cover some preventive services. Additionally, some occupational and physical therapies may be covered by Medicare Part B. Unlike Part A, Part B coverage does require a monthly premium. While standard premium amounts do exist, premiums can be higher for some beneficiaries than others. This is because Part B premiums may be based on beneficiary income. It is important to remember that Part B is not a 100% insurance coverage plan, and beneficiaries will be responsible for the balance of expenses not paid by Medicaid and not all medical services are covered.

If you have any questions about Medicare plans, coverage, or services; please call us at the toll-free number at the top of this page.

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