Medicare

Medicare is a health insurance program administered by the US government.  In general eligibility begins on the first day of the month you attain age 65.  Medicare is also available for those disabled by social security standards for 2 years and people suffering from specified medical conditions.  Original Medicare covers hospital (part A) and doctors (part B).  For those with enough work history and their spouses there is no premium for part A and a range of premiums for part B, in 2019, from $135.50 to $460.50 depending on income reported in 2017.  The official website for Medicare is medicare.gov. 

Original Medicare does not cover the cost of prescription drugs.  That can be obtained from approved insurance carriers through either a stand-alone prescription drug plan or a Medicare Advantage (MAPD) plan that includes prescription drugs.  Plans vary by state and county but must meet certain standards established by Medicare. 

Types of Medicare

Medicare Advantage

Plans offered by insurance companies that comply with the minimum standards required by Center for Medicare and Medicaid services (CMS).  Cms.gov is the website.  Plans come in a variety of options including PPO, HMO, Private Fee for Service, and Special Needs Programs.  Plans may or may not include prescription drugs.  These plans operate on a calendar year basis and members may change to different plan or return to original Medicare during the annual open enrollment period from October 15 to December 7 with the change effective on January 1 of the following year.  Plans can also be changed for specified qualifying life events outside of open enrollment.  Premiums vary by plan and carrier with many plans in south Florida available for no addition cost. 

Prescription Drug Plans

Like Medicare Advantage plans they must comply with the minimum standards required by CMS.  They subject to same rules for plan changes.  There are premiums for these plans which vary depending on the level of coverage.

Medicare Supplements

Often referred to as Medigap plans, these plans provide addition insurance for beneficiaries of original Medicare. Since they do not include prescription drug coverage that must be obtained separately with a prescription drug plan.  Medicare supplements require a premium that varies by insurance carrier and type of plan.