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we’re here to Answer all your questions
Choosing a Medicare health plan can be confusing and overwhelming to most. We at Vance Insurance Group, Inc. are here to help.
What are the different parts of Medicare?
Parts of Medicare
What Are the Parts of Medicare?
Medicare has four different parts that provide coverage for specific services. Learning what each part covers can help you better understand your options and feel more confident about your decisions.
- Medicare Part A (Hospital Coverage)
Together, Medicare Part A and Medicare Part B are known as Original Medicare. Medicare Part A is hospital insurance that provides coverage for:
- Inpatient care
- Skilled nursing facility care
- Hospice care
- Some home health care
Most people don’t pay a monthly premium for Medicare Part A. It’s coverage that’s earned from Medicare taxes that you or a spouse have paid while working. If you don’t qualify for premium-free Part A, you can also buy Part A coverage. Our licensed insurance agents can help guide you through that process.
Medicare Part B (Medical Coverage)
Together, Medicare Part A and Medicare Part B are known as Original Medicare. Medicare Part B is medical insurance for medically necessary services and preventive services. It provides coverage for:
- Doctor’s services
- Outpatient care
- Ambulance services
- Clinical research
- Durable medical equipment
- Limited prescription drugs
- Mental health
- Early stage preventive services
Most people will pay a monthly premium for Medicare Part B. The standard amount is set each year and may increase based on your gross income as reported to the IRS.
If you receive benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management, your Part B premium is automatically deducted from Security benefit payment. Otherwise, you will receive a bill.
You’re not required to enroll in Medicare Part B during your Initial Enrollment Period. However, in many cases delaying enrollment means you’ll have to pay a late enrollment penalty for as long as you have Part B coverage. We can help you decide if enrolling in Part B is right for you.
Medicare Part C (Medicare Advantage)
Medicare Part C, commonly known as Medicare Advantage, is coverage offered by private insurance companies that have a contract with the federal government. Medicare Advantage combines your Part A hospital, Part B medical and often Part D prescription drug coverage into one plan.
- Provide all the benefits of Original Medicare (Parts A and B).
- Often include extra benefits — like vision, hearing, dental and wellness — that Original Medicare doesn’t cover.
- Limit the amount of money you pay out-of-pocket for medical expenses each year.
- May require you to use providers within the plan’s network and charge you more when you use out-of-network providers.
- Must notify you of any changes to the plan before the next enrollment year.
- Are only available to you if you’re enrolled in both Medicare Part A and Medicare Part B.
With Medicare Advantage, you must continue to pay your Medicare Part B premium. You may also have to pay a monthly premium to the insurance company that provides your coverage.
Medicare Part D (Prescription Drugs)
Offered by private insurance companies, Medicare Part D coverage helps you pay for your prescription drugs. There are two basic ways to get Part D prescription drug coverage:
Purchase a standalone Medicare Part D plan
- You must have both Parts A and B (Original Medicare) to join a Part D plan.
- Join a Medicare Advantage (Medicare Part C) plan that includes Part D prescription drug coverage
All Part D plans — including Medicare Advantage plans with Part D benefits — cover a wide range of prescription drugs. However, coverage and cost vary from plan to plan:
- Each plan has a formulary — a list of the specific prescription drugs the plan covers.
- Many plan formularies also have tiers that place covered prescription drugs into different cost levels.
- Prescription drugs in a lower tier will generally cost you less than those in a higher tier.
Medicare Supplement (Medigap)
Original Medicare (Parts A and B) doesn’t cover everything. It only covers a portion of your costs for covered services — and it doesn’t limit what you pay out-of-pocket for health care expenses each year.
To help fill these coverage gaps, many private insurance companies offer Medicare Supplement, or “Medigap”, insurance policies that help pay for your health care costs. When you have a Medigap policy, Medicare continues to pay its share of the approved amount for covered services. Your Medigap policy then pays its share.
Here are some important things to know about Medigap policies:
- You must have Original Medicare (Parts A and B) to buy one.
- They have a monthly premium that you pay to the insurance company.
- You must also continue to pay your Medicare Part B premium.
- They don’t include prescription drug coverage — you must purchase a Part D plan separately.
- They generally don’t cover things like long-term care, vision, dental, hearing or private-duty nursing.
- They only cover one person — if you and your spouse want Medigap coverage, you’ll each need separate policies.
How is Medicare Different From Other Health Insurance?
You may be surprised at the differences between Medicare and other types of health insurance. If you’ve had health coverage through your employer, your plan likely included medical and prescription drug coverage, along with other benefits. It also may have covered both you and your spouse.
Medicare only covers one person at a time. This means you and your spouse must enroll separately. In addition, Medicare gives you options that can make it possible to receive your benefits in a variety of different ways.
You can:
- Choose hospital and medical coverage delivered through the federal government.
- Add prescription drug coverage delivered through a private company.
- Purchase a supplemental insurance policy from a private insurer that can help cover some of the costs.
- Choose coverage from a private insurer that combines hospital, medical and often prescription drug coverage into one plan.
In short, with Medicare you can choose coverage that fits your needs, budget and lifestyle. We can help you take full advantage of that freedom.
Who is Eligible for Medicare?
- Age 65+
- Under age 65 with certain disabilities
- Have End-Stage Renal Disease (ESRD)
When and How Do I Enroll?
If you’re like most people, you’ll enroll in Medicare around the time you turn 65. Your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn 65 and ends three months after that birthday.
Keep in mind that if you don’t get Medicare during this Initial Enrollment Period, you may have to pay Medicare Part B or Part D late enrollment penalties. Plus, you could be missing out on coverage and benefits that can help protect your health and finances. That’s why it’s generally a good idea to enroll as soon you can. How you enroll generally depends on if you’re getting benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management.
If you’re receiving benefits from any of these sources at least four months before you turn 65:
You’ll automatically get Medicare Part A and Part B starting the first day of the month you turn 65.
- You’ll automatically get Medicare Part A and Part B starting the first day of the month you turn 65.
- If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.
If you’re not receiving benefits from any of these sources at least four months before you turn 65:
- You’ll need to sign up with Social Security to get Medicare Part A and Part B.
- You can apply online at socialsecurity.gov, at your local Social Security office or by calling Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
- If you worked for a railroad, call the RRB at 1-877-772-5772.
If you’re under 65 and have a qualifying disability, you’ll automatically get Part A and Part B:
- After you get disability benefits from Social Security for 24 months.
- After you get certain disability benefits from the RRB for 24 months.
- The month your disability benefits begin if you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s Disease).
If you have ESRD (End-Stage Renal Disease), you can choose to enroll in Part A and Part B:
- You’ll need both Part A and Part B to qualify for the full benefits that cover certain dialysis and kidney transplant services.
- You can apply online at socialsecurity.gov, at your local Social Security office or by calling Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
Medicare Disclaimers
Vance Insurance Group represents Medicare Advantage HMO, PPO, PFFS, and Prescription Drug Plan organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system. Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply. Plan Enroll is a brand operated by Integrity Marketing Group, LLC and is used by its affiliated licensed insurance agencies that are certified to sell Medicare products. Vance Insurance Group and PlanEnroll is a non-government website and is not endorsed by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (DHHS) or any other government agency.
We do not offer every plan available in your area. Currently we represent 6 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Contact Us
Location:
1200 S Horner Blvd #5046, Sanford NC 27331
Support:
info@vigrp.com
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