Ashford Insurance

Texas Medicare Basics

Medicare Made Easy

Texas Medicare basics

Original Medicare has two parts. Part A covers hospital services and Part B covers other types of medical expenses. You may go to any doctor or hospital that accepts Medicare. Medicare supplement policies only work with original Medicare.

Medicare Part A (hospital coverage) pays for:

  • care in a hospital.
  • care at a skilled nursing facility after a hospital stay.
  • home health care.
  • hospice care.
  • all but the first three pints of blood each calendar year.

Medicare Part B (medical coverage) pays for

  • doctor visits.
  • home health care.
  • lab services.
  • outpatient hospital care.
  • durable medical equipment and supplies.
  • preventive health services, like exams, health screenings, and shots.

Medicare Part D (prescription drug coverage) pays for generic and brand-name prescription drugs. You can get prescription drug coverage by joining a stand-alone prescription drug plan or by buying a Medicare Advantage plan that includes drug coverage. If you have group health insurance, your health plan might already cover prescriptions. Ask your plan’s sponsor whether the plan has prescription drug coverage that is comparable to Medicare Part D.

The Centers for Medicare and Medicaid Services (CMS) publishes the Medicare & You handbook that describes Medicare coverages and health plan options. CMS mails the handbook to Medicare beneficiaries each year. You can also get a book by calling 800-MEDICARE (800-633-4227).

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.