Medicare 101

Understanding Medicare requires understanding these concepts:

Original Medicare – Part A (Hospital costs/Skilled Nursing costs), and Part B (Doctors/Nurse Practitioners, Medical Clinic, and Medical Equipment costs). Medicare pays for 80% of approved charges leaving a 20% co-insurance requirement.

Medicare supplement insurance/”Medigap” – provides coverage for the 20% co-insurance requirement on Original Medicare. There are various plan coverages designated by letters A to N. Note – some coverages (E, H, I, and J) are no longer issued to newly eligible enrollees. Enrollees who previously purchased those policies may continue to keep them

Medicare Advantage (aka “Medicare Health Plans” or “Medicare Part C Plans”) – Certain health insurers and health system providers design Medicare services in an HMO (Health Maintenance Organization), PPO Preferred Provider Organization, and PFFS Private Fee for Service manner. These organizations receive a monthly or periodic fee based on enrollment, and are not dependent on claim reimbursement from Medicare as in the original Medicare system.

Prescription Drug Plan (aka “PDP” or “Medicare Part D Plans”) – Prescription drug coverage.

Want to learn more about Medicare? Check out  to get more tips from my good friend Liz Tredennick a Medicare Specialist.