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Medicare Basics

Most Americans join Medicare when they turn 65, but it’s also available to younger people with certain disabilities and people with end-stage renal disease (ESRD) or permanent kidney failure requiring dialysis or a kidney transplant.

What Is Medicare?

Medicare is a national health insurance program administered by the federal government. It is not part of the health insurance marketplace. Medicare is made up of four parts. Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) are considered Original Medicare. Medicare Part C (Medicare Advantage plans) and Medicare Part D (prescription drug plans) are plans offered by insurance companies and private companies that contract with Medicare. You can elect to purchase more Medicare coverage offered by Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation.

Original Medicare

Offered by the Federal Government

Hospital Insurance

Part A – Hospital Insurance

Part A helps pay for:

  • Inpatient hospital care
  • Skilled nursing facility care after a hospital stay
  • Some home health care and hospice services
Medical Insurance

Part B – Medical Insurance

Part B helps pay for:

  • Doctor's office visits and services
  • Most outpatient care
  • Home health care
  • Durable medical equipment
  • Many preventive services

More Medicare Coverage

Additional Medicare Coverage Offered by Blue Cross and Blue Shield of Texas

You can choose to enroll in:

Hospital, Medical, and Prescription Drug Insurance

Part C – Medicare Advantage Plans

Part C combines what’s covered by Part A and Part B and adds benefits, often including prescription drug coverage (Part D)

Part C always covers you for all benefits included in Parts A and B.

May include coverage for:
  • Dental, hearing and/or vision services
  • Health, wellness and fitness programs

Part C plans may also include:

  • Options that may or may not include prescription drug coverage
  • Provider networks to help manage costs
  • A Part B Premium Buy-down benefit that reduces the Medicare Part B premium that you pay to the Social Security Administration
  • A preloaded flexible spending card to help reduce your out-of-pocket expenses for covered dental, vision, and hearing services

If you enroll in a Blue Cross Medicare AdvantageSM plan, you cannot also enroll in a Medicare Supplement Insurance Plan*.

You can also choose to enroll in:

Prescription Drug Coverage

Part D – Prescription Drug Coverage

Part D helps cover costs of prescription drugs with copays or coinsurance.

Or, you can choose to enroll in a Medicare Supplement Insurance Plan on its own or paired with a Part D plan:

Medicare Supplement Insurance

Medicare Supplement Insurance Plans

Helps with costs that Medicare Parts A and B do not cover

Medicare Supplement Insurance Plans help to pay for:
  • Coinsurance
  • Copays
  • Deductibles

Help Me Choose a Plan

If you’re not sure what plan you need, answer a few questions to help you decide.

Now that you’ve picked a plan, it’s time to enroll.

Useful Tools

Plan A: UWMSP(A)-2010, Plan F: UWMSP(F)-2010, Plan High Deductible F: UWMSP(F-HD)-2010, Plan G: UWMSP(G)-2010, Plan K: UWMSP(K)-2010, Plan L: UWMSP(L)-2010, Plan N: UWMSP(N)-2010, Medicare Select Plan F: UWMSP-SEL(F)-2010, Medicare Select Plan G: UWMSP-SEL(G)-2010, Medicare Select Plan K: UWMSP-SEL(K)-2010, Medicare Select Plan L: UWMSP-SEL(L)-2010, Medicare Select Plan N: UWMSP-SEL(N)-2010.

Benefits and premiums under this policy may be suspended for up to 24 months if you become entitled to benefits under Medicaid. You must request that your policy be suspended within 90 days of becoming entitled to Medicaid. If you lose (are no longer entitled to) benefits from Medicaid, this policy can be reinstated if you request reinstatement within 90 days of the loss of such benefits and pay the required premium.