What is Medicare?

Medicare is health insurance for People 65 or older, Certain people under 65 with disabilities, and People of any age with End-Stage Renal Disease.

What are the parts of Medicare?

Medicare Has Four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (medicare Advantage), and Part D (Prescription Drugs).

Part A helps cover Inpatient care in hospitals, Skilled nursing facility care, Hospice care, and Home health care.

Part B Covers Services from doctors and other health care providers, Outpatient care, Home health care, Durable medical equipment, And Many preventive services. Most people pay the standard Part B premium amount.

Part C Is An “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Plans may have lower out-of-pocket costs than Original Medicare. Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, and dental services.

Part D Helps cover the cost of prescription drugs (including many recommended shots or vaccines). It’s Run by private insurance companies that follow rules set by Medicare. It May help lower your drug costs and help protect against higher costs in the future

What is a Deductible?

A deductible is an amount that you're responsible for in the event of a loss. This is the amount you pay out-of-pocket, and insurance covers the remainder.

What is Co-Insurance?

Co-insurance is your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay co-insurance plus any deductibles you owe. For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.  

What is a Copayment?

A copayment copay is an amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor's visit, hospital outpatient visit, or prescription drug. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor's visit, lab work, or prescription. Copayments are usually between $0 and $50 depending on your insurance plan and the type of visit or service.

What is an Out of Pocket Maximum?

The out-of-pocket maximum is the most you pay during a policy period (usually one year) before your health insurance or plan starts to pay 100% for covered essential health benefits. This limit includes deductibles, co-insurance, copayments, or similar charges and any other expenditure required of an individual for a qualified medical expense. This limit does not have to include premiums or spending for non-essential health benefits.