Medicare Parts Explained
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Serving clients since 2009
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Medicare Part A (Hospital Insurance)
What you need to know
Copay: Fixed amount, like $25 you pay when you receive care or pick up a prescription.
Out-of-pocket maximum : This is the most you could ever pay in a year on covered health care services, excluding your monthly premium. Any deductible, copay, coinsurance or out-of-pocket cost for covered services goes towards your out-of-pocket maximum. If you reach this amount, all you need to do is to continue paying your monthly premium. We will pay 100% of the cost when you get care for covered services.
Medicare Part B (Medical Insurance)
- Doctor visits
- Outpatient hospital care
- Lab tests and other medical services
- Individuals residing in the United States
(except residents of Puerto Rico) who become
entitled to premium-free eligible for Medicare Part A and Enrolled in Medicare Part B.
- Part B requires a monthly premium which
most people have deducted directly from their
monthly social security check
- In addition, there is a Part B annual deductible
amount and other costs (such as copayments
and coinsurance) that may apply.
Medicare Part C (Medicare Advantage Plans)
Medicare Advantage Plans include:
- Health Maintenance Organizations (HMO & HMO-POS)
- Preferred Provider Organizations (PPO)
- Most of our Medicare Advantage Plans also offer prescription drug coverage.
|Preferred Provider Organization||Health Maintenance Organization||Health Maintenance Organization-Point-of-Service|
|No Primary Care Physician||Primary Care Physician||Primary Care Physician|
|In-Network & Out-of-Network Providers||In-Network Providers||In-Network & Out-of-Network Providers|