Use caution before choosing a Medicare Advantage plan.

Most plans require prior authorization for health care. MA plans can also change providers, benefits, premiums, and copays each year. An MA plan may elect not to renew its contract with Medicare at the end of the year for any reason, and, in some instances, during the year.

MA plans contract with the Medicare agency annually. Many MA plans also include Part D prescription drug coverage. MA plans generally require patients to obtain services only from certain providers in return the plans may offer reduced premiums, deductibles and coinsurance payments, and/or additional benefits not offered in traditional Medicare. These private insurance options are authorized by Medicare Part C, which is also called Medicare Advantage (MA). Medicare beneficiaries have the option to receive their Medicare benefits through private health insurance plans. In addition, Medigap health insurance can be purchased to cover some of Medicare’s co-insurances and deductibles. Help with Medicare Co-pays & Other Expensesīeneficiaries with limited incomes may be eligible for help from federal and/or state programs to cover some or all of Medicare’s required co-payments and to help with prescription drug costs. However, Medicare Part D covers prescription drugs through private plans. The traditional program generally does not cover prescription drugs. These beneficiaries can get their health care from any provider who is certified by Medicare. Half of most beneficiaries are in the traditional program. Beneficiaries are responsible for some premiums, deductibles, and co-payments. Coverage is divided between two parts of Medicare, Part A and Part B. Medicare has been in existence since 1965. Individuals can enroll and get information at their local Social Security office and on-line. People with ERSD and ALS may be eligible without waiting 24 months. Disabled individuals who have received Social Security Disability benefits for 24 months are also eligible for Medicare. Individuals who are 65 years old and eligible for Social Security or Railroad Retirement benefits are automatically eligible for Medicare Part A and may choose to enroll in Part B. Skilled care to maintain or slow decline of a condition can also be covered. Generally, coverage is available for the cost of health care (except for hospice care and specific preventive services) only when the services are medically reasonable and necessary for diagnosis, treatment or rehabilitation of illness or injury. Thus, it covers some of the cost of some health care. Medicare is modeled after private health insurance.

Medicare Matters: A Video Timeline about Medicare

Help with Medicare Co-pays & Other Expenses.

Medicare Matters: A Video Timeline about Medicare.

Listen to Medicare & Health Care Stories.

Join the Center for Medicare Advocacy Founder’s Circle.

Career, Fellowship & Internship Opportunities.

Ossen Medicare Outreach, Education and Advocacy Project.

Connecticut Dually Eligible Appeals Project.

The Center for Medicare Advocacy Founder’s Circle.

CMA Annual Report | Fiscal Year July 2021 – June 2022.

Nursing Home / Skilled Nursing Facility Care.

Medicare part abcd explained