Medicare is health insurance for individuals aged 65 and older who have worked and paid into the Social Security system. Younger individuals receiving Social Security Disability also quality for Medicare.
FOUR PARTS TO MEDICARE
Part A - Hospital Insurance
Medicare A covers inpatient stays, including semi-private room, food, and tests.
Call SHINE for more information on the Part A deductibles and coverage.
Part B - Medical Insurance
Part B coverage includes outpatient services, testing, doctor visits and doctor services in a hospital. Part B is optional and may be deferred if the beneficiary or his/her spouse is still working and has group health coverage through that employer.
Call SHINE for more information on Part B costs and possible penalties.
Part D - Drug Coverage
Anyone with Part A or B is eligible for Part D. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all.
Part C - A Combination of Part A, B and D Benefits
These plans are also called Medicare Advantage plans. Part C plans are usually Health Maintenance Organization (HMO's) and Preferred Provider Organization (PPO's). HMO's are networked to provider groups. PPO's allow a beneficiary to go out of the network. For almost all Part C plans, the beneficiary is required to have a primary care physician; that is not a requirement of Original Medicare.
Part C Medicare Advantage health plans members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care, annual physicals, coverage outside the United States, and even gym or health club memberships.
With many Medicare Plan Options available, it can be difficult to find the right health plan for your medical needs. Whether you’re looking for a Medicare Advantage Plan or Medicare Part D Plan, the SHINE Program helps you find the right plan to minimize your out of pocket Medicare costs.
Please call us for assistance at
SHINE (Serving the Health Insurance Needs of Everyone) is funded by the Agency for Community Living and coordinated by the Massachusetts Executive Office of Elder Affairs in partnership with the Friends of The Milford Senior Center.
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The SHINE Program
60 North Bow Street, Milford, MA 01757, USA 1-800-243-4636, option 3 email@example.com
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