Keeping Healthy: Medicare 101
By: Elsa Gillis
Updated: August 9, 2012
Whether you're already enrolled or on the cusp of your 65th birthday- the Medicare discussion is inevitable. But you do have some choices in how it works for you. Medicare Sales Representative Paula Florentino first breaks down the basics.
"I actually like to call it the ABC's of Medicare. Your Part A of Medicare, you automatically get once you turn 65. Your Part A of Medicare will cover your in-patient hospital care, your skilled nursing, hospice and home health care. The Part B of Medicare is the one you're going to elect to take, you're going to pay for it it's not free...and then there is the Part C of Medicare which is known as the Medicare advantage plans, and the Part D of Medicare is the stand alone prescription drug plan.
Because Medicare doesn't cover all health care costs, consumers can purchase additional coverage through Medicare advantage or traditional supplemental plans.
"What I mostly tell people is with the Medicare advantage plan versus the supplemental plan, the Medicare advantage plan you're going to have a much lower premium...plus you're going to get extra benefits with the Medicare advantage plan, you'll get a dental benefit on some of the plans, you'll also have the part d the prescription drug plan included.
There are no out-of-pocket costs for medical care under the supplemental plan, but it doesn't include a prescription drug benefit, which can be purchased separately.
"With the Medicare supplement plans, you retain your original Medicare and the supplemental plans fills in the gaps of original Medicare so basically a provider will bill Medicare first then the remaining balance and the rest will be sent to your Medicare supplement insurer.
Florentino says Medicare was never meant to pay for everything - which is why you need this secondary insurance to pay for copays, deductibles and co-insurance. Florentino says she suggests different plans based on the person. If you are coming up on your 65th birthday, or just have questions about Medicare, she suggests calling your local social security administration office.
