Q: What Is a Medicare Advantage Plan?

Medicare Part C, also known as the Medicare Advantage program, allows you to choose a health plan offered by a private insurance company that is approved by Medicare. Medicare Advantage plans include:

  • Managed Care Organizations (such as a PPO or HMO)
  • Private Fee-for-Service Plans

Medicare Advantage plans receive payments from Medicare to provide you with the benefits covered by Medicare, including Part A and Part B. Most Medicare Advantage plans include Part D drug coverage and many offer extra coverage, such as vision and hearing care, dental services, and wellness programs.

Q: Who Is Eligible for Medicare Benefits?

A:  Medicare is a federal government program that provides health insurance for people age 65 and older, people under age 65 with certain disabilities, and people with permanent kidney failure requiring dialysis or a kidney transplant. The Medicare program is made up of several "parts" that offer various benefits, including hospital insurance Part A), medical insurance for doctors' services (Part B), and prescription drug coverage (Part D). 

Q: What Does Medicare Part A Cover?

A:  Medicare Part A, also known as the Hospital Insurance program, helps cover the costs of care in the following facilities:

  • Inpatient care in hospitals
  • Inpatient care in a skilled nursing facility
  • Inpatient rehabilitation facility
  • Hospice care services
  • Some home health care services
  • Inpatient mental health and psychiatric care

If you are eligible for Medicare you will not have to pay a monthly premium for Part A if you or your spouse paid Medicare payroll taxes while working.

What Happens to Medicare Under Health Reform?

The Affordable Care Act makes several changes to Medicare that most likely will improve your benefits and your access to primary care services. Some significant changes include:

  • Coverage Gap Savings: If you reach the coverage gap in 2010 you will receive a one-time rebate check of $250 from Medicare. In 2011, you will be able to get a 50% discount on brand-name drugs and a 7% discount on generic drugs in the coverage gap. There will be additional savings in the coverage gap each year until it's completely closed by 2020.
  • Preventive Care: Beginning in 2011, Medicare will pay for an annual checkup, including a physical examination and a total elimination of cost sharing for appropriate preventive services and screenings.
Medicare easy guide
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