Medicare is a health insurance program administered by the federal government, providing health insurance coverage to people who are 65 years of age or older, under age 65 with certain disabilities and at any age with End-Stage Renal Disease.  Medicare is broken down into four  categories:

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MEDICARE PART A (Hospital Insurance)

You are entitled to receive Medicare Part A on the first day of the month you turn 65. In most cases, it's free. You usually won't pay a premium for Medicare Part A if you or your spouse paid Medicare taxes for at least 10 years while working.  In most cases, you'll automatically be signed up for Part A.  Covered services include

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  - In-patient care in hospitals

  - In-patient care in a skilled nursing facility

  - Hospice care services​
  - Home health care services​
  - In-patient care in a Religious Nonmedical Health Care Institution

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​MEDICARE PART B (Medical Service)

Part B coverage offers medically necessary doctor’s services, outpatient care and most other services that Part A does not cover.  These may include physical or occupational therapies and some home health care services.  Part B also covers some preventive services. Though many services and products are covered, keep in mind that Part B is still not a complete insurance coverage plan. Original Medicare (Part A and Part B) covers many health care services and supplies; however, there are many costs (“gaps”) it doesn’t cover.  Covered services include:

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  - Office visits to a primary care physician or a specialist

  - Some preventive services, such as flu shots and mammograms

  - Laboratory costs, including blood work and X-rays

  - Medical equipment, such as wheelchairs and walkers

  - Outpatient physical therapy

  - Mental health care

  - Ambulance services

  - One initial physical exam within the first 12 months of enrollment

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You may be eligible for Part B if you are disabled, or, in certain situations, if you have end-stage renal disease (ESRD).  Be mindful, however, that if you don't sign up during your initial enrollment period, you may have to pay a late enrollment penalty.  Medicare Part B premium levels are set each year and vary based on your annual income.

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MEDICARE PART C (Medicare Advantage)

Medicare Part C is a combination of Part A and Part B options and is provided by private insurance companies that are approved by Medicare.  Part C is often a lower out-of-pocket risk alternative to the Original Medicare Plan, and usually provides extra benefits such as vision, hearing, dental, and/or health and wellness programs and may include prescription drug coverage (Part D).  Part C plans often have networks in which you are required to use the doctors or hospitals that are contracted with the plan.  Costs for products and services vary by plan and by insurance company.  There are several plan options available with Medicare Advantage.

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MEDICARE PART D (Prescription Drug Coverage)

​Part D is a prescription drug coverage insurance offered by private companies that have been approved by Medicare. Except for certain situations, you should enroll in Part D when you first become eligible to avoid any penalties. Part D was designed to lower prescription drug costs for Medicare recipients and to protect against future costs.  Keep in mind some Part D plans do have a coverage gap or “donut-hole”, meaning you will have to pay out-of-pocket costs up to a limit.  Your yearly deductible, your co-insurance or co-payments, and what you pay in the coverage gap all count towards this out-of-pocket limit.  The limit does not include the drug plan’s premium.

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MEDICARE SUPPLEMENTAL INSURANCE (Medi-Gap) is a private health insurance policy designed to supplement Original Medicare (Part A and Part B). Medi-Gap helps pay some of the health care costs, or “gaps” that Original Medicare doesn’t cover like co-payments, co-insurance and deductibles.  Every Medigap policy must follow federal and state laws and can only offer you a “standardized” plan.  Each standardized plan must offer the same basic benefits, no matter which insurance company provides it. In most states these are sold as plans A through L. Generally, in order to purchase a Medi-Gap policy, you must also have Medicare Part A and Part B.