What is Original Medicare?
Medicare is a social security coverage program administered by the United States government, which provides medical care to people 65 years of age or older, some younger people with disabilities, and people with chronic kidney disease (ESRD) that consists of a failure permanent kidney that requires dialysis or transplantation. Different parts of Medicare help cover specific services.
Who can have Medicare?
US citizens and legal residents
Legal residents must live in the United States for at least 5 consecutive years, including the 5 years before applying for Medicare.
You must also meet one of the following requirements:
• Over 65 years of age
• Under 65 years of age and has a qualifying disability
• Of any age and have been diagnosed with end-stage renal disease or amyotrophic lateral sclerosis
Original Medicare has two parts:
Part A is hospital insurance
Helps pay for hospital stays and inpatient care.
Part B is health insurance
Helps pay for doctor visits and outpatient care.
Original Medicare (Parts A and B) DO NOT cover:
• All the costs of your care.
• Prescription drugs.
• Routine dental, vision, or hearing care.
• Glasses, contact lenses, or hearing aids.
• Long-term or custodial care.
• Excess charges for services rendered by physicians who do not accept Medicare assignment.
• Care received outside of the United States, except in certain circumstances.
What is a Medicare Advantage Plan?
A Medicare Advantage plan (like a PPO or HMO) is one way to get your Medicare benefits. Unlike “Original Medicare,” in which the government pays for Medicare benefits when you receive them, Medicare Advantage plans, sometimes known as “Part C” or “MA Plans,” are offered by approved private companies. by Medicare and receiving payments from Medicare for providing coverage of the benefits. If you join a Medicare Advantage plan, the plan will provide all of your Medicare Part A (hospital insurance) and Part B (medical insurance) coverage. This plan is different from a Medigap (Medicare supplement insurance) policy, (which we will explain below), which only pays for costs that Medicare does not cover. All types of Medicare Advantage plans cover emergency care and urgently needed care. Medicare Advantage plans must cover all the services that Original Medicare offers except hospice care. Original Medicare covers this care even if you are in a Medicare Advantage plan. Make sure you find out how the plan works before you join.
Part A - Hospitals
Part A covers inpatient hospital care. Skilled nursing facility care. Nursing home care (inpatient care in a skilled nursing facility that is not long-term care) Hospice care. Home health care.
Part B - Doctors
Part B covers certain doctor services like clinical research. Ambulance services. Durable Medical Equipment (DME). Mental health. Hospitalized patient. Outpatient. Partial hospitalization. Limited outpatient prescription drugs.
Parte C - Medicare Advantage
A type of Medicare health plan offered by a private company that has a contract with Medicare to provide you with all the benefits of Medicare Part A and Part B. Medicare Advantage plans include health maintenance organizations, preferred provider organizations, plans private fee-for-service plans, special needs plans, and Medicare medical savings account plans.
Part D - Medications
Part D adds prescription drug coverage to Original Medicare, some Medicare cost plans, some Medicare private fee-for-service plans, and Medicare medical savings account plans. These plans are offered by insurance companies and private companies approved by Medicare. Medicare Advantage plans may also offer prescription drug coverage.
Informative Videos (Spanish)
Welcome to Medicare
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