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What is Medicare?

Medicare is federal health insurance offered primarily to people age 65 and older, and to people under age 65 with certain disabilities. Medicare started with just two parts—Part A (hospital coverage) and Part B (medical coverage). Later, as the needs of Medicare plan members changed, the federal government added Part C and Part D.

It’s important to understand that Medicare (Part A and Part B—sometimes referred to as Original Medicare) do not cover all of your medical expenses. Find out about other options that are available, and why they may be right for you.

Part A

Hospital insurance—for inpatient stays
  • Free for most people, which means no monthly premiums
  • Covers you in a hospital, skilled nursing home, or hospice, or home health care
  • When you receive care, you pay a Part A deductible and coinsurance. These are out-of-pocket expenses. You're responsible for paying these expenses unless you have a separate health insurance plan to cover them.

Part B

Medical insurance—for doctor services and more
  • Optional coverage
  • Includes doctor services both in and of the hospital. Plus outpatient care, durable medical equipment, home health care, and some preventive services.
  • You pay the Part B monthly premium unless you qualify for a subsidy program for your premiums through Medicaid.

Part D

Premera's Medicare Advantage plans conveniently combine drug and medical coverage in the same plan.

If you're choosing a Premera Medical Supplement plan and also need Part D drug coverage, you must obtain that coverage separately. Visit Medicare.gov for more information.


Part C

Medicare Advantage:
  • Part C Medicare Advantage (MA) plans replace Original Medicare with coverage offered by private organizations, like insurers, that are contracted with Medicare.
  • These plans offer everything covered by Original Medicare Part A and Part B, plus they often include prescription drug coverage and coverage of certain services not paid by Original Medicare.
  • Premiums and deductibles vary by plan.
 

Why do many people choose to buy additional coverage?

Unless you qualify for a program to help pay your Medicare costs, you'll have to pay all these costs yourself. As mentioned earlier, there’s a monthly premium for Part B, which is typically deducted from your Social Security check each month. Both Medicare Part A and Part B have deductibles and coinsurance that you must pay. Each year, these costs are reviewed—and often adjusted—by the federal government.


It’s important to remember that Medicare does NOT cover most prescription drugs, and you may need additional prescription drug coverage.

© 2018 Premera Blue Cross is an Independent Licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County. Premera Blue Cross is an HMO plan with a Medicare contract. Enrollment in Premera Blue Cross depends on contract renewal. This information is not a complete description of benefits. Call 888-868-7767 (TTY/TDD: 711) 7 days a week, 8 a.m. to 8 p.m. for more information. To join a Premera Blue Cross Medicare Advantage Plan, you must have Medicare Part A and Part B and live in the Premera Blue Cross Medicare Advantage service area (King, Pierce, Lewis, Skagit, Snohomish, Spokane, Stevens, Thurston, and Whatcom counties in Washington). Members must select a Primary Care Provider (PCP) from the Premera Blue Cross Medicare Advantage Plans provider network. For accommodation of persons with special needs at sales meetings, call 888-868-7767 (TTY/TDD: 711), 7 days a week, 8 a.m. to 8 p.m.

H7245_H9302_PBC1701 - Last updated 2018-10-01

Plan form numbers: Plan A 021190 (06-2010); 021194 (06-2010); Plan N 021191 (06-2010); 021195 (06-2010); Plan F 021192 (06-2010); 021196 (06-2010); High Deductible Plan F 021193 (06-2010); 021197 (06-2010); Plan G 042193 (01-2018); 042194 (01-2018).