Basics of Medicare

4 Parts to Medicare referred to as:“The ABC’s of Medicare”

• Inpatient care in hospitals

• Inpatient care in a skilled nursing facility (not custodial or long term care)

• Hospice care services

• Home health care services

• Inpatient care in a Religious Nonmedical Health Care Institution

• Typically paid for by Social Security, some will have to pay $450

Medicare: Part A (HOSPITAL INSURANCE)

• Ambulance Services

• Clinical Lab Services

• Doctor Services

• Durable Medical Equipment

• Home Health Services

• Physical Exams

• Annual Deductible ($162.50 for 2011)

Medicare:Part B (MEDICAL INSURANCE)

• Combines Medicare Part A, Part B and USUALLYPart D

• Offered through private insurance companies

• Maintains network of Medicare approved doctors & hospitals. You may pay more or all costs if care is not seen by provided network from plan

• Pay monthly premium on top of part B deductible

• Offers PPO, HMO, PFFS and SNP (special needs plans)

Medicare:Part C (MEDICARE ADVANTAGE)

• Helps cover cost of prescription drugs

• May help in protecting against higher cost in the future

• In most cases covers all diabetic supplies

• Could pay “late-enrollment” penalty if not applying as soon as you’re eligible

Medicare:Part D (PRESCRIPTION DRUG or PDP’s)

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