-97% of Providers Nationwide accept Traditional Medicare
-No Referrals Needed
-No Prior Authorization Needed from your primary care doctor or an insurance company
- You and your doctor make all the decisions in regards to your healthcare, an insurance company has no say
Medicare Part A provides hospital coverage. It will help pay for “room and board” fees for any hospital stays. Part A will begin paying for expenses after the deductible for the benefit period has been met.
Most individuals receive premium-free Part A. As long as an individual has worked for ten years and paid payroll tax during that time, Part A will remain premium-free. However, if an individual has not met that requirement, Part A can have a premium.
Days 91 and beyond: $800 coinsurance PER DAY
Part B offers benefits for outpatient medical care. This includes visits to the doctor and many preventive services. It will pay 80% of covered services after the deductible has been met ($240 in 2024)
$240 Annual Part B Deductible Met - 80/20 split after, uncapped. Meaning unlimited financial risk.
Part B Excess Charges: Medical Providers reserve the right to charge an additional 15% of the Medicare approved rate. $10,000 bill = $1,500 in Excess Charges
Part C plans offer “all-in-one” Medicare coverage. They bundle the benefits from Parts A and B and sometimes include additional benefits for routine dental, vision, and hearing services, as well as prescription drug coverage. Medicare Advantage Plans are managed and issued by private insurance carriers contracted with Medicare.
If an individual enrolls in a Part C plan, the benefits are all provided by the private insurance company instead of the traditional Medicare program.
Part D offers prescription drug coverage. Like Part C plans, Part D plans are offered by private insurance companies.
Most Medicare Advantage plans offer Part D Drug Coverage included in the plan (MAPD)
With a Medicare Supplement, you must add a stand alone Part D Drug Plan (PDP)
Medicare Alphabet Explained
Part A and B together make up Original/Traditional Medicare
Medicare Part C(Medicare Advantage) is required by CMS to offer at least as good of coverage as Original Medicare - but offers additional benefits Medicare doe such as Dental, Vision, Hearing, OTC, and Part D Drug Coverage.
You either need:
-MAPD - Medicare Advantage Prescription Drug Plan
-PDP - Stand alone Prescription Drug Plan to go with your Supplement Plan