Medicare insurance plans are subsidized healthcare services provided by the federal government in the USA to its eligible citizens. As per the program criteria, elderly people and individuals with specific disabilities can enroll in Medicare health programs for medical care and services to meet their healthcare demands. To be more specific, USA citizens who fulfill the following criteria to avail the benefits of Medicare plans from health care service providers listed in the plan’s network:
- Elderly people in the age group of 65 years and above
- People with specific disabilities listed in Medicare plans by the Social Security Administration
- People suffering from amyotrophic lateral sclerosis and End-Stage Renal Disease
Medicare insurance plans are administrated by the Centers for Medicare and Medicaid Services (CMS) to primarily provide health insurance. It is a national healthcare program funded by the U.S. federal government under the Social Security Act in the country. Medicare plans are divided mainly into the following four parts to cover different healthcare services that are generally offered by private insurance companies as per the CMS guidelines.
- Medicare Part A (Hospital Insurance)
- Medicare Part B (Medical Insurance)
- Medicare Advantage Plan (Also known as Medicare part C)
- Medicare Part D (Prescription Drug Coverage)
Medicare Part A, Part B, and Part D plans are termed as original Medicare plans, while the Medicare Advantage plan provides all the benefits of Original Medicare plans with some extra healthcare coverage and benefits such as eye care, dental care, and hearing-related medical services. As a beneficiary of Original Medicare insurance plans, you will receive the following benefits:
Medicare Part A: It generally provides hospital insurance to individuals and covers expenses such as hospital and nursing bills for stays and care in professional as well as home-based settings.
Medicare part B: It covers medical bills and expenses for doctor visits, ambulance services, preventive services, outpatient care, medical supplies, and mental health care.
Medicare Part D: It is a prescription drug coverage program and mostly covers the cost of self-administrated drugs that are not covered in Medicare Part A and Part B Plans.
When you enroll in an original Medicare plan, the federal government pays for your medical expenses when you get any healthcare service from providers listed in your plan’s network. The beneficiary pays a monthly premium to the government to get Medicare benefits when needed.
Medicare Advantage Plan
If you want a complete health insurance plan with added benefits without enrolling in multiple programs, then you can opt for Medicare Advantage Program to meet your medical needs. It is offered by Medicare-approved private insurance companies to cover your medical expenses as part of your Medicare benefits. It is an alternative way to get original Medicare coverage with additional benefits. Individuals pay monthly premiums to private insurance companies from whom they have purchased their plan to receive medical benefits. Medicare Advantage plans are further divided into the following categories:
- Health Maintenance Organization (HMO) plans
- Preferred Provider Organization (PPO) plans
- Private Fee-for-Service (PFFS) plans
- Special Needs Plans (SNPs)
- HMO Point-of-Service (HMOPOS) plans
So, if you are looking for any Medicare Insurance Plan in Texas, the USA, consult with our health insurance experts at ICUSA to decide which plan best suits your requirements. We will help you understand Original Medicare Plans and Medicare Advantage Plan so that you can make well-informed decisions to meet your needs.