What is Medicare?
Medicare is a federal health insurance program that pays for a variety of health care expenses. It is available for people age 65 and older, or for those who are under age 65 and either on Social Security Disability Income (SSDI) or diagnosed with certain diseases such as End-Stage Renal Disease (ESRD) and Lou Gehrig’s Disease (Amyotrophic Lateral Sclerosis or ALS).
In general, Medicare covers services (such as doctor visits, lab tests, and surgeries) as well as supplies (like wheelchairs or walkers) that are considered medically necessary to treat a disease or condition.
There are multiple types of Medicare Plans, and depending on your individual circumstances, some may be more beneficial to you than others. If you live in Washington state contact us to speak to a local, licensed insurance agent and find out which Washington Medicare plan or plans are right for you.
Medicare Part A
In general, Medicare Part A covers:
- Hospital care
- Skilled nursing facility care
- Nursing home care, as long as custodial care (assistance bathing and dressing) isn’t the only care needed
- Home health services
Medicare Part B
Medicare Part B covers 2 main types of services:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition.
- Preventive services: Health care to prevent illness or detect it at an early stage.
Part B coverage includes things such as ambulance services, clinical research and lab testing, immunizations (such as the flu shot), and durable medical equipment.
Medigap (Medicare Supplement Insurance)
A Medigap plan is a supplemental insurance plan provided by a private insurance company, designed to help fill the “gaps” that Medicare does not cover, such as co-insurance and copay costs. There are multiple federally standardized Medigap plans, and each one offers a different level of coverage.
Medicare Advantage (Part C)
A Medicare Advantage plan is an “all-in-one” insurance plan offered by a private insurance company. It includes all of the same benefits covered by Original Medicare Parts A and B, plus many plans also offer additional benefits, such as higher levels of coverage, and coverage for prescription drugs.
Medicare Part D
A Medicare Part D plan is an optional plan offered by a private insurance company to help cover the costs of prescription drugs. Each plan is different and may cover different prescription drugs, so it is important to ensure that the plan you choose (if you decide to get Part D coverage) includes coverage for your medications.
Page Last Updated 4/04/2018