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  • What are the different parts of Medicare coverage?

    Understanding Medicare    »    What are the different parts to Medicare?

    Medicare covers many health care needs for seniors and others who qualify. In addition to Original Medicare offered by the government, private companies approved by Medicare provide a different way to get your health care and prescription drug coverage. These private plans are known as "Medicare Advantage" plans. The type of Medicare coverage that you select will affect your out-of-pocket expenses, benefits (to some extent), ability to select a doctor or other health care provider, administrative convenience, and coverage rules.

    Part A

    The part of Medicare that covers hospice care, home health care, skilled nursing facilities, and inpatient hospital stays, including rehabilitation hospital and psychiatric hospital care.
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    Part B

    The part of Medicare that covers physician care, outpatient hospital care and surgery, home health care, durable medical equipment and supplies, and ambulance services. Part B also covers some preventive services to help maintain your health. Part B coverage is optional, though you may be charged a penalty fee if you are without coverage and later want to enroll in Part B.
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    Medicare Advantage

    Plans offered by private insurance companies that contract with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage plans may also cover other services, including prescription drugs. Medicare Advantage plans have different structures, and may be HMOs, PPOs, or Private Fee-for-Service plans (PFFS). If you are enrolled in a Medicare Advantage plan, Medicare services are covered through the plan, and Original Medicare will not pay for any healthcare services received by an enrollee in a Medicare Advantage plan.
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    Medicare Cost Plans

    A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. In a Medicare Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

    Medigap (Medicare Supplement Insurance)

    Medigap plans are supplemental insurance plans sold by private insurance companies to fill "gaps" in Original Medicare coverage. You can choose from a range of standardized plans, each offering different coverage. Beginning in 2010, there are 11 available Medigap policies (A, B, C, D, F, high deductible F, G, K, L, M, and N). To qualify for enrollment in a Medigap policy, you generally must have Medicare Part A and Part B. Medigap policies only work in conjunction with the Original Medicare plan and will not pay for costs associated with Medicare Advantage. People in Medicare Advantage plans should not purchase Medigap policies.
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    Medicare Part D - Prescription drug coverage

    Prescription drug coverage is available to all people who are eligible for Medicare. To receive coverage for prescription drugs, people must enroll in a private prescription drug plan, sometimes known as a "Part D plan." Plans are offered through insurance companies approved by Medicare. Part D coverage is optional, though you may be charged a penalty fee if you are without prescription drug coverage and later want to enroll in a Part D plan.
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