Medicare
Medicare is the federal health insurance program for:
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People who are 65 or older
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Certain younger people with disabilities
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People with end-stage renal disease (ESRD)
“Original” Medicare
Part A – Hospital/Inpatient
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Inpatient insurance provided by the Federal Government that helps pay for inpatient hospital care, skilled nursing facility care, hospice care, home health care, etc.
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Most people pay $0 if you or your spouse paid Medicare taxes for 40 calendar quarters (10 years).
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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
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Medical insurance provided by the Federal Government that helps pay for doctor’s visits, ambulance rides, lab tests, medical equipment, etc.
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Premiums can change each year and are based off of your income.
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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
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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
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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.
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Works with your “Original” Medicare and Part D plan to complete your suite of care.