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Ashford Insurance

The Medicare Alphabet Explained

Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford is the owner of Ashford Insurance, an independent health insurance agency specializing in Texas Medicare insurance.

The different Parts such as A, B, C, and D are the different parts of Medicare...

The Medicare Alphabet Explained:

The different parts such as A, B, C, and D are the different parts of Medicare.

Plans such as Plan F, G, and N are Medicare Supplements also known as Medigap. Policies that help those on Medicare pick up out-of-pocket costs.

Original Medicare has four different parts; A, B, C, & D.

Medicare Part A is your Hospital Insurance and it covers inpatient hospital stays, skilled nursing stays, home health, and hospice. A Medicare Supplement helps pick up the out-of-pocket costs.

Medicare Part B is your Medical Insurance which will cover doctor services, outpatient care, and surgery, durable medical equipment as well as preventative services. A Medicare Supplement will help pick up out-of-pocket costs.

Medicare Part C, also known as a Medicare Advantage Plan, is not a Medicare Supplement. There are different types of Medicare Advantage Plans including HMO, PPO, PFFS (Private Fee for Service), and SNP (Special Needs Plans).

Medicare Part D is a Medicare prescription drug coverage that is administered by private insurance companies. If you don’t enroll in prescription drug coverage at the right time, you may be subject to a Part D Late Enrollment Penalty.

Here is how Medicare Supplements and Medicare Advantage Plans are different:

Medicare Supplement Plans A, B, C, D, F, G, K, L, M, and N work directly with “Original Medicare”. Medicare pays its share of the Medicare-approved amount for Medicare-covered healthcare costs. Then your Medicare supplement will pay its share. With a Medicare Supplement, you have the freedom to choose whichever hospital, doctor, or medical provider you want as long as they accept Medicare. Your monthly premiums may increase every year. Medigap Plans do not cover prescriptions so you must enroll and pay separately for a “Standalone” Medicare (Part D) Prescription drug plan.

To qualify for Part C, Medicare Advantage Plans HMO, PPO, PFFS, or SNP. You must be enrolled in both Medicare Parts A & Part B, meaning you have to keep paying for Part B. You must live in the area six months a year. Lastly, you must not have End-Stage Renal Disease (the last stages of kidney failure and you would be on kidney dialysis).

Medicare pays the Medicare Advantage insurance company a certain amount every month for your care while you are on the plan. Your Part B must always be in effect. You use your plan’s Medicare Advantage insurance card, not your Medicare red, white and blue card. The Plans must provide your Part A and Part B benefits and some Medicare Advantage Plans have Part D prescription drug plans included.

You may have a zero to low dollar premium with various co-pays, deductibles, and a maximum out-of-pocket cap. Many of these plans offer extra benefits such as gym memberships, dental benefits, transportation, and other additional benefits. Many of these plans require you to use their network of Doctors, Providers, and Hospitals and the ones with out-of-network benefits will often cost more to use.

For assistance please contact Sonia Ashford at 817-952-3153.

 

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Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance since 2005.