The ABCDs of Medicare with First Choice Medical Group

The ABCDs of Medicare

Medicare is the national health insurance program for three types of patients:

  1. Patients 65 and older (the primary audience)
  2. Certain qualifying young people with disabilities
  3. People with end-stage renal disease (permanent kidney failure requiring dialysis)

Original Medicare has three parts, each covering a specific category of healthcare: Part A (hospital insurance), Part B (general medical insurance), and Part D (prescription drug coverage). 

A fourth part, Medicare Advantage Plans, are often referred to as Medicare Part C.  Medicare Advantage plans are offered by private, Medicare-approved insurance companies to combine Medicare Part A (hospital) and Part B (general medical) insurance into one health plan.  Most Medicare Advantage plans also include prescription drug coverage (Part D).  These plans can be a good option because they include annual wellness visits and set a limit on what you’ll have to pay out-of-pocket each year for all covered services. 

When signing up for Medicare, you may get your benefits either through the original Medicare plan or a Medicare Advantage plan, depending on your needs and how you qualify.

Medicare is not to be confused with Medicaid, which is a health insurance program administered by individual states to deliver affordable health insurance to low-income families, pregnant women, the elderly, and those with disabilities.  In California, the Medicaid program is called ‘Medi-Cal.’

As a Medicare eligible person, you will likely need and use a combination of these services, depending on your health and your age.

 

Don’t Miss Annual Enrollment Period

Annual Enrollment Period is your time to get the health benefits you need to maintain your health and wellness. The Annual Enrollment Period Dates are October 15th to December 7th.

The professionals at First Choice Medical Group can help walk you through the process. We’re here to support you and give you the resources you need to maintain a high level of quality care.

Get in touch with us today and live a healthier tomorrow!


Medicare Part A: Hospital Services

In general, Part A covers:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Inpatient care in a skilled nursing facility (not custodial or long-term care)
  • Hospice care
  • Home health care

What is not covered by Medicare Part A:

  • Long-term care (also called custodial care)
  • Most dental care
  • Eye examinations related to prescribing glasses
  • Dentures
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care
  • Observation status in the hospital (even if you stay overnight in a regular hospital you might be classified as an outpatient)

Medicare Part B: Medical Service

Part B helps pay for the care you receive from doctors. It also covers:

  • Outpatient care
  • Medical tests
  • Durable Medical Equipment and supplies
  • Preventive care and Routine care, including mammography and Pap tests
  • Getting a second opinion before surgery

Medicare Part C: Medicare Advantage Plans

Medicare Advantage Plans provide all benefits covered by Part A and Part B and more.

Some include vision, hearing, and dental coverage, plus wellness programs. Some also provide free transportation services for medical appointments. Most plans include coverage for prescription drugs (Part D) at no additional charge.

The amount of money you pay toward some services may differ when you have a Medicare Advantage Plan.

Only Medicare-approved private companies can offer Medicare Advantage (MA) plans.

Medicare Part D: Prescription Drug Plans

You must have prescription drug coverage. Some plans already have a Medicare part D coverage included.

You can choose:

  • Standalone prescription coverage (Prescription Drug Plan)
  • Medicare Advantage plan coverage that includes medical and prescription coverage.
  • Durable Medical Equipment and supplies
  • Preventive care and Routine care, including mammography and Pap tests
  • Getting a second opinion before surgery

FOR MORE INFORMATION

Call 833-446-1758 to speak to an authorized representative or licensed insurance agent