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Understanding Medicare

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Introduction

Navigating Medicare can feel overwhelming, but it doesn’t have to be. Whether you’re new to Medicare or looking to make the most of your existing coverage, we’re here to guide you every step of the way.

Medicare is a federal health insurance program designed primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. Its goal is to provide coverage for essential healthcare needs, but it requires enrollees to understand its parts and choose options that meet their personal circumstances.

Key Components of Medicare

Part A (Hospital Insurance)

Covers inpatient hospital stays, care in skilled nursing facilities, hospice care, and some home health care. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working (1,2)

Part B (Medical Insurance)

Covers outpatient care, preventive services, certain doctor services, and durable medical equipment. It requires a monthly premium and helps with medically necessary and preventive services (2)

Part C (Medicare Advantage)

Offered by private companies approved by Medicare, these plans bundle Part A and Part B and often include Part D (drug coverage). They may also offer additional benefits such as dental, vision, and hearing care (2))

Part D (Prescription Drug Coverage)

Helps cover the cost of prescription drugs. Administered by private insurers, these plans may also protect against unexpected drug costs (2))

Choosing Coverage

Beneficiaries can opt for Original Medicare (Parts A and B) with an optional Part D plan and Medigap (supplemental insurance) or a Medicare Advantage plan that integrates Parts A, B, and D. Each option has unique benefits and limitations, so understanding these choices is critical (1) (2)

Additional Resources

Preventive Care and Cost Savings

Medicare covers many preventive services, such as screenings and vaccinations. Programs like Medigap and Medicaid may help reduce out-of-pocket costs for eligible individuals (1) (3)

Enrollment Periods

Enrolling in Medicare is time-sensitive, with specific windows to join, make changes, or leave plans. Missing these periods can result in penalties or gaps in coverage (1) (2)

For more detailed information on Medicare, visit Medicare.gov or call 1-800-MEDICARE. These resources provide tools to compare plans, estimate costs, and understand eligibility criteria

  1. https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/how- does-medicare-work
  2. https://www.medicare.gov/publications/11306-Medicare-Medicaid.pdf
  3. https://www.medicare.gov/providers-services/original-medicare/part-a

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For Employers, Advisors, & Agents

Our Medicare back office gives you a way to provide a trusted Medicare resource to your employees or clients. We partner with you (remove) to assist you, at no additional expense,(Add) to educate your clients or employees, provide them with suitable options, enroll and support every step of the way. We ensure they get the right coverage that fits their unique needs.

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