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Medicare Product Basics

Medicare Part A

Medicare Part A is your hospital coverage. You are entitled to Part A after working 40 quarters and either turning 65 or disabled for 2 or more years. There is no premium for Part A but there are deductibles, co-insurance and no out of pocket limits.

Medicare Part B

Medicare Part B is your medical coverage. There is a monthly premium for Part B that you need to pay, regardless what other coverage you decide to choose. Most people, if they are collecting Social Security, will have it automatically deducted. Eligibility for Part B is the same as Part A. If you continue to work after 65 you can choose to hold off your enrollment in Part B. Just like Part A, there are deductibles, co-insurance and no out of pocket limits.

Medicare Advantage Plans (Part C)*

A Medicare Advantage plan combines your Part A & B and most of the times includes Part D (Prescription Drug). This is a very attractive option because it offers predictability for out of pocket costs while also having a low (or no) premium beyond the Part B premium. Medicare Advantage Plans also include an out of pocket maximum so you know "worst case scenario" costs. There are also often other perks such as dental, vision and gym memberships included in the coverage.

To be eligible you need to be enrolled in both Medicare Part A and Part B, reside in the service area and not have ESRD. There is no difference in cost if you are 50 or 90 as long as you are eligible. 

Medicare Supplement Plans (Medigap)*

A Medicare Supplement Plan does just that, Supplements your Medicare. There are a few different options that vary in cost sharing and premium.Medicare Supplement Plans don't cover prescriptions. Most people that select a Medicare Supplement Plan also get a Part D plan to complete their coverage.

Eligibility depends on a few different scenarios. If you don't enroll when you become first eligible you may be subject to underwriting which could result in denial or increased premium.

Medicare Prescription Drug Plans (Part D)*

Medicare Prescription Drug plans are just that, Drug Plans for Medicare recipients. If you have Medicare and don't have other credible coverage or a Part D plan you may be penalized by Medicare by way of a Late Enrollment Penalty if you choose to get coverage later. 

To be eligible you need to have Medicare Part A or B and reside in the plans service area.

* Denotes products offered by private insurance companies and what La Baye Insurance offer.

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