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Medicare is part of the Social Security system designed to provide healthcare for people ages 65 and older. 

For people under the age of 65 who have been on Social Security disability for at least 2 years, 

or have been diagnosed with end stage renal disease. 

Medicare was designed to cover the majority of recipients’ healthcare costs but still leaves them exposed to deductibles, coinsurance, co-pays, and excess charges. These out-of-pocket expenses are often referred to as “gaps in coverage.” 

Medicare Part A coverage includes: 

1. Hospital care 
2. Skilled nursing facility care 
3. Nursing home care (as long as custodial care isn’t the only care you need)
4. Hospice 
5. Home health services 

Medicare Part B coverage Includes:

1. Diagnostic tests/lab work/screenings 
2. Doctor services 
3. Nursing services 
4. Chemotherapy 
5. Certain diabetic supplies 
6. Flu and pneumonia vaccinations 
7. Durable medical equipment 
8. Some mammography and pap smear screening 

Medicare Part B excludes:

1. Hearing Aids
2. Eye exams and eye glasses
3. Routine physical screenings

A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. 

If you have Original Medicare, and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs, and then your Medigap policy will pay it’s share, minimizing your out-of-pocket costs. 

A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage provides a way to get Medicare benefits, while a Medigap policy is a supplement to your Original Medicare benefits. 

Medicare Prescription Drug Plans provide some insurance coverage for brand name and generic prescription drugs. 

Medicare works with insurers and other private companies to offer many different plans. 

To get a Medicare Prescription Drug Plan, you must already have Medicare Part A 

and/or Part B. 

There are many different plans to choose from. 

A Medicare Part C plan is a private insurance policy that replaces Medicare Part A and Part B. This means that if you enroll in a private Medicare Part C plan, you no longer receive coverage through Medicare Part A or Medicare Part B. 

Medicare Part C plans are regulated by the federal government, 

which requires every plan to provide at least the same coverage as the government-run Medicare Parts A and B. If you enroll in a Medicare Part C plan, you can't buy a Medigap policy. 

Keep in mind that each Medicare Part C plan is slightly different, depending on what that plan’s private insurance company chooses to offer beyond basic Medicare. 

Why look at Medicare Part C plans? The main benefit is cost. However, there can be some drawbacks to the Medicare Part C plan. Two areas of concern are choosing a doctor covered by your plan and needing to see a specialist. If you want to consult a doctor who’s not in the plan’s network, you’d will have to pay some or all of the cost. 

If you’re considering a Medicare Part C plan, one of your first steps should be to see if your regular doctors are in the plan’s network. If not, and you want to stay with your doctors, this plan isn’t a good one for you. 

As you can see, there are benefits and drawbacks to Medicare Part C. This is why it’s important to choose a Medicare Agent who is knowledgeable about all aspects of Medicare to help you choose the plan that’s right for you. 

Part A premium - Most people don’t pay a monthly premium for Part A. 

Part A hospital inpatient deductible - $1,632 Deductible for each benefit period. 

Part B premium - Most people pay $174.70 each month.   

Part B deductible - $240 per year & then  Co Payments  of  20%.