What is Medicare?
- People 65 or older
- People under 65 with certain disabilities
- People of any age with End-Stage Renal Disease (ESRD)
Medicare consists of 4 parts:
| Medicare Plan | Type of Coverage | Plan Details |
|---|---|---|
| Medicare Part A | Hospital Insurance |
|
| Medicare Part B | Medical Insurance |
|
| Medicare Part C | Advantage Plan | Plans offered by private insurance companies that contract with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage plans may also cover other services, including prescription drugs. Medicare Advantage plans have different structures and may be HMOs, PPOs or Private Fee-for-Service plans (PFFS). If you are enrolled in a Medicare Advantage plan, Medicare services are covered through the plan, and Original Medicare will not pay for any healthcare services received by an enrollee in a Medicare Advantage plan. |
| Medicare Part D | Prescription Drug Coverage |
|
Medigap Plan (Supplemental)
| Medigap Plan Coverage | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Medigap Benefit | A | B | C | D | F* | G | K | L | M | N |
| Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B coinsurance or copayment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100%*** |
| Blood (first 3 pints) | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Part A hospice care coinsurance or copayment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled nursing facility care coinsurance | — | — | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A deductible | — | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 50% | 100% |
| Medicare Part B deductible | — | — | 100% | — | 100% | — | — | — | — | — |
| Medicare Part B excess charges | — | — | — | — | 100% | 100% | — | — | — | — |
| Foreign travel emergency (up to plan limits) | — | — | 80% | 80% | 80% | 80% | — | — | 80% | 80% |
| Out-of-Pocket Limit | ||||||||||
| $5240 | $2620 | |||||||||
| *Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for medicare-covered costs up to the deductible amount of $2,240. in 2018 before your Medigap plan pays anything.
**Plan N pays %100 of the Part B coinsurance, except for copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission. |
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