What is Medicare?
Medicare is the federal health insurance program for:
- People 65 or older
- People under 65 with certain disabilities
- People of any age with End-Stage Renal Disease (ESRD)
Original Medicare has 2 Parts:
Part A - Hospital Insurance helps cover:
- Hospital Care
- Care in a skilled nursing facility
- Hospice Care
- Some home health care
For most individuals, Medicare Part A (hospital insurance) is free. If neither you nor your spouse has paid Medicare taxes for at least 10 years, you will need to pay a monthly premium. (You can find this amount in the "Your Medicare Costs" section at www.medicare.gov.)
Part B - Medical Insurance helps cover:
- Doctor and other health care providers' services
- Outpatient care
- Durable medical equipment
- Home Health Care
- Some preventative care services, such as your flu shots and yearly wellness visits
Medicare Part B requires a monthly premium. The Part B premium can come right out of your Social Security check. Most people will pay the standard premium amount. If the modified adjusted gross income is above a certain amount, you may pay more. (Medicare uses the modified adjusted gross income reported on your IRS tax return from two years ago.)
Timing for Part B enrollment varies based on individual circumstances; however, in most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty.
Original Medicare offers important basic medical coverage, but there are still "gaps" in the coverage Parts A and B provide. Private insurance companies offer additional coverage options to help with health care costs that are not paid by original Medicare.
Blue Cross and Blue Shield of Vermont offers two forms of additional coverage:
- Medicare Supplemental Plans (also called Medigap plans) assist with the remaining costs to Medicare Part A & B after Medicare pays its share.
- Medicare Part D Prescription Drug Coverage helps you pay for the cost of your prescription medications at the pharmacy or mail order.
Together with original Medicare, Medicare Supplemental Coverage and Part D Prescription Drug Coverage provide more comprehensive peace-of-mind than original Medicare alone.