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What is medicare

Medicare is controlled by a federal program, Centers for Medicare and Medicaid (CMS) is a health insurance program for People 65 or older, under 65 with certain disabilities, or end stage renal disease. Initial Enrollment Period IEP allows you to sign up for Medicare 3 months before you turn 65, the month you turn 65 and 3 months after you turn 65.  Medicare has different parts:

Medicare Part A (Hospital Insurance) helps cover inpatient hospital care, hospice care, some home health care. and skilled nursing facilities.  Most people don't pay a premium for part A because they or their spouse made contributions (at least 40 units) through their payroll taxes  The inpatient hospital deductible for 2022 is $1,556.

Medicare Part B (Medical Insurance) helps cover doctor's services and outpatient care, physical and occupational therapists, some home health care, and medically necessary services and supplies.  Most people pay a premium for Part B of $170.10 for 2022.  Medicare Part B has a deductible of $233 for 2022 and covers 80% of covered medical costs.
 
Medicare Part D (Prescription Drug Coverage) covers prescription drugs and you must join a plan approved by Medicare in a timely manner to avoid a penalty.  Most people pay a premium for Part D unless it is part of a Medicare Advantage plan or they receive financial assistance from the state. The maximum deductible for Part D in 2022 is $445.

Medicare Part C (Medicare Advantage Plan) provided by private insurance companies, combines Part A (Hospital Insurance), Part B (Medical Insurance) and usually Part D (Prescription Drug Coverage.  Most Medicare Advantage Plans include extra benefits such as dental, vision, hearing aids, etc.  There are thousands of Medicare Advantage Plans available in 2022 that have no premium or low premium.  Plans have a Maximum Out Of Pocket (MOOP) that protects you from a financial catastrophe.  Most Medicare advantage plans operate as a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) plan.  HMOs limit members to use the doctors and hospitals in their networks and may require a referral from a primary care physician to see a specialist or prior authorization for some medical services..  PPO's generally let members get care outside the plan's network, but members may have to pay more for care not in network.  There are certain times you may enroll in a Medicare Advantage plan.  
Initial Coverage Enrollment Period (ICEP) allows you to sign up for a Medicare Advantage Plan and Part D when you turn 65 and begins 3 months before the month of your Ja, the month of your birthdate and 3 months after your birthdate. You may elect a Medicare Advantage plan after you have been on disability for 24 months even before you are 65.  Annual Enrollment Period (AEP) from October 15  to December 7 of every year you may select a new Medicare advantage plan or part D plan or return to Original Medicare. Open Enrollment Period (OEP) begins January 1 through March 32 and allows you to change Medicare Advantage plans or return to Original Medicare.  Special Enrollment Period (SEP) occurs when there is a life event and allows you to change your Medicare advantage or Part D plans.

Medicare Part A-N (Medicare Supplement or Medigap) provided by private insurance companies covers benefits that Original Medicare does not cover.  Medigap prices vary by plan benefits, and are not based on your income.  Medigap plans complement Original Medicare and cover benefits that Original Medicare does not cover.  Medigap Plans are not endorsed by the federal government.  There is no need for prior authorization or a referral from a primary care doctor.  You may go to any doctor in the United States that accepts Medicare.

Your health is your most important asset.  To learn more about Medicare and find the plan that best fits your needs contact a licensed agent at www.tx3insurance.com

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