Here at Firm Foundations, we help you understand the "in's and out's" of Medicare. We help you identify supplemental plan types and which ones may fit your needs best. By focusing on your expectations and financial needs, we are able to provide a customized search for the best coverage available to you.
We encourage people who are eliglible for Medicare to contact our office at 530-891-4673 to set up an appointment to explore what options are most beneficial to you.
Below, we've provided a general outline of how Medicare works, for your convenience.
Medicare provides health insurance for Americans aged 65 and older who have worked and paid into the system. It also provides health insurance to younger people with disabilities, end stage renal disease and amyotrophic lateral sclerosis.
On average, Medicare covers about half (48 percent) of the health care charges for those enrolled in Medicare. The enrollees must then cover the remaining approved charges either with supplemental insurance or with another form of out-of-pocket coverage. Out-of-pocket costs can vary depending on the amount of health care a Medicare enrollee needs. They might include uncovered services—such as long-term, dental, hearing, and vision care—and the supplemental insurance. Medicare has four (4) parts and all benefits are subject to medical necessity.
Part A (Hospital Insurance) covers most medically necessary hospital, skilled nursing facility, home health and hospice care. It is free if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years); you will pay a monthly premium if you have worked and paid taxes for less time.
Part B: Medical Insurance
Part B (Medical Insurance) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. You pay a monthly premium for this coverage.
Part C: Advantage Plans
Medicare Advantage plans must offer at least the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs and coverage restrictions.You can also get Part D as part of the benefits package if you choose. Many different kinds of Medicare Advantage plans are available. You may pay a monthly premium for this coverage, in addition to your Part B premium. Unfortunately, for our local and some surrounding areas, Advantage Plans are not available.
Part D: Prescription Drug Plans
Medicare Part D (outpatient Prescription Drug Insurance) is the part of Medicare that provides outpatient prescription drug coverage. Part D is provided only through private insurance companies that have contracts with the government—it is never provided directly by the government (like Original Medicare is).