Medicare Plans | PCF Senior Benefits

There are two ways to get Medicare

Medicare is health insurance for people age 65 or older, below age 65 with certain disabilities and any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) or ALS (also called Lou Gehrig’s disease).

When considering Medicare, you'll have many things to consider. First, you need to review the benefits that fit your coverage needs. Understanding your coverage options will help you choose between Original Medicare (Part A and Part B) and a Prescription Drug Plan (Part D) or a Medicare Advantage plan (Part C).

Medicare Basics

The two main options for Medicare are Part A and Part B. Medicare Part A (also known as Hospital Insurance) pays for inpatient hospital stays, skilled nursing facility care, and hospice care after you pay deductibles and coinsurance.

Medicare Part B covers medically necessary doctor appointments, diagnostic tests, and some medical equipment. Part B may also offer coverage for home health care.

Medicare
Advantage Part C

Medicare Advantage Part C covers everything included in Part A and Part B (except hospice) and, depending on the particular plan, may provide additional benefits like dental, vision, hearing, and health club memberships. Most Medicare Advantage plans also include prescription drug coverage (Part D).

You must be enrolled in Part A and B to be eligible for Part C.

Medicare Supplement

Often referred to as Medigap plans, Medicare supplement plans help to cover costs you’d be responsible for with Medicare Part A and Part B, such as deductibles and co-insurance.

During your initial enrollment window, you are guaranteed the right to purchase a Medicare supplement plan without any health questions. If you purchase outside the initial enrollment window, you may be subject to a health status review.

Prescription Drug Plans

Medicare Part D, the prescription drug plan benefit, provides outpatient prescription drug coverage. Part D is provided through private insurance companies that have been contracted by the federal government.

Part D plans are available stand-alone or through most Medicare Advantage plans. These plans will cover most vaccinations when necessary to prevent illness. Each plan will have a unique formulary that details what drugs are covered and which are not.