Original Medicare covers most seniors (age 65+). In addition to (or as an alternative to) Original Medicare, seniors are also entitled to a wide range of health insurance options. To select the best options, it is important to first understand the basic entitlements that are available under Original Medicare.

Original Medicare Entitlements

Original Medicare is a federally funded and managed health insurance program that provides health insurance for seniors (age 65+) and also younger people with a Social Security Administration determined disability and also people with end stage renal disease and amyotrophic lateral sclerosis.

Original Medicare has three basic parts:

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Medicare Part A
Hospital Insurance

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Most people pay a monthly premium for Part A. To fully cover your potential Part A expenses, you have to additionally purchase a Medicare (Medigap) supplement or a Medicare Advantage plan.

Medicare Part B
Medical Insurance

Part B covers doctors’ services, outpatient care, medical supplies, and preventive services. Everyone pays a monthly premium for part B. In most cases, that fee is deducted from monthly social security benefit payments. To fully cover your potential Part B expenses, you have to additionally purchase a Medicare (Medigap) supplement, or a Medicare Advantage plan.

Medicare Part D
Prescription Drug Coverage

Part D covers a portion of prescription drug costs. To get full Part D coverage you have to join a private Medicare approved drug plan or purchase a Medicare Advantage plan that provides Part D coverage.

So, What Happened To Part C?

Logic would suggest that Original Medicare should have a Part C. Well, actually there is a Part C; but Part C is not part of Original Medicare. Rather, Part C is Medicare Advantage.

Part C And Other Medicare Options

Medicare Part C is Medicare Advantage, Medicare Advantage Plans are generally HMO or PPO health care organizations. They are provided and operated by private companies (as opposed to the Federal government).

Medicare Advantage Plans provide Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Many plans also provide additional insurance coverage for vision, hearing, dental, wellness programs, transportation to and from doctors and possibly over the counter pharmacy products. Most Medicare Advantage plans also include Part D Prescription Drugs.

A very important additional Medicare option for low-income seniors is Medicaid. In Arizona, Medicaid is administered by the Arizona Health Care Cost Containment System (or AHCCCS). AHCCCS provides extensive medical insurance coverage at low and possibly no cost.

Read more about AHCCCS Medicaid coverage.

Nonprofit ACCESSMed Foundation helps Arizona seniors understand all of the benefits that they are entitled to under Original Medicare. And, we help seniors (and their caregivers) apply for all of the options they are entitled to (always at no cost).

Click on the GET HELP link at the bottom of any page on this website.

 

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