Medicare
The Medicare is a federal program to help pay for the healthcare of people age 65 or older, for some disabled people under age 65, and for people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare is divided into parts; Part A, Part B, Part C, and Part D. Part C is an alternative to Parts A and B.
Medicare is a private fee-for-service (PFFS) plan, which means that beneficiaries can choose any doctor or specialist that accepts Medicare. Medicare is administered directly by the federal government, but claims and payments flow through private health insurance companies that act as intermediaries.
Medicare Part A is free to eligible recipients and helps pay for in-hospital care. Medicare Part B is optional and helps pay for regular medical care (e.g., doctor's bills, X-rays, lab tests). Individuals who choose to enroll in Part B must pay a premium, a deductible, and co-payments.
Medicare Part C (originally called Medicare + Choice) is available to persons who are eligible for Part A and enrolled in Part B. Under Part C, private health insurance companies contract with the federal government to offer Medicare benefits through their own policies. The insurance companies that do so are able to offer Medicare beneficiaries health coverage not only through PFFSs, but also through managed care plans (such as HMOs) and preferred provider organizations (PPOs). Insurance companies can offer Medicare recipients benefits that are not covered under original Medicare, although a premium may be charged for the extra coverage. Further, managed care plans and PPOs can typically offer Medicare recipients benefits at a lower cost because enrollees can only get covered health care through the plan's network of providers, allowing the insurance company to "manage" the costs. The result is that many Medicare beneficiaries have a wider array of health plan options from which they can choose, allowing them to obtain the best coverage they can get at a cost they can afford. For more information, see this article: "Medicare Part C Coverage"
Medicare Part D prescription drug coverage is available to everyone with Medicare, regardless of income, health status, or how they currently pay for prescription drugs. Everyone with Medicare needs to make a decision about prescription drug coverage. Even if you don't use a lot of prescription drugs now, you should still consider joining a plan. For more information, see this article: "Medicare Part D Prescription Coverage"
1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Have your Medicare card, a list of the drugs you use, and the name of the pharmacy you use ready when you call.
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Get a free copy of the booklet "Medicare & You"
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The Ohio Department of Insurance
50 W. Town Street
Third Floor - Suite 300
Columbus, Ohio 43215
(614) 644-2658 (Phone)
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For help enrolling, contact your local office on aging for events in your area. For the telephone number, visit www.eldercare.acl.gov on the web.
As you are aging and making your Medicare decisions, this is a good time to also plan your estate. Please call 216.225.9181, Email, or use the contact form to schedule a consultation.