Navigating your Medicare Choices

Medicare is a longstanding, vital and complex government social program that provides unique health insurance designed for older Americans, including older adults in Pima County. Understanding its various components can be a tough process, but it’s important to make informed decisions when choosing your healthcare plan. The good news is, we’re here to help! We’ll break down the different components of Medicare, and help to empower your search with the information navigate your healthcare options effectively.

Part A: Hospital Insurance

Medicare Part A, frequently referred to as hospital insurance, covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. For most people, Part A is premium-free if you or your spouse paid Medicare taxes while working. It helps cover the costs of essential services you might need during a hospital stay, ensuring you receive the necessary care without facing overwhelming financial burdens.

Part B: Medical Insurance

Medicare Part B provides coverage for outpatient care, doctor visits, preventive services, and some home health care. While Part B requires a monthly premium, it’s essential for covering services that Part A doesn’t, including doctor’s visits, lab tests, and preventive screenings. Part B ensures you have access to comprehensive medical services, allowing you to maintain your overall health and well-being.

Part C: Medicare Advantage Plans

Medicare Part C, also known as Medicare Advantage, offers an alternative way to receive your Medicare benefits. These plans, provided by private insurance companies approved by Medicare, include coverage from both Part A and Part B, and often include additional benefits such as vision, dental, and prescription drug coverage. Medicare Advantage plans provide flexibility and customization, allowing you to choose a plan tailored to your specific needs.

Part D: Prescription Drug Coverage

Medicare Part D is the prescription drug coverage component of Medicare. It helps cover the cost of prescription medications, ensuring you can afford the medications prescribed by your healthcare provider. Part D plans vary in coverage and cost, so it’s essential to research different plans to find one that includes your necessary medications at an affordable price. Having reliable prescription drug coverage can significantly improve your quality of life by ensuring you have access to the medications you need.

Medigap: Supplemental Insurance

Medigap, also known as Medicare Supplement Insurance, is private insurance that helps cover the “gaps” in Original Medicare (Parts A and B). These gaps include copayments, coinsurance, and deductibles. Medigap policies provide additional financial security, allowing you to budget your healthcare expenses more effectively. It’s important to note that Medigap plans only work with Original Medicare and cannot be used with Medicare Advantage plans.

Understanding the various parts of Medicare is crucial for older adults in Pima County to make well-informed decisions about their healthcare coverage. By familiarizing yourself with Part A, Part B, Part C (Medicare Advantage), Part D, and Medigap, you can navigate the healthcare system with confidence. Remember, choosing the right Medicare coverage ensures you receive the necessary care and medications while protecting your financial well-being. Stay empowered and take charge of your healthcare journey in Pima County!

If you have any questions or need assistance in navigating these choices, Pima Council on Aging is here for you! We are Pima County’s State Health Insurance Assistance Program and Senior Medicare Patrol agency!

Our team of volunteer counselors and staff are trained to provide Medicare assistance to all of Pima County Medicare beneficiaries.

For further assistance, call (520) 546-2011 or email medicare@pcoa.org