Social Media Icons - Top Right

What is Medicare?

Medicare is a federal health insurance program accessible to individuals who are 65 years and older, as well as to those under 65 with specific disabilities or medical conditions like End-Stage Renal Disease.

It comprises various components, known as Parts A, B, C, and D, each designed to meet different healthcare requirements.

What is Medicare?

Medicare is a federal health insurance program accessible to individuals who are 65 years and older, as well as to those under 65 with specific disabilities or medical conditions like End-Stage Renal Disease.

It comprises various components, known as Parts A, B, C, and D, each designed to meet different healthcare requirements.

Original Medicare

Medicare Parts A and B are referred to as "Original Medicare".

These parts are managed by the federal government. Some individuals who receive Social Security benefits are automatically enrolled in Original Medicare while others need to apply for it as they approach their 65th birthday.

Original Medicare

Medicare Parts A and B are referred to as "Original Medicare".

These parts are managed by the federal government. Some individuals who receive Social Security benefits are automatically enrolled in Original Medicare while others need to apply for it as they approach their 65th birthday.

Medicare Part A (Hospital Insurance)

Medicare Part A includes coverage for inpatient services in hospitals or skilled nursing facilities, as well as home health care and hospice care for patients with terminal illnesses.

Part A Cost

Deductible

You must first meet a Part A deductible before Part A helps with your covered medical expenses.

Options

There is no insurance premium for Part A if you or your spouse have paid into Social Security for a minimum of 10 years.

If not, you have the option to purchase Medicare Part A.

Copays

Copayments or cost-sharing might be required for certain services. This includes prolonged hospital or skilled nursing facility stays.

Coinsurance

Part A has coinsurance for:

• Inpatient hospital care lasting between 61-90 days total per benefit period.

• Inpatient mental health care lasting between 61-90 days total per benefit period.

• Skilled nursing care lasting between 21-100 days total per benefit period.

Coinsurance is also available for a limited number of additional days.

Medicare Part A (Hospital Insurance)

Medicare Part A includes coverage for inpatient services in hospitals or skilled nursing facilities, as well as home health care and hospice care for patients with terminal illnesses.

Part A Cost

Deductible

You must first meet a Part A deductible before Part A helps with your covered medical expenses.

Options

There is no insurance premium for Part A if you or your spouse have paid into Social Security for a minimum of 10 years.

If not, you have the option to purchase Medicare Part A.

Copays

Copayments or cost-sharing might be required for certain services. This includes prolonged hospital or skilled nursing facility stays.

Coinsurance

Part A has coinsurance for:

• Inpatient hospital care lasting between 61-90 days total per benefit period.

• Inpatient mental health care lasting between 61-90 days total per benefit period.

• Skilled nursing care lasting between 21-100 days total per benefit period.

Coinsurance is also available for a limited number of additional days.

Medicare Part A:

Additional Information

You can utilize your coverage anywhere in the United States, as most hospitals in the country participate in Medicare.

Medicare Part B (Medical Insurance)

Medicare Part B provides coverage for doctor visits, durable medical equipment, speech therapy, occupational therapy, physical therapy, and various other outpatient services.

Part B Cost

Deductible

Similar to Part A, you must first meet an insurance deductible before Part B helps with your medical costs.

Copays

Copayments or cost-sharing might be required for certain services, such as those provided in an outpatient hospital setting

.

Coinsurance

You are responsible for 20 percent of the cost for certain medical services, including doctor visits, outpatient therapy, and durable medical equipment.

Preventative Care

Medicare-covered preventive care services, including annual wellness visits and mammograms for women, are fully covered. No deductibles, copayments, or coinsurance are required for these services.

Premium

Medicare Part B requires a monthly insurance premium, which depends on your enrollment timing and annual household income.This premium is typically deducted from Social Security benefits.

It is distinct from the premiums for Medigap, Medicare Advantage (Part C), or Prescription Drug Coverage (Part D).

Note about Medicare Part B Limits: Medicare Part B imposes annual limits on services for physical

therapy, occupational therapy, and speech-language pathology.

Medicare Part B (Medical Insurance)

Medicare Part B provides coverage for doctor visits, durable medical equipment, speech therapy, occupational therapy, physical therapy, and various other outpatient services.

