Health Insurance for Small Businesses

Medicare is a federal health insurance program in the U.S. for people age 65 and older, as well as certain younger individuals with disabilities. It is divided into four parts, each covering different aspects of healthcare:

1. Medicare Part A (Hospital Insurance):
   
   • Coverage: Helps pay for inpatient hospital stays, skilled nursing facility care (not long-term care), hospice care, and some home health care.
   • Cost: Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working. There is usually a deductible and coinsurance for hospital stays.

1. Medicare Part B (Medical Insurance):
   
   • Coverage: Helps pay for outpatient care, doctor’s visits, preventive services (like flu shots and screenings), and some home health care. It also covers durable medical equipment and supplies.
   • Cost: Part B has a monthly premium that varies based on income, and you’ll typically pay a deductible and coinsurance or copayments for services.

1. Medicare Part C (Medicare Advantage):
   
   • Coverage: This is an alternative to Original Medicare (Parts A and B) and is offered by private insurance companies approved by Medicare. Medicare Advantage plans often include additional benefits like vision, hearing, and dental coverage, and may also include Part D prescription drug coverage.
   • Cost: You generally pay a premium for the Medicare Advantage plan (in addition to the Part B premium), and out-of-pocket costs vary by plan.

1. Medicare Part D (Prescription Drug Coverage):
   
   • Coverage: Provides prescription drug coverage through private insurance companies. It helps pay for both brand-name and generic drugs.
   • Cost: Part D plans have a monthly premium that varies depending on the plan and the coverage level. You may also have a deductible, copayments, or coinsurance, and there is an annual coverage limit.

How They Work Together:

• Original Medicare includes Part A and Part B. If you only have Original Medicare, you might want to consider getting a standalone Part D plan for prescription coverage and a Medicare Supplement (Medigap) policy to help cover additional out-of-pocket costs.
• Medicare Advantage (Part C) often includes Part A, Part B, and sometimes Part D coverage in one plan, plus additional benefits. However, you can’t have both a Medicare Advantage plan and a Medigap policy at the same time.

Eligibility:

• Part A and Part B: Available to U.S. citizens and legal residents who are 65 or older, or younger individuals with certain disabilities.
• Part C: Available to those who are eligible for Part A and B.
• Part D: Available to those who have Medicare Part A and/or Part B.

Understanding how each part works and what it covers can help you make informed decisions about your healthcare coverage as you approach Medicare eligibility.