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What Is Medicare?

Medicare is a Health Insurance Program for:

  • People age 65 or older.
  • People under age 65 with certain permanent disabilities.
  • People diagnosed with End-Stage Renal Disease.

Part A (Hospital Insurance)

Medicare Part A provides partial hospitalization insurance coverage. Most people do not pay for Medicare Part A premiums, because they (or their spouse) paid sufficient Medicare taxes before they retired. If you are already enrolled in Medicare, your red-white-and-blue Medicare card should say HOSPITAL (PART A) on it.

If you do not qualify for Social Security because you or your spouse did not accumulate enough credits for coverage while you were working, or you are partially disabled but have returned to work, you may still be able to buy Medicare Part A insurance.

Part B (Medical Insurance)

Medicare Part B provides routine care coverage. Most people pay a monthly premium for Medicare Part B services. Beneficiaries can also purchase additional services by paying a higher premium. Enrollment in Medicare Part B is optional.

Medicare Part B pays for doctors’ services, outpatient care, and other medical services that Part A doesn’t cover, such as physical and occupational therapy, and some home health care. Part B helps pay for these covered services and medically necessary supplies.

In 2011, Medicare Part B enrollees will pay a monthly premium of $96.40 or $110.50 for coverage. Some high-income beneficiaries may pay higher Medicare Part B premiums. Beneficiaries who enrolled after their initial special enrollment period may also pay higher lifetime premiums for Part B services. Your monthly premium is normally deducted from your Social Security benefit check.  If you do not receive a benefit check, you will receive a quarterly bill for your premiums.

Medicare Part C (Medicare Advantage)

Medicare Advantage Plans (also known as Medicare Part C) provide HMO-like insurance coverage for both Part A and Part B services. Most MA plans also include Medicare Part D, prescription drug coverage.

When you enroll in a Medicare Advantage plan, you must be eligible to receive Medicare Part A, and you must pay Medicare Part B premiums.  Medicare Advantage plans may also have their own premiums, which you would pay in addition to your Medicare Part B premium.  Some Medicare Advantage plans also offer extended coverage options, and services that may not be covered by Medicare Part A or Medicare Part B, like health and wellness programs or basic dental services.

Medicare Part D (Prescription Drug Coverage)

Medicare Part D is an optional Prescription Drug plan. Most prescription drugs are not covered by Medicare Part A or Medicare Part B.  If you enroll in a Medicare Part D plan, you will pay an additional monthly premium. Most Part D plans pay for drugs based on a formulary that changes each year.  Not all prescription costs are covered with a Medicare Part D plan.  Many prescription plans could produce high out-of-pocket costs if coverage limits are exceeded during the plan year.

For more information about Medicare and Medicare Advantage plans in Arizona, please call (480) 706-1702.

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