Medicare Definitions
Medicare Defined & Made Easy
Medicare Definition:
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). If you or your spouse have worked full time for 10 or more years over a lifetime, you are probably eligible to receive Medicare Part A for no additional charge. If you have to buy Part A, you’ll pay up to $413 each month.
Medicare Part A Definition:
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. What Medicare covers is based upon, Federal and state laws, National coverage decisions made by Medicare about whether something is covered, local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.
Medicare Part B Definition:
Medicare Part B is available at a monthly rate set annually by Congress ($144.60 in 2020 for incomes $85000.00 or less for an individual). Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Some seniors are eligible to receive the medical insurance portion (Part B) free as well, depending on their income and asset levels. For more information, inquire about the Qualified Medicare Beneficiary (QMB), Special Low Income Medicare Beneficiary (SLMB), and Qualifying Individual programs through your county social services office.
Medicare Part C Definition:
Medicare Part C (Medicare Advantage Plans) is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMO’s), Preferred Provider Organizations (PPO’s), Private Fee-for-Service Plans (PFFS’s), Special Needs Plans (SNP’s), and Medicare Medical Savings Account Plans (MSA’s). If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Most Medicare Advantage Plans have prescription drug coverage included.
Medicare Part D Definition:
Medicare Part D (prescription drug coverage) adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.
Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans. Keep in mind, you may owe a late enrollment penalty if you go without a Medicare Prescription Drug Plan (Part D), or without a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, or without creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over.
Next, learn: How Medicare Works
Need help? Call us for an appointment at (817) 952-3153
Ashford Insurance is an independent health insurance agency specializing in Texas & Oklahoma Medicare insurance. Ashford Insurance is here to help you understand Medicare in simple, plain terms that anyone can understand. We specialize in helping folks who are Medicare eligible to learn about the coverage options available through the Medicare Health Insurance Program.
Ashford Insurance Agents








Our Products
Here is a partial list of the products offered by Ashford Insurance
Chronic Plans
Have a chronic illness?
Prescription
Prescription Drug coverage.
Dental Plans
Dental Insurance
Short Term Medical
Temporary Insurance
Health Insurance
ACA FFM Exchange
Notary Services
Notary Public
Contact Form
(817) 952-3153
M-T 9:00 – 4:00
F 9:00- 12:00
Weekends & Evenings by Appointment
Address
1245 Southridge Court Suite 101, Hurst, TX, 76053
* A licensed sales agent may call or e-mail as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.
Newsletter Signup
Recent Blog Articles

How to Pick an Unbiased, Helpful Medicare Adviser
It’s not easy finding a knowledgeable, respected, and trustworthy authority on Medicare. Here are some steps to increase your chances.

Missed Your Medicare Initial Enrollment Period?
If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP) to enroll in Part B or Premium Part A unless you have limited income and savings and are eligible for a Buy In.

How to File a Grievance
If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance.