The healthcare system in the US is messy to say the least, and the pandemic has highlighted this for people both here and overseas. The cost of a ride to the hospital in an ambulance alone can set you back $1,000 USD in some states, which gained media attention and outrage from citizens in other countries. When it comes to illness or injury, you’ll need to circumnavigate the nuances of public health insurance options like Medicare and medicare terms.

Finding the right Medicare plan for you or your loved one is going to take some work, hence why so many people utilize an insurance broker. Before you contact us about our Medicare services Staten Island NY, it can be helpful to get your head around the terminology we use. Knowing what plans or support you are eligible for can save you a lot of time and money, so read on to learn more.

Here is a brief glossary of the Medicare-related terms that make up our Medicare services Staten Island NY.

 

Disclaimer

All information here has been gleaned from the Medicare.gov website, and is subject to change.

 

Medicare Terms

Medicare is the federal health insurance program for people under the following conditions:

• Of or over the age of 65

Certain younger people with disabilities

• Those with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)

 

Within Medicare are four different Parts which pertain to different services.

 

Medicare Part A (Hospital Insurance)

The most commonly referred to part of Medicare, and arguably the most important for most who rely on Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. For most seniors (65 or over), Medicare Part A is free.

It’s important to note that Medicare Part A does not cover custodial care in a nursing facility.

 

Medicare Part B (Medical Insurance)

Part B covers medically necessary outpatient care, certain doctor’s services, medical supplies, and preventive services. Unlike Part A, Part B does require most enrollees to pay a premium of $170.10 per month (in 2022).

 

Original or Traditional Medicare Terms

This refers to Medicare Part A and Part B, and while it may be sufficient for some people, most will need to seek Part D (Drug Insurance) and the Part C (Advantage Plan) to cover all potential costs.

 

Medicare Part D (Drug Insurance)

This is an optional benefit which can cover the costs of prescription drugs, and is provided by insurance companies approved by Medicare. This plan usually has levels depending on the quality of prescription medication desired (generic vs. brand name).

 

Medicare Part C (Advantage Plan)

If the Traditional Medicare isn’t enough for your needs, a Medicare Advantage Plan (Part C) may be more suitable. This is a plan offered by a private company that contracts with Medicare, and provides all of Part A and B benefits with a few exclusions.

Medicare Advantage Plans Include:

– Health Maintenance Organizations
– Preferred Provider Organizations
– Private Fee-for-Service Plans
– Special Needs Plans
– Medicare Medical Savings Account Plans

There are a few make or break factors in the Medicare Advantage Plan:

– Most Medicare services are covered by the plan

– Most Medicare services aren’t paid for by Original Medicare

– Most Medicare Advantage Plans offer prescription drug coverage

Medicare Annual Enrollment

Also known as Medicare’s annual election period, this refers to the period between October 15th and December 7th each year when people can make changes and/or enroll in new plans in their Medicare. This is important as the elements of each plan are subject to changes in price, availability, and other factors each year.

Medigap / Medicare Supplements

As the name suggests, these are plans offered by private insurance and healthcare providers to cover “gaps” in the original Medicare plan. Where the original Medicare covers 80% of the cost of hospital visits or medical care, a Medicare Supplement plan can cover the other 20%.

These plans come in all shapes and sizes to suit different people, it may be best to work alongside an insurance broker to find the right for you or your loved one.

Getting Access To Medicare Terms & Services Staten Island NY

Here at Mark Turner Insurance, we know that Medicare is complicated. As a provider of Medicare services Staten Island NY for some time now, we have experience in helping a huge range of individuals find the right plan for themselves or their loved ones.

Remember that healthcare and health insurance don’t have to cripple you financially, and that by finding the exact right Medicare plans for your needs, you can have the freedom to live your life to the fullest.