Understanding How Medicare Works

The essential ABCs (and D!) of Medicare

The Medicare program was designed in four parts, each part covering a different benefit category. As a Medicare-eligible person, you will likely need and use a combination of these services depending on your health, and as you get older.

Part A – Hospital Coverage

Most people who qualify for Medicare automatically get Part A coverage without having to pay a premium. Part A includes inpatient hospital care and home health after the hospital stay.

Part B – Medical Coverage

Part B covers your medically necessary doctors' services and outpatient care. A premium for Part B is deducted from your social security check each month to help pay the cost of this coverage.

Part C – Medicare Advantage Plans

If you have part C, your coverage is provided by a private health plan called a Medicare Advantage plan. These health plans are contracted with Medicare to care for you. The coverage includes everything covered under Part A and Part B, except hospice care (original Medicare continues to cover hospice care). Often, the plans include Part D prescription benefits at no extra costs. The plans may include additional benefits not available with Original Medicare, such as vision, gym membership, transportation, and more.

Part D – Prescription Drug Coverage

If you choose Part D coverage, it can help lower your prescription drug costs. This coverage is available as a stand-alone plan or may be included in a Medicare Advantage plan. To learn more and have your questions answered, contact your local licensed insurance agent. You may also desire to attend an upcoming Medicare 101 session taught by local area licensed insurance agents. To find an event near you, click here.

A Quick Look at Medicare: Click here to download a simple guide about Medicare.

Choosing Coverage Based on Your Health Needs

Choosing only Original Medicare means that you have Medicare Part A and/or Medicare Part B only. Keep in mind. Medicare does not cover 100% of your medical and hospital costs. You will be required to meet a deductible and then pay a percentage of the cost of your care. Original Medicare also does not provide coverage for prescription drugs. For this, you need an additional stand-alone plan that may charge an expensive monthly premium.

Purchasing a Medicare Supplemental Policy: The supplement policy, also known as Medi-Gap policy, provides additional, variable coverage to fill in part or all the gaps or costs not covered by Original Medicare, and cost to you may be an expensive monthly premium.

Selecting a Medicare Advantage plan: A Medicare Advantage plan (also called as Medicare Part C) includes all the healthcare benefits you are entitled to under Original Medicare and may include coverage like vision, hearing, dental and prescription drug coverage, or provide monies toward over-the-counter supplies.  Some Medicare Advantage plans may come with a $0 premium.  Medicare Advantage plans can, however, choose not to cover the costs of services that are not medically necessary under Medicare.  Medicare Advantage plans contract with the government to provide coverage to you, so you still have Medicare. To obtain medical services, you will present an insurance member card instead.

To learn more and have your questions answered, contact your local licensed insurance agent. You may also desire to attend an upcoming Medicare 101 session taught by local area licensed insurance agents. To find one near you, click here.

Why Medicare Advantage May Be A Good Choice for Patients Who Are Over 65

Many Medicare Advantage plans offer benefits that are ideal for helping you afford good healthcare coverage for current and future healthcare needs.

If you find that you spend a lot of money on healthcare for things like co-insurance, specialist visits, prescriptions, and tests, a Medicare Advantage plan can help lower these costs with affordable copays on these services. A copay is a set, fixed amount of money that you pay as your share of the cost of care. You are still required to pay a monthly Part B premium as part of a Medicare Advantage plan but may find Medicare Advantage plans with premiums as low as $0 per month.

FamilyCare Medical Group participates in a special program called Salt City Senior Care Advantage in partnership with participating Medicare Advantage plans. When you select one of these plans, you have access to a new approach to care delivery that focuses on keeping you healthy and helping coordinate care resources when you need them.

To learn more and have your questions answered, contact your local licensed insurance agent. You may also want to attend an upcoming Medicare 101 session taught by local area licensed insurance agents. To find an event near you, click here.

What is Included in a Medicare Advantage Plan?

Medicare Advantage plans offer a variety of benefits designed to help members save on their healthcare spending. An experienced advisor can help review the benefits of each plan and help find the right one for you. One way to do this is to make an appointment with a licensed agent who can help you compare plans and understand which providers belong in the network and what the cost of any medications you are currently taking would be. If you see a healthcare provider that does not belong to the plan, your services may not be covered, or your costs could be higher.

To find a plan that is right for you, and continue receiving care from FamilyCare Medical Group, contact your local licensed insurance agent. You may also desire to attend an upcoming Medicare 101 session taught by local area licensed insurance agents. To find an event near you, click here.

The following are the 2022 Medicare Advantage Plans we work with:
  • Aetna
  • Humana
  • UnitedHealthcare

Medicare Advantage: Saving on Hospital Care, Prescription Drugs and other Health Care Expenses

Receiving health care at a hospital can be very costly. However, many Medicare Advantage plans offer low copays on physician visits and include a limit on how much you pay for these services.

Each Medicare Advantage plan can charge different out-of-pocket costs, making it even more important to compare benefits and find the plan that is right for your needs and budget. Original Medicare does not cover prescriptions, and adding a supplemental prescription plan can often cost you more in monthly premiums. However, many Medicare Advantage plans include prescription coverage for no additional cost.

Medicare Advantage plans can offer a number of additional benefits for you that are not offered in Medicare Parts A and B (Original Medicare). They may include dental, vision, and hearing coverage, as well as extra benefits designed to help members save money and stay healthy, including:

  • Gym membership
  • Nutritional programs
  • Transportation to and from medical appointments
  • Over-the-counter medical supply allowances

To find a plan that is right for you, and continue receiving care from your physician at FamilyCare Medical Group, contact your local licensed insurance agent.  If you don't have an insurance agent, you may call (315)232-0013 to speak with an independent licensed insurance broker who is familiar with our practice and the plans that we are contracted with.  You may also desire to attend an upcoming Medicare 101 session taught by local area licensed insurance agents. To find one near you, click here.

Need help navigating your Medicare options?

A licensed Medicare broker is a professional independent of any specific health plan and is appointed to represent multiple health plans. They can review your specific needs and help you compare Medicare coverage options for this enrollment year.

We can put you in touch with brokers who understand the Salt City Care Advantage program. These brokers can help you evaluate coverage options to find one that meets your needs. With your permission, we will give your contact information to a broker to contact you to discuss coverage options.

Prefer to discuss over the phone? Call us at (315) 370-1508.

* = Required

 

By clicking here, I authorize Salt City Senior Care Advantage to furnish my contact information to a broker and I authorize the broker to contact me.

I also authorize the broker to email, call or text me at the phone number and email provided (even if that number is on any Do Not Call Registry or is a wireless number) regarding Medicare coverage options, including potentially through insurance products and services (such as Medicare Advantage plans). The broker’s messages may be artificial or pre-recorded, or may be sent by an automatic telephone dialing system to the relevant number. I understand that I am not required to opt in to receive text messages, calls, or emails as a condition (directly or indirectly) of transacting with Salt City Senior Care Advantage or broker. I am the current authorized user of the phone number and email address provided. I consent to calls with me being recorded and monitored. I understand that text messages are recurring and on-going and that messaging and data rates may apply. I consent to and understand that emails are recurring and on-going unless I choose to unsubscribe. I understand that I can withdraw consent or unsubscribe at any time by texting.

Copyright © 2023 Salt City Senior Care Advantage