New to Medicare?
Medicare doesn’t have to be confusing. Prime Senior Benefits will help you understand your options.
What is Medicare?
Medicare is a federal health insurance program that provides medical benefits to specific groups of U.S. citizens. Individuals 65 or older are eligible for Medicare, and some younger individuals with disabilities or End-Stage Renal Disease.
Medicare relies on the taxes people pay during their careers, so it is not affected by income. The coverage functions similarly to many private healthcare insurance options. It will pay a portion of the beneficiary’s medical cost while expecting a deductible and co-pay from the beneficiary. Unlike private healthcare insurance options, however, a person and their spouse will have to enroll separately as Medicare can only provide for one person at a time.
Though the name is similar, it should not be confused with Medicaid, a health coverage program available to low-income individuals and families. Since Medicare is a federal program, there is less variation between states than with Medicaid. While the requirements to be eligible for Medicaid are strictly defined, any U.S. citizen over 65 has access to Medicare.
Who is eligible to receive benefits?
A United States citizen is eligible for Medicare within the first month of turning 65. For those receiving Social Security or Railroad Retirement disability benefits, Medicare is available after 25 months of receiving those benefits, except for those with ALS. They become eligible as soon as they receive Social Security disability benefits. Those with End Stage Renal Disease will become eligible on the first day of the third month of receiving renal dialysis treatments.
We'll help you get the most from your Medicare benefits.
At Prime Senior Benefits, we specialize in the senior market. We believe that you have the right to understand your options thoroughly. Our licensed Medicare insurance consultants are thoroughly educated in this ever-changing market, and ready to help you understand which health plan is best for your needs.
The four parts of Medicare
Part A
Medicare Part A covers hospital services and inpatient care in skilled nursing facilities, hospitals, home healthcare settings, and hospices. The federal government administers it, and you can enroll in Part A at your local Social Security office.
Part B
Part B covers outpatient care, including provider services, home health care, ambulance services, therapeutic/rehabilitation services, mental health services, durable health care equipment, and prescription drugs that a physician typically administers. Like Part A, it is administered by the government.
Part C
Also called Medicare Advantage, Part C is an alternative way to receive your Medicare benefits. Private insurance companies approved by Medicare offer these plans. They are an “all in one” alternative to Original Medicare and include Parts A and B. They often include prescription drug coverage and extra services not covered by Original Medicare.
Part D
Part D, or prescription drug plans, covers outpatient prescription drugs you would pick up at a pharmacy. Like Part C, Part D is offered by private insurance carriers and is available for purchase as a separate plan for those with Original Medicare. It can also be included as part of a Medicare Advantage Prescription Drug plan.
Who administers Medicare?
The four parts of the program are administered slightly differently. You enroll in each one separately – or bundle them through Part C.
Parts A and B are known as Traditional or Original Medicare. The federal government administers this program.
Part C bundles Part A, Part B, and Part D services. Part C is administered by government-approved private insurance companies and regulated by the federal government.
Private insurance companies administer part D. This coverage is optional but available to everyone with traditional coverage. Part C doesn’t require a separate drug plan.
We’ve got you covered.
The easiest way to enroll in Medicare is to work with an independent insurance agent. An independent agent can partner with and sell policies for different insurance companies, so you can be sure you are getting the best coverage possible. At Prime Senior Benefits, we have years of experience helping people like you get the coverage that will benefit you best.
We will provide multiple quotes to compare your options and thoroughly explain those options. We’ll only enroll you in a plan if it provides the best benefits. We are available Mon – Fri 9 am – 5:30 pm. You can also send us a message through our website or email.
Medicare Advantage
Also referred to as Part C, private insurance companies contracted with Medicare offer these plans. They provide all of your Part A and B benefits.
Medicare Supplements
Also known as Medigap, Medicare Supplements help pay the leftover 20% that Parts A and B don’t cover. They essentially "cover the gap".
Prescription Drug Plans
Also known as Part D, this is an optional benefit that covers your prescription drugs. It is offered to everyone who has Medicare.
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