Part B Cost

Deductible

Similar to Part A, you must first meet an insurance deductible before Part B helps with your medical costs.

Copays

Copayments or cost-sharing might be required for certain services, such as those provided in an outpatient hospital setting.

Coinsurance

You are responsible for 20 percent of the cost for certain medical services, including doctor visits, outpatient therapy, and durable medical equipment.

Preventative Care

Medicare-covered preventive care services, including annual wellness visits and mammograms for women, are fully covered. No deductibles, copayments, or coinsurance are required for these services.

Premium

Medicare Part B requires a monthly insurance premium, which depends on your enrollment timing and annual household income.This premium is typically deducted from Social Security benefits.

It is distinct from the premiums for Medigap, Medicare Advantage (Part C), or Prescription Drug Coverage (Part D).

Note about Medicare Part B Limits: Medicare Part B imposes annual limits on services for physical

therapy, occupational therapy, and speech-language pathology.

Medicare Part B:

Additional Information

If you have Original Medicare under Part B and your physician accepts Medicare, you can utilize your

coverage anywhere within the United States. You have the freedom to choose any doctor in the country who accepts Medicare patients. Additionally, Part B premiums, standard deductibles, and cost-sharing amounts typically undergo annual adjustments, with changes taking effect on January 1st.

More Info

Product Descriptions

Stand-alone Medicare Prescription Drug Plans (Part D)

Medicare Prescription Drug Plan (PDP) : A stand-alone drug plan that adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.

Medicare Advantage Plans (Part C) and Cost Plans

Medicare Health Maintenance Organization (HMO): A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. In most HMOs, you can only get your care from doctors or hospitals in the plan’s network (except in emergencies).Medicare Preferred Provider Organization (PPO) Plan: A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. PPOs have network doctors and hospitals but you can also use out-of-network providers, usually at a higher cost.Medicare Private Fee-For-Service (PFFS) Plan: A Medicare Advantage Plan in which you may go to any Medicare-approved doctor, hospital and provider that accepts the plan’s payment, terms and conditions and agrees to treat you – not all providers will. If you join a PFFS Plan that has a network, you can see any of the network providers who have agreed to always treat plan members. You will usually pay more to see out-of-network providers.Medicare Point of Service (POS) Plan: A type of Medicare Advantage Plan available in a local or regional area which combines the best feature of an HMO with an out-of-network benefit. Like the HMO, members are required to designate an in-network physician to be the primary health care provider. You can use doctors, hospitals, and providers outside of the network for an additional cost.Medicare Special Needs Plan (SNP): A Medicare Advantage Plan that has a benefit package designed for people with special health care needs. Examples of the specific groups served include people who have both Medicare and Medicaid, people who reside in nursing homes, and people who have certain chronic medical conditions.Medicare Medical Savings Account (MSA) Plan: MSA Plans combine a high deductible health plan with a bank account. The plan deposits money from Medicare into the account. You can use it to pay your medical expenses until your deductible is met.Medicare Cost Plan: In a Medicare Cost Plan, you can go to providers both in and out of network. If you get services outside of the plan’s network, your Medicare-covered services will be paid for under Original Medicare but you will be responsible for Medicare coinsurance and deductibles.Medicare Medicaid Plan (MMP): An MMP is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual eligible Medicare beneficiaries.

Dental/Vision/Hearing Products

Plans offering additional benefits for consumers who are looking to cover needs for dental, vision or hearing. These plans are not affiliated or connected to Medicare

Hospital Indemnity Products

Plans offering additional benefits; payable to consumers based upon their medical utilization; sometimes used to defray copays/coinsurance. These plans are not affiliated or connected to Medicare.

Medicare Supplement (Medigap) Products

Plans offering a supplemental policy to fill “gaps” in Original Medicare coverage. A Medigap policy typically pays some or all of the deductible and coinsurance amounts applicable to Medicare-covered services, and sometimes covers items and services that are not covered by Medicare, such as care outside of the country. These plans are not affiliated or connected to Medicare.

Bateman Insurance Agency

National Producer Number: 978321

DISCLAIMER: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.

Social Media Icons - Bottom Left