Your Guide to Medicare Benefits and Coverage

Medicare is health insurance for people 65 or older, younger disabled people, and dialysis patients. In order to get the most from your Medicare plan, it’s important to really understand the advantages of your Medicare benefits and coverage.

The Four Parts of Medicare

According to the Centers for Medicare and Medicaid Services, Medicare has four different parts:

Medicare Part A (hospital insurance):

• Inpatient care in hospitals
• Skilled nursing facility care
• Hospice care
• Home healthcare

Medicare Part B (medical insurance):

• Services from doctors and other healthcare providers
• Outpatient care
• Home healthcare
• Durable medical equipment
• Many preventive services

Medicare Part C (Medicare Advantage):

• Includes all benefits and services covered under Part A and Part B
• Usually includes Medicare prescription drug coverage (Part D) as part of the plan
• Run by Medicare-approved private insurance companies that follow rules set by Medicare
• May include extra benefits and services for an extra cost

Medicare Part D (Prescription Drug Coverage):

• Helps cover the cost of prescription drugs
• Run by Medicare-approved private insurance companies that follow rules set by Medicare
• May help lower your prescription drug costs and help protect against higher costs in the future

How to Access Your Medicare Benefits and Coverage

You first enroll in original Medicare, and if you want prescription drug coverage, you'll need to join a Medicare Prescription Drug Plan (Part D). You may also find you want a Medicare Supplement Plan (Medigap) to cover the expenses original Medicare doesn’t pick up.

Your second choice is to join a Medicare Advantage Plan. These plans often include prescription drug coverage.

The more you know about Medicare benefits and coverage, the better prepared you will be to pick the right plans for your healthcare now and in the future.

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A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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