Retiree Health Choices is a Chicago technology company that helps retirees and Boomers navigate the often-complex Medicare sector. Recently, Retiree Health Choices launched EasyMedicareChoices.com to put retirees in the drivers’ seat with retirement insurance choices.
Before anyone enrolls in Medicare, however, they need to better understand the lexicon of the retirement insurance system.
Here is a list of 11 basic words from the Medicare dictionary Boomers and retirees should become familiar with:
Medicare.When Americans turn 65-years-old, the federal health insurance program kicks in. Others younger with disabilities may be eligible.
Original Medicare. This coverage is fee for service. The government pays health care providers directly for Part A and Part B Medicare benefits.
Medicare Part A Everyone registers for Medicare Part A that is hospital insurance. It covers hospital stays, hospice, some home health care and also care in a skilled nursing facility.
Medicare Part B. Everyone also signs up for Medicare Part B. This is medical insurance to cover certain types of physician services, outpatient care, medical supplies and preventive services.
Medicare Part C.Part C is a Medicare Advantage Plan. Private companies offer this health plan. They contract with Medicare and provide Part A and Part B benefits. When you sign up for Medicare Advantage, coverage includes HMO, PPO, fee for service, special needs and medical savings accounts.
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Medicare Part D. This coverage is for prescription drugs. Private companies and insurance companies offer Medicare Part D. Medicare Advantage Plans may offer prescription drug coverage, as well.
Medicare Supplement.Medicare Supplement plans, sold by private companies, help cover costs, like deductibles, co-payments, or co-insurance not included in original Medicare insurance. When people with Medicare have other insurance, the one that pays first up to the limits of coverage is the primary payer.
Secondary Payer. If there are costs not paid by the primary payer, the secondary payer, which is often Medicare, may pay some or all of the uncovered costs.
Conditional Payment. A conditional payment is a payment Medicare makes for services another payer may be responsible for. Medicare makes this conditional payment so you won’t have to use your own money to pay the bill. The payment is “conditional” because it must be repaid to Medicare when a settlement, judgment, award, or other payment is made.