Providing Everything you Need for your Medicare Journey

About Medicare
The Medicare program has several “parts,” Medicare Part A, B, C and D.

Together, Parts A and B are called Original Medicare through the Center for Medicare & Medicaid Services (CMS). The United States government set up Original Medicare to cover a wide range of medical expenses for individuals 65 and older and individuals with certain disabilities.

MEDICARE PART A
Medicare Part A is hospital insurance provided by Medicare through the Centers for Medicare & Medicaid Services

Most people do not have to pay a premium for Medicare Part A. If you or your spouse worked at least 10 years (40 quarters) and paid Medicare taxes while working, you’ll get premium-free Part A.

What Does Medicare Part A Cover:
• Inpatient care in a hospital
• Inpatient care in a skilled nursing facility (not custodial or long-term care)
• Hospice care
• Home health care
• Inpatient care in a religious nonmedical health care institution


MEDICARE PART B
Medicare Part B is medical insurance provided by Medicare through the Centers for Medicare & Medicaid Services

You’ll typically pay a premium for Medicare Part B unless you qualify for financial assistance. Because of this, you have the option of turning it down, although you might pay a late-enrollment penalty if you decide to enroll in Medicare Part B later on. This monthly Part B premium amount may vary from year to year.

What Does Medicare Part A Cover:
• Medically necessary doctor services
• Preventative and diagnostic services
• Preventative shots
• Screenings
• Ambulance transportation
• Outpatient hospital care, such as some physical or occupational therapy
• Mental health services
• Some home health care services
• Durable medical equipment


MEDICARE PART C
Medicare Part C, or Medicare Advantage, is a program that offers an alternative way to receive your Original Medicare benefits (Part A and Part B).

Medicare Advantage plans are available from private insurance companies that contract with Medicare. They’re required to cover everything that Original Medicare (Part A and Part B) does, except for hospice care, which Medicare Part A covers when you have a Medicare Advantage plan. Under the Medicare Part C program, you get your Original Medicare coverage through the Medicare Advantage plan instead of directly through Medicare.

Here are some brief descriptions of common types of Medicare Advantage plans. Each of these is available from private insurance companies that contract with Medicare. Availability and cost may vary by plan and service area.

Medicare Preferred Provider Organization (PPO)
A network of doctors, clinics, hospitals, and other health-care providers. With this type of plan, you don’t have to choose a primary care physician up front to coordinate your care. Instead, you can see any doctor or specialist who accepts Medicare assignment. If you go to providers outside your PPO network, your out-of-pocket costs may increase.

Medicare Health Maintenance Organization (HMO)
A type of plan in which you choose a primary care physician who will coordinate your care and refer you to any specialists you have to see. An HMO typically has a network of health-care professionals, and going outside of that network could require you to pay the full amount for any services.

Medicare Private Fee-for-Service (PFFS)
A type of Medicare Advantage plan in which the plan, not Medicare, sets payment terms. Some plans cover your visits to any doctor or specialist without worrying about network restrictions if the doctor or health-care provider accepts the plan’s terms, fees, and conditions. Other PFFS plans have provider networks.


MEDICARE PART D
Medicare Part D is the prescription drug coverage, available through Medicare-approved private insurance companies. Part D is optional.

There are 2 ways to get Part D coverage:
• Standalone if you only have Medicare Part A and Part B coverage.
• Included in your Medicare Advantage plan.


MEDIGAP SUPPLEMENT (MEDIGAP)
A Medigap policy is health insurance sold by private insurance companies to fill gaps in Original Medicare coverage. Medigap policies can help pay your share (like coinsurance, copayments, or deductibles) of the costs of Medicare‑covered services.


MEDICARE ADVANTAGE
Medicare Advantage plans are sometimes referred to as Medicare Part C. They are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium.


MEDICARE PRESCRIPTION DRUG COVERAGE
Medicare Part D is the prescription drug coverage, available through Medicare-approved private insurance companies. You can either get this coverage through a stand-alone Medicare Prescription Drug Plan if you’re enrolled in Original Medicare or a Medicare Advantage plan that includes prescription drug benefits


ADDITIONAL COVERAGES
Many seniors pay large out of pocket amounts for Dental, Vision and Hearing expenses. CHRISTI can help in providing quality coverages for these expenses, in addition to Long-term Care, Final Expense and Life Insurance needs