Medicare language and information are packed with acronyms. In your attempt to stay informed you may come across an article that should be informative. You start to read and before you know it you are swimming in a bowl of alphabet soup.
An understanding of the common Medicare acronyms will help you stay informed. And staying informed will help you to consistently make the right choices about your Medicare Insurance and myaarpmedicare
Too many letters! Each of the four parts of Medicare is designated by a letter; A-B-C and D. Each of the Medicare Supplement Plans is designated by a letter A-B-C-D-F-G-K-L-M and N. Then you have the Medicare Advantage Plans or Part C plans that are often referred to by acronyms; MA, MAPD, PPO, HMO, PDP, PFF more letters!
It can become quite confusing. Let’s start by understanding the Parts of Medicare. Medicare is divided into four parts.
Part A: Part A covers inpatient room and board and skilled nursing and supplies.
Part B: Part B covers physician, surgery, testing, therapy, durable medical equipment, certain drugs
Parts A and B are referred to as Original Medicare. It is government health insurance. In most cases you do not pay a premium for Part A after you retire. You have been paying by way of your taxes while you were working. Part B is optional and if you want to be covered under Part B you will be required to pay a monthly premium which will be deducted from your Social Security check each month.
Part C: Part C is private Medicare. It takes the place of your government Medicare. You must be enrolled in Parts A+B in order to enroll in Part C. Part C Plans are also known as Medicare Advantare Advantage Plan that does not include drug coverage.
HMO- Health Maintenance Organization- a Part C Medicare Advantage Plan. You must reside in the plans coverage area and must pick from Providers that members of the plan.
PPO- Preferred Provider Organization- a Part C Medicare Advantage Plan that has a network of providers that accept the plan. You are not required to stay within the network, however your co-pays and out-of- pocket expenses will be much higher if you don’t.
PFF- Private Fee for Service- a Part C Medicare Advantage Plan that allows you to go to a provider of your choice, provided that your Provider accepts the amount that the plan will pay for services.
Part D: Medicare Prescription Drug Coverage is provided by private companies under the supervision of Medicare. While all of the plans are required to cover certain drugs, they can varies greatly in terms of co -pays and monthly premiums.
PDP- Prescription Drug Plan- is a standalone drug plan. You typically would have a PDP if you had original Medicare and a Medicare Supplement Plan or if you were enrolled in an MA plan that did not include drug coverage.
Medicare Supplement Plans Each of the Medicare Supplement Plans is designated by a letter; A-B-C-D-F-G-K-L-M and N. These are insurance plans offered by private companies that are designed to close the gaps left in the coverage of Original Medicare Parts A+B. You must be enrolled in Parts A+B of original Medicare in order to purchase a Medicare Supplement Plan. There are currently 10 plans available.
Medicare requires each Supplement Plan to provide “basic benefits” which is what Plan A covers. Each of the remaining 9 plans offer various optional benefits in addition to the basic benefits provided with Plan A. Your choice