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Cover what cant be covered by Medicare

Medicare Basics

Original Medicare covers Part A and Part B to those who are a citizen of the United States or have been a legal resident for at least 5 years and have been working a minimum of 10 years in Medicare-covered employment. 


Any doctor's office that accepts Medicare will accept your Original Medicare. According to the 80/20 rule, Medicare will pay for 80% of the services while the other 20% must be paid for by you. You can also receive supplemental coverage like Medicare Supplement Insurance (Medigap), Medicare Advantage, or have coverage from a former employer, union, or Medicaid to assist cover your out-of-pocket expenditures with Original Medicare (such as your 20% coinsurance).

Parts of Medicare

Part A

  • Inpatient Care in Hospitals

  • Skilled Nursing Facility Care

  • Hospice Care

  • Home Healthcare 

  • How to Qualify

Part B

  • Services from Doctors and Other Healthcare Providers

  • Outpatient care

  • Home Healthcare

  • Durable Medical Equipent

  • Many Preventative Services

  • How to Qualify

  • Injectables or Self-Administered Drugs are Covered

Part C

  • Includes all services under parts A and B.

  • Usually includes Medicare prescription drug plan (Part D) as part of the plan.

  • Run by the Medicare-approved private insurance companies that follow rules set by Medicare.

  • Plans have a yearly limit on your out-of-pocket costs for medical services.

  • May include extra benefits and services that aren't covered by Original Medicare, sometimes for an extra cost. 

Part D (Drug Coverage): Assists in offsetting the price of prescription medication (including many recommended shots or vaccines). You can either receive it by enrolling in a Medicare Advantage Plan with drug coverage or by adding a Medicare drug plan on top of Original Medicare.

What is a Medicare supplement?

A Medicare Supplement Insurance (Medigap) coverage is health insurance that can help cover some of the costs of health care that original Medicare does not cover, such as coinsurance, copayments, and deductibles.

Medigap policies are sold by private insurance firms. Some Medigap policies additionally cover benefits that Original Medicare does not, such as emergency international travel fees. Other types of health coverage, such as Medicare Advantage Plans (such HMOs or PPOs), standalone Medicare Prescription Drug Plans, employer/union group health coverage, Medicaid, or TRICARE, do not pay your share of the costs. If you have Medicaid or a Medicare Advantage Plan, insurance providers are often unable to sell you a Medigap policy.

What is a Medicare Advantage?

Your Part A, Part B, and typically Part D coverage are all combined into one plan under Medicare Advantage. Plans may provide additional benefits including vision, hearing, and dental care that Original Medicare does not.

You sign up for a plan provided by a private company that has been given Medicare's approval and complies with its requirements. If you need a referral to see a specialist, for example, the rules under each plan may change. Depending on the plan you choose, the costs for your monthly premiums and the services you receive change. All emergency, urgent care, and nearly all medically required treatments that Original Medicare provides must be covered by plans. Some insurance companies customize their benefits packages to include extra coverage for treating particular diseases.

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