What is Medicare?

What is Medicare? Medicare is a federal health insurance program for people age 65 and older. It’s also available for people of any age with certain disabilities. Here, we’ll walk you through the four parts of Medicare, Medicare Supplement, and where dental, vision and hearing benefits fit in.

Medicare includes four types of coverage: A, B, C and D. Together, Part A and Part B are called Original Medicare.

• Part A: Your hospital benefits
• Part B: Your medical benefits
• Part C: Medicare Advantage plans
• Part D: Medicare prescription drug coverage

Part A is provided by the federal government and is available at no cost if you or your spouse made payroll contributions to Social Security for at least 10 years.

Part A covers all or a portion of the costs for services such as:

• Inpatient hospital care
• Skilled nursing care
• Home health care
• Hospice care

Part B is provided by the federal government with a monthly premium based on your income.

Part B covers all or a portion of the costs for services such as:

• Doctor visits
• Some preventive care, like flu shots
• Lab services, X-rays, MRIs, CT scans and EKGs
• Some diagnostic screenings, like colorectal cancer and mammograms
• Emergency room services
• Outpatient mental health care

Part C, also known as Medicare Advantage, is offered by private insurers like Blue Cross NC. Medicare Advantage plans can be purchased to replace Original Medicare and generally offer more benefits and coverage than Original Medicare. Most also include prescription drug coverage. Medicare Advantage plans are built around a preferred network of doctors and hospitals, much like a group or individual plan you may have had prior to turning age 65.

Part D is prescription drug coverage. Sometimes Part D is called a Medicare Prescription Drug Plan (PDP). It is offered by private insurers. You would add a Part D plan if you choose Original Medicare or Medicare Supplement and need prescription drug coverage.

Medicare Supplement plans were created to cover some of the costs – or gaps – that Original Medicare does not cover. For this reason, you may sometimes see these plans referred to as Medigap coverage. Medicare Supplement plans are available from private insurers like Blue Cross NC. They are standardized by the Federal government and do not include drug coverage.

One big question when shopping for Medicare is if vision, dental and hearing benefits are included with your coverage. Original Medicare and some Medicare Supplement plans do not cover dental, hearing and vision services that are not medically necessary. You can purchase dental or vision plans separately from private insurers like Blue Cross NC, or you can choose a Medicare Advantage plan that includes dental, hearing and vision benefits or allowances.