While this general information regarding Medicare is a refresher for some, it is new to many.
Either way, it is important to understand Medicare language as you enter the program for the first time or continue participating.
Who runs the Medicare Program?
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Sheldon
The Centers for Medicare & Medicaid Services (CMS), a federal agency, runs Medicare.
What is Medicare?
Medicare is health insurance for people:
65 and older
Under 65 with certain disabilities, and
Any age individual with permanent kidney failure requiring dialysis or a kidney transplant.
What is Medicare Part A?
Medicare Part A helps cover inpatient care in hospitals. This includes limited care in skilled nursing facilities.
The cost for Part A is generally free if the participant or their spouse paid Medicare taxes while working.
What is Medicare Part B?
Medicare Part B helps cover medical services like doctor's services, outpatient care, some prevention services, screenings and other services Part A does not cover. Part B is optional.
The cost for Part B is $96.40 per month. The premium changes annually. There is a low-income program available for assistance with the Part B premium.
What is Medicare Part C?
Medicare Part C refers to Medicare Advantage Plans, which are health plan options approved by Medicare but run by private companies. They provide Part A and B coverage and must cover medically necessary services. They generally offer extra benefits and may include Part D coverage. You generally have to see doctors who belong to the plan or who accept the plan.
Some Medicare Advantage Plans charge a monthly premium in addition to your Part B premium.
What is Medicare Part D?
Medicare offers prescription drug coverage for everyone with Medicare through Part D. This coverage may help lower prescription drug costs and helps protect against higher costs in the future. These plans are run by insurance companies and other private companies approved by Medicare. Part D is optional.
Costs for Part D include a monthly premium, co-payments at the drugstore and possibly a deductible. There is a low-income program that may assist with the Part D premium and costs at the drugstore.
You can make changes to your Part D plan during the annual enrollment period, Nov. 15-Dec. 31 of each year.
What is a Medicare Supplement?
Medicare Supplemental Insurance (also called Med Sup or Medigap insurance) is a health insurance policy sold by private insurance companies to fill in the "gaps" in the Original Medicare plan. It is a private insurance that can help pay Medicare deductibles, co-insurance amounts and, on some occasions, expenses not eligible under Medicare.
If you have a question about the Medicare program or a Medicare Supplement, local help is available by contacting the North Dakota Insurance Department at 1-888-575-6611 or ndshic@nd.gov.
Cindy Sheldon, Bismarck, is director of the N.D. Health Insurance Counseling Program.