Introduction to Medicare

Medicare

Medicare is the federal health insurance program for:

• People who are 65 or older

• Certain younger people with disabilities

• People with end-stage renal disease (ESRD)

“Original” Medicare

 Part A – Hospital/Inpatient

• Inpatient insurance provided by the Federal Government that helps pay for inpatient hospital care, skilled nursing facility care, hospice care, home health care, etc.

• Most people pay $0 if you or your spouse paid Medicare taxes for 40 calendar quarters (10 years).

• The Part A deductible is per “benefit period.”  A benefit period starts when you enter a hospital or skilled nursing facility for an overnight stay (not observation) and ends when you have been out for 60 days in a row. The Part A deductible applies to each benefit period, so it is possible to have to pay multiple deductibles per year.

Part B – Medical/Outpatient

• Medical insurance provided by the Federal Government that helps pay for doctor’s visits, ambulance rides, lab tests, medical equipment, etc.

• Premiums can change each year and are based off of your income.

• The Part B deductible is annual. After the Part B deductible is met, Medicare pays 80% of the Medicare-approved amount for a specific medical procedure.

Pharmacy

Part D – Prescription Drug

• Drug coverage offered by private insurance companies that are contracted with the Federal Government. In order to qualify for a Part D plan, you must be enrolled in Medicare Parts A & B. Each insurance company defines a list of covered drugs and the pharmacies where you can get them. Coverage is broken into stages and out-of-pocket costs are determined by the stage you are in.

WEA Trust Solution

WEA-MedPlus

• Our wraparound plan that helps to fill in the gaps left by Medicare by covering the Part A & B deductibles, skilled nursing care visits, home health care, mental health, kidney disease treatment, chiropractic care, immunizations and preventive services like your annual physical, vision and hearing exams.

• Works with your “Original” Medicare and Part D plan to complete your suite of care.

WEA-MedPlus works along with your existing Medicare coverage.

To learn more about Medicare visit