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The “ABC’s” of Medicare

Medicare is divided into several different programs, or parts.

You will choose to enroll in either Original Medicare, which encompasses Parts A and B, or Medicare Part C (also called Medicare Advantage).

Medicare Part A

Medicare Part A is commonly considered hospitalization insurance. Part A covers costs related to:

  • Inpatient care in a hospital
  • Skilled nursing home care Inpatient care in a skilled nursing facility that is not custodial or long-term
  • Hospice care
  • Home health care

Medicare Part B

Medicare Part B provides for the rest of your non-hospitalization healthcare needs. Under Part B you receive coverage for:

  • Medically necessary services such as doctor visits, tests, and other services as needed to diagnose or treat your condition
  • Preventive services like routine screenings, check-ups, vaccinations, and more
  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health services
  • Limited outpatient prescription drugs

Together, Medicare Parts A and B are called Original Medicare.

Medicare Part C

Medicare Part C, or Medicare Advantage is designed to roll the coverage of Parts A and B into one plan, offered by a private health insurance company that contracts with Medicare. By law, Medicare Advantage plans must offer at least the same coverage as Original Medicare. Many Advantage plans also include Part D, or prescription drug coverage.

Common types of Part C plans include:

  • Health Maintenance Organization (HMO) plans
  • Preferred Provider Organization (PPO) plans
  • Private Fee-for-Service (PFFS) plans
  • Special Needs Plans (SNPs)
  • HMO Point of Service Plans (HMOPOS)
  • Medicare Medical Savings Account (MMSA)

If you opt for a Part C plan, you will have the opportunity to review plans each year during an Annual Election Period.

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