FIND THE RIGHT MEDICARE SOLUTION FOR YOU

Preventive services
Part B covers a wide range of preventive services to help maintain your health and detect illnesses at an early stage. These services include annual wellness visits, screenings for cardiovascular disease, cancer, diabetes, and more. Many of these preventive services are provided at no cost to you if you meet eligibility requirements.

Outpatient care
Part B covers medically necessary services you receive as an outpatient from a Medicare-participating provider. This includes services received in a doctor's office, clinic, or hospital outpatient department. Examples of covered outpatient services are X-rays, lab tests, certain vaccinations, and durable medical equipment like wheelchairs and walkers.

Mental health services
Part B covers outpatient mental health services, such as psychotherapy, family counseling, and yearly depression screenings. These services can be provided by doctors, clinical psychologists, clinical social workers, and other qualified professionals. Partial hospitalization programs are also covered if they're offered by a hospital outpatient department or community mental health center.

Ambulance services
Medicare Part B covers ground ambulance transportation to a hospital, critical access hospital, or skilled nursing facility when medically necessary. It covers air transportation (airplane or helicopter) only when you require immediate and rapid transportation that cannot be provided by ground transportation.
Limited outpatient prescription drugs

While most prescription drugs are covered under Medicare Part D, there are some exceptions. Part B covers certain drugs that you wouldn't usually give to yourself, like those you get at a doctor's office or hospital outpatient setting.

Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare. These plans bundle Part A, Part B, and often Part D (prescription drug coverage) into a single plan, providing a convenient way to manage your Medicare benefits.

When you enroll in a Medicare Advantage plan, you're still in the Medicare program and must continue paying your Part B premium (and your Part A premium, if applicable). In addition, you may have to pay a monthly premium for your Medicare Advantage plan, although some plans have $0 premiums.

Medicare Advantage plans must cover all the services that Original Medicare covers, but they can do so with different rules, costs, and restrictions. Many plans offer additional benefits that Original Medicare doesn't cover, such as routine dental, vision, and hearing care, fitness programs, and over-the-counter medications.

It's important to review the details of each Medicare Advantage plan carefully before enrolling, as the costs and benefits can vary significantly from plan to plan and from region to region.

You'll also want to ensure that your preferred healthcare providers are included in the plan's network, as some plans may have limited provider networks or require referrals to see specialists.

Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare. Part C plans include both Part A and Part B coverage, and often provide additional benefits. Here is a list of services typically covered by Medicare Part C:

Part A and Part B benefits
All Medicare Advantage plans must cover the same services that Original Medicare covers under Part A and Part B. This includes inpatient hospital care, skilled nursing facility care, home health care, preventive services, outpatient care, mental health services, and ambulance services.

Prescription drug coverage
Most Medicare Advantage plans (known as MA-PDs) include prescription drug coverage, which is usually equivalent to Medicare Part D. This means you can get your Medicare benefits and prescription drug coverage through a single plan, rather than enrolling in a separate Part D plan.

Additional benefits
Many Medicare Advantage plans offer extra benefits that Original Medicare doesn't cover. These may include:

• Routine dental care, such as cleanings, X-rays, and dentures
• Routine vision care, including eye exams and glasses
• Routine hearing exams and hearing aids
  Fitness memberships, such as SilverSneakers
• Transportation to medical appointments
• Over-the-counter medications and health products
  

Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps cover the cost of prescription medications and can be added to Original Medicare (Part A and Part B), some Medicare Cost Plans, some Medicare Private-Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

If you have Original Medicare and want prescription drug coverage, you must enroll in a separate Part D plan. If you have a Medicare Advantage plan, prescription drug coverage is often included (known as an MA-PD plan), but you can also choose a plan without drug coverage and enroll in a separate Part D plan.

Part D plans have a monthly premium, which varies by plan and can be deducted from your Social Security payment or paid directly to the insurance company. You may also have to pay an annual deductible, copayments, or coinsurance for your medications. If your income is above a certain level, you may have to pay an Income Related Monthly Adjustment Amount (IRMAA) in addition to your Part D premium.

It's important to note that Part D plans have a coverage gap, often called the "donut hole," where you pay a higher percentage of your drug costs after you and your plan have spent a certain amount on covered drugs. Once you reach the catastrophic coverage stage, you'll pay significantly lower copayments or coinsurance for the rest of the year.

Like Medicare Advantage plans, Part D plans can vary in terms of costs, covered medications, and pharmacy networks, so it's crucial to compare plans and choose one that best meets your needs and budget.

Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps cover the cost of prescription medications and can be added to Original Medicare (Part A and Part B), some Medicare Cost Plans, some Medicare Private-Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. 

Here is a list of what Medicare Part D typically covers:

Prescription drugs
Part D plans cover a wide range of prescription drugs, including both brand-name and generic medications. Each plan has its own formulary, which is a list of covered drugs divided into tiers. Lower-tier drugs generally have lower copayments or coinsurance, while higher-tier drugs have higher out-of-pocket costs.

Vaccines
Part D plans cover commercially available vaccines, such as the shingles vaccine, when medically necessary to prevent illness. Some vaccinations, like flu shots, are covered under Part B instead of Part D.

Medication therapy management
If you take medications for different medical conditions, you may be eligible for medication therapy management (MTM) services. MTM can help you understand how to manage your medications effectively and safely. Part D plans must offer MTM services to members who meet certain criteria, such as having multiple chronic conditions or taking several medications.

Transitional fills
If you're new to a Part D plan or your plan changes its formulary, you may be able to get a one-time, temporary supply of a drug you're currently taking. This gives you time to work with your doctor to find an alternative medication or request a formulary exception from your plan.

It's important to note that while Part D covers a broad range of prescription drugs, not all medications are covered. Each plan has its own formulary and may have certain restrictions, such as prior authorization, quantity limits, or step therapy.

Additionally, Part D plans may have an annual deductible, copayments, or coinsurance, and a coverage gap (known as the "donut hole") where you pay a higher percentage of drug costs until you reach the catastrophic coverage stage.