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Medicare Options for Beneficiaries
If you are a person who is now eligible for Medicare and are interested in the options available to you, you have come to the right website. Health Plans of America has the tools, resources and information to help you make smart decisions about Medicare Supplement, Medicare Advantage, and Prescription Drug Plans. 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. Medicare is a federally-funded health insurance program that covers chronic conditions as well as those that are acute. Medicare Part A is commonly referred to as Hospital Insurance and does not have a premium for most consumers. It covers services considered medically necessary such as inpatient hospital care, critical access care, short-term care in skilled nursing facilities, hospice, and home health care. Medicare Part B is referred to as Medical Insurance and covers medically necessary services such as doctor and outpatient care. Unlike Part A, Part B coverage does require a monthly premium. It's important to note that Medicare Parts A and B provide specific benefits. Most people eligible for Medicare are covered under the Original Medicare Plan. What individuals pay for Medicare will vary based on plan selection.
Medicare Supplement Plans — Otherwise referred to as “Medigap” insurance, these plans help pay for “gaps” in Original Medicare. There are 10 standardized plans available in most states. Each plan type covers a different combination of out-of-pocket Medicare costs.
Medicare Part C Plans — Otherwise referred to as “Medicare Advantage”, these plans replace traditional Medicare with a private health insurance plan that offers the same benefits and possibly additional benefits. They work like an HMO or PPO health plan. They limit out-of-pocket expenses every year and may require you to stay in-network for services.
Medicare Part D Plans — Covers the cost of outpatient prescription drugs. You can get Part D coverage through a stand alone prescription drug plan that you can use alongside Original Medicare, or you can join a Medicare Advantage plan that includes Part D drug coverage. The plans have a Formulary or List of Covered Drugs, and only Formulary drugs count as out-of-pocket.
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.