Medicare (Parts A & B)

• Am I Eligible For Medicare?
• How to Select a Medicare Health Plan
• Enrollment Questions
• How Much Does Medicare Cost?
• Should I Take Medicare Part B?
• What Does Medicare Cover?
• What Are My Rights Under Medicare?
• What is Medicare Supplement Insurance?

What is Medicare?

Medicare is a federal health insurance program for people 65 and older, and for eligible people who are under 65 and disabled. Medicare is run by the Centers of Medicare and Medicaid Services, and agency of the U.S. Department of Health and Human Services. It is controlled by Congress. Medicare was never intended to pay 100% of medical bills. Its purpose is to help pay a portion of medical expenses. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, and services not covered by Medicare.

There are two parts to Medicare: Part A and Part B:

• Part A is hospital insurance. It helps pay for inpatient hospital care, limited coverage in a skilled nursing facility, and full coverage for eligible home health care and hospice care.
• Part B is medical insurance. It helps pay for doctor services, outpatient hospital services, durable medical equipment, home health care not covered by Part A, and other services.

Managed Care Plans

Another option is a Medicare managed care plan. When you enroll in a managed care plan, you choose your doctor from a list of primary care doctors who are part of that plan's network. Your primary care doctor then coordinates all of your health care needs. If you do not choose a primary care doctor, the managed care plan will assign one to you.

In some managed care plans, you can see a doctor outside the network, but it will cost you more money. Also, you may have to pay a co-payment for some services and visits.

Today, there are many different kinds of managed care plans. Their benefits, costs, and rules vary. Be sure to compare each plan and consider the type of insurance (fee-for-service vs. managed care) that is best for you. For information about Medicare benefits, call the Social Security Administration office listed in your phone book. Or call the toll-free Medicare hotline at 1-800-MEDICARE (1-800-633-4227). Information about Medicare eligibility, enrollment, insurance plans, and more is also available online at www.medicare.gov.

Source: Indiana Senior Health Insurance Information Program (SHIIP)