Reid Health Alliance Medicare
Have questions? Get connected.
Call 877-749-3002 or visit Health Alliance's website.
What is
Medicare?
Medicare is a federal health insurance program through the Centers
for Medicare & Medicaid Services (CMS). The Social Security Administration
started Medicare to help people pay for their health costs if they're 65 or
older or have certain disabilities. It is mostly paid for by payroll taxes and
premiums paid by Medicare beneficiaries.
Medicare
has four parts.
Part A -
Hospital Coverage (inpatient hospital stays, skilled nursing facilities, hospice
and some home health care)
Part B - Medical
Coverage (doctor visits, outpatient care and some home health care)
Part C -
Medicare Advantage (from a private company and pays in place of Original
Medicare)
Part D -
Prescription Drug Coverage
At a
Glance: Medicare Coverage Options
|
|
Original Medicare |
Medicare Advantage |
Medicare Supplement |
|
Managed by: |
Federal
Government |
Private
Insurance Companies |
Private
Insurance Companies |
|
Coverage |
Limited
to what Medicare covers |
Often
covers services Medicare doesn't like dental, vision and hearing |
Limited
to what Medicare covers |
|
Prescription Coverage |
No |
Most
plans include Rx coverage |
No |
|
Provider network |
No |
Yes,
some plans allow you to see any doctor or hospital that accepts Medicare |
No |
|
Monthly Cost |
Most
people pay a Part B premium |
Part
B premium + monthly premium (if applicable) |
Part
B premium + monthly premium |
Original
Medicare (Parts A and B)
Original
Medicare is the traditional Medicare program managed by the federal government.
It includes Part A and Part B coverage but only covers about 80% of your
healthcare costs. Original Medicare does not include coverage for prescription
drugs (Part D plan). You should consider signing up for a separate Part D plan
to ensure that you have coverage for your prescription drug needs.
Medicare
Advantage (Part C)
Medicare Advantage combines all your coverage (doctor's visits,
hospital and pharmacy) into one plan, like the health plan you might have been
used to while you were working. In addition, Medicare Advantage plans often
cover services that Medicare doesn't cover like care coordination, health
coaching, dental, vision and hearing. Medicare Advantage plans have yearly
limits to keep your out-of-pocket costs lower. Original Medicare does not.
Medicare Advantage $0 premium plans have become popular recently, where you do
not have to pay a monthly premium for the plan, you must still pay your Part B
premium.
Medicare
Supplement (Medigap)
Medicare
Supplement plans help pay for the costs that Original Medicare doesn't pay for,
like coinsurance, copayments and deductibles. With these plans the government
sets the rules, and the plans only cover services that Original Medicare
covers. Medicare Supplement plan premiums often increase with age. They also do
not include coverage for prescription drugs (Part D plan). You should consider
signing up for a separate Part D plan to ensure that you have coverage for your
prescription drug needs.
Things to
Consider When Choosing a Medicare Plan:
·
Ensure you can continue to see your doctor
·
Review the formulary (drug list) to make sure
your drugs are covered
·
Look at how your past healthcare costs line up
with a plan. Consider if there is an opportunity to change plans to save money.
·
Look for additional plan perks, like health
coaching and care coordination, fitness benefits and more.
·
Check to see if you're eligible for Extra Help
through Medicare.
Learn More:
Medicare:
800-Medicare (800-633-4227)
Call to request Medicare info, enroll in a Medicare plan,
verify Extra Help status or find state health insurance counselors.
Social Security
Administration: 800-772-1213
Call for issues regarding Extra Help, like enrolling,
verifying status or getting more info.
Also call to enroll in Medicare or schedule monthly
premiums to be withdrawn from Social Security.
U.S. Railroad
Retirement Board: 877-772-5772
Call to schedule monthly premiums to be withdrawn from
the U.S. Railroad Retirement Board.
Health Alliance Medicare is a Medicare Organization with a Medicare contract. Enrollment in Health Alliance Medicare depends on contract renewal. Other providers are available in our network.