Medicare ABC's

Medicare is the federal health insurance program created in 1965 for people ages 65 and over, regardless of income, medical history, or health status. The program was expanded in 1972 to cover certain people under age 65 who have a long-term disability. Today, Medicare plays a key role in providing health and financial security to 60 million older people and younger people with disabilities. The program helps to pay for many medical care services, including hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility and home health care, and hospice care

Medicare Part A covers inpatient hospital stays, skilled nursing facility (SNF) stays, some home health visits, and hospice care. Part A benefits are subject to a deductible. Part A also requires coinsurance for extended inpatient hospital and SNF stays. $0 if you have worked in the United States for 10 years or 40 quarters.

Medicare Part B covers physician visits, outpatient services, preventive services, and some home health visits. Many Part B benefits are subject to a deductible, and, typically, coinsurance of 20 percent. Typically $174.70 per month.  

Part B late enrollment penalty is an extra 10% added to your monthly premium for each year you could have signed up for Part B, but didn't:  

• You must pay the penalty for as long as you have Part B.  
• The penalty is based on your income, and the government sets the amounts each year.  
• You can appeal the penalty within 60 days of receiving the letter informing you about it.

You can avoid the penalty by:  

• Signing up during your initial enrollment period, which is the three months before and after your 65th birthday  
• Signing up during a Special Enrollment Period (SEP) if you or a spouse is working and covered by a group health plan  
• Signing up during an 8-month SEP if you are 65 or older and have coverage through a group health plan  
• Getting Part B during a Special Enrollment Period if you are an active-duty service member or the spouse or dependent child of an active-duty service member 

Medicare Part C  also known as Medicare Advantage, is a health plan option that provides coverage for Part A (hospital insurance) and Part B (medical insurance). It's offered by private companies that are approved by Medicare (like an HMO or PPO).  Medicare Advantage plans may also include additional coverage, such as: Dental insurance, Vision, Hearing, Health and wellness programs, and Prescription drug coverage (Part D).

Medicare pays a set amount to the companies that offer Medicare Advantage Plans each month. However, each plan may have different out-of-pocket costs and rules for how you receive services. For example, you may need a referral from your doctor to see a specialist, or you may only be able to use doctors, facilities, or suppliers that are part of the plan.  

You can change your Medicare Advantage plan during the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7. You can also make changes during Special Enrollment Periods, which occur when certain events happen in your life, like moving or losing other coverage.