Medicare 101 Basics

Medicare Cost     Medicare Ins and Outs    Original Medicare   Medicare Advantage   Medigap/Supplemental 

Medicare Handbook 2019      Social Security and Medicare     Social Security & Medicare Spanish

Texas Benefits / Medicade     Apply for Medicare     Apply for EXTRA HELP      The Donut Hole

What are the parts of Medicare? 

• Part A (Hospital Insurance)

  •  Helps cover: • Inpatient care in hospitals • Skilled nursing facility care • Hospice care • Home health care. 

  • Part B (Medical Insurance) Helps cover: • Services from doctors and other health care providers • Outpatient care • Home health care • Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment and supplies) • Many preventive services (like screenings, shots, and yearly “Wellness” visits). 

  • Part D (Prescription drug coverage) Helps cover: • Cost of prescription drugs Part D plans are run by private insurance companies that follow rules set by Medicare. 

Your Medicare options 

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare:

•  Original Medicare 

  •  Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).

  •  • If you want drug coverage, you can join a separate Part D plan. 

  • • To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage. 

You can add: 

• Part D 

You can also add: 

• • Supplemental coverage (Some examples include coverage from a Medicare Supplement Insurance (Medigap) policy, or coverage from a former employer or union.) 

Medicare Advantage (also known as Part C) 

• Medicare Advantage is an “all in one” alternative to Original Medicare.  These “bundled” plans include Part A, Part B, and usually Part D. 

• Some plans may have lower outof-pocket costs than Original Medicare. 

• Some plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, or dental. Part A Part B You can add: Part D You can also add: Supplemental coverage (Some examples include coverage from a Medicare Supplement Insurance (Medigap) policy, or coverage from a former employer or union.) Part A Part B Most plans include: Part D Some plans also include: Lower out-of- pocket costs Extra benefits