What is Original Medicare?

Original Medicare includes Medicare Part A and Part B, which you sign up for through the Social Security Administration. Here’s a concise overview of Original Medicare:

Medicare Part A: Hospital Insurance

Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care,
lab tests, surgery, and some home health care.

Medicare Part B:

Medical Insurance

Medicare Part B covers certain doctors, services, outpatient care, medical supplies, and
preventive services.

What Medicare Solutions Do We Offer?

At Creative Insurance Solutions, we provide a variety of Medicare solutions designed to meet
the healthcare needs of seniors and eligible individuals. Here’s a concise overview of our
offerings to fill in the gaps in Original Medicare:

Medicare Advantage (Part C)

Medicare Advantage, Part C, is a bundled plan offered by private insurance companies that includes all Part A and Part B benefits, and usually Part D. Options include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and more.

Medicare Prescription Drug Plan (Part D)

The Medicare Prescription Drug Plan (Part D) adds drug coverage to Original Medicare and
some other Medicare plans. Essential for managing prescription medication costs and is a requirement for Medicare beneficiaries unless they have prescription drug coverage through an employer or the Veterans Administration.

Medicare Supplements (Medigap)

Helps pay some of the healthcare costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Provides additional financial protection and peace of mind.

These Medicare solutions offer comprehensive coverage options to ensure you have access to the necessary healthcare services and support. For more details, feel free to contact us or visit our website.

What Does Medicare Part A & B Cover?

Medicare Part A and Medicare Part B provide essential health coverage for seniors and eligible individuals:

Medicare Part A: Hospital Insurance

Inpatient Hospital Stays

Covers room, meals, and general nursing services.

Skilled Nursing Facility Care

Includes short-term care following a hospital stay.

Hospice Care

For terminally ill patients, including support services and certain medications.

Home Health Care

Limited to medically necessary part-time or intermittent skilled nursing care and therapy services.

Lab Tests and Surgery

Essential diagnostic and surgical procedures.

Medicare Part B: Medical Insurance

Doctor’s Services

Includes visits to primary care physicians and specialists.

Outpatient Care

Covers services that don’t require hospital admission, such as consultations and minor procedures.

Preventive Services

Screenings, vaccinations, and preventive check-ups to maintain health and detect issues early.

Medical Supplies

Durable medical equipment like wheelchairs and oxygen supplies.

Preventive Services

Screenings, vaccinations, and preventive check-ups to maintain health and detect issues early.

In summary, Medicare Parts A and B collectively cover provide benefits for a wide range of
necessary medical services, ensuring comprehensive healthcare access for seniors and eligible individuals, but without additional coverage can result in significant out-of-pocket costs for services.

How Can Medicare Advantage (Part C) Benefit You?

Medicare Advantage (Part C) offers numerous benefits that can enhance your healthcare experience:

Comprehensive Coverage

Medicare Advantage combines Medicare Part A (hospital insurance) and Part B (medical insurance) into a single plan. Many plans also include Part D (prescription drug coverage).

Additional Benefits

Part C often covers services not included in Original Medicare, such as vision, hearing, dental, and wellness programs.

Cost Savings

Medicare Advantage plans may lower out-of-pocket costs compared to Original Medicare. Many plans have a yearly out-of-pocket maximum, providing financial protection.

Convenience

Medicare Advantage simplifies your healthcare with one plan, often including prescription drugs, and additional benefits.

Choice of Plan Options

Medicare Part C has several types of plans available, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Special Needs Plans (SNPs), allowing you to choose a plan that best fits your needs.

Coordinated Care

Many Medicare Advantage plans emphasize coordinated care, ensuring that your healthcare providers work together for the best outcomes.

Why Enroll in a Medicare Prescription Drug Plan (Part D)?

Enrolling in a Medicare Prescription Drug Plan (Part D) offers several key benefits:

Comprehensive Coverage

Medicare prescription drug plans help cover the cost of prescription medications, reducing out-of-pocket expenses for essential drugs.

Financial Protection

Medicare Part D plans provide predictable drug costs, protecting you from high medication expenses and aiding in budget management.

Access to Medications

Medicare prescription drug plans assist with covering the medications you need to manage chronic conditions, acute illnesses, and overall health maintenance.

Wide Plan Selection

A variety of plans are available to meet different needs and preferences, allowing you to choose one that covers your specific medications and fits your budget.

What Are Medicare Supplements (Medigap) and How Do They Work?

Medicare Supplements, also known as Medigap, are private insurance policies designed to cover costs not covered by Original Medicare (Part A and Part B), such as copayments, coinsurance, and deductibles. Here’s how they work:

What Are Medigap Policies?

Private Insurance

Medigap policies are sold by private companies to complement your Original Medicare coverage.

Standardized Plans

Medigap plans are standardized and labeled A through N, offering the same basic benefits regardless of the insurance provider.

How Do They Work?

Supplemental Coverage

After Original Medicare pays its share of covered healthcare costs, Medigap helps pay some or all remaining out-of-pocket expenses.

Nationwide Use

Medicare supplements are accepted by any healthcare provider that accepts Medicare, offering flexibility and ease of access.

Separate from Medicare Advantage

Medigap is different from Medicare Advantage (Part C) and cannot be used in conjunction with Medicare Advantage plans.

Do You Need Medicare Travel Coverage?

Medicare generally provides limited coverage for medical services outside the United States. Here’s why you might need Medicare travel coverage:

Limited International Coverage

Original Medicare

Medicare A and B typically do not cover healthcare outside the U.S. Exceptions are rare and generally limited to emergencies near the U.S. border or on a cruise ship within territorial waters.

Medicare Advantage Plans

With Medicare Advantage, coverage for international travel varies by plan, but most limit or exclude out-of-country medical services.

Peace of Mind

Travel insurance can provide access to necessary medical services and emergency assistance, ensuring you’re protected wherever you go.

 

You may not need Medicare Travel Coverage if your travel is limited to within the United States. If you travel internationally, however, it’s advisable to consider supplemental travel insurance to cover potential medical expenses not included in your Medicare plan. This extra protection provides the pace of mind that you can get the medical care you need when abroad and helps to minimize the expense of that care.