WHAT IS MEDICARE

For many of those new to Medicare, they can get “mega-scared”. Don’t be scared–be informed and feel empowered! After all you are joining thousands of Americans who now enjoy some of the same great health care coverage and benefits at a reasonable price. Medicare is a federal program that provides health care coverage if you are 65 or older. It is also available for those under 65 and receive Social Security Disability Insurance for at least 24 months or have End-Stage Renal Disease. Medicare is operated by a federal agency, The Centers for Medicare and Medicaid Services (CMS). This program is paid by Social Security and Medicare taxes collected on your income. Additional funding comes from Medicare premiums and the federal budget.

Once you’re eligible for Medicare, you can enroll in “Original Medicare, fee-for-service program offered directly through the federal government or choose to enroll in or choose to enroll in a Medicare Advantage Plan, a type of private insurance offered by insurance carriers (Anthem Blue Cross for example) that contract with Medicare (the federal government).

You  have reached a fork in the road–it’s important to understand your Medicare choices and choose your coverage wisely. How you choose your benefits can affect your out-of-pocket costs and where you can obtain your health care. With Original Medicare, many of the physicians are under assignment with the CMS, which allows patients to choose the doctors and hospitals they prefer. Medicare Advantage Plans (Part C) have network restrictions, which limits your access to doctors and hospitals. However, Medicare Advantage Plans can also provide additional benefits that Original Medicare does not cover, such as routine vision or dental care and prescription drugs.

You still have Medicare if you enroll in a Medicare Advantage Plan, which means that you must pay your monthly Part B premium. Each Medicare Advantage Plan must provide all Part A and Part B services offered by Original Medicare, however under different costs, rules and restrictions that affect how and when your receive care.

Everyone who is enrolled in Medicare receives a red-white-and-blue Original Medicare card, Don’t leave home without it, you never know when you’ll need it. If you choose to receive your coverage through Original Medicare, you will show this card when you receive services. Protect this card (It has your Social Security number printed on it), also keep it covered or laminated. If lost or stolen you will need to apply for a new card through the Social Security Administration.  If you choose to receive your Medicare benefits through a Medicare Advantage Plan, you will still get an Original Medicare card but you will show your private plan card (Cigna Health card for example) when you get services. No matter how your get your Medicare health benefits, only give your Medicare number to your doctors or health care providers.