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Health Insurance Basics

Your Guide to Medicare Benefits and Coverage

July 31, 2017

Medicare is health insurance for people 65 or older, younger disabled people, and dialysis patients. In order to get the most from your Medicare plan, it’s important to really understand the advantages of your Medicare benefits and coverage.

The Four Parts of Medicare

According to the Centers for Medicare and Medicaid Services, Medicare has four different parts:

Medicare Part A (hospital insurance):

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home healthcare

Medicare Part B (medical insurance):

  • Services from doctors and other healthcare providers
  • Outpatient care
  • Home healthcare
  • Durable medical equipment
  • Many preventive services

Medicare Part C (Medicare Advantage):

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May include extra benefits and services for an extra cost

Medicare Part D (Prescription Drug Coverage):

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May help lower your prescription drug costs and help protect against higher costs in the future
How to Access Your Medicare Benefits and Coverage

You first enroll in original Medicare, and if you want prescription drug coverage, you'll need to join a Medicare Prescription Drug Plan (Part D). You may also find you want a Medicare Supplement Plan (Medigap) to cover the expenses original Medicare doesn’t pick up.

Your second choice is to join a Medicare Advantage Plan. These plans often include prescription drug coverage.

The more you know about Medicare benefits and coverage, the better prepared you will be to pick the right plans for your healthcare now and in the future.

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call our Customer Service number, (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a nuestro número de Servicio de Atención al Cliente (TTY: 711). 注意:如果您使用非英語的其他語言,您可以免費獲得語言援助服務。請致電聯絡客戶服務部(聽語障用戶請致電:711)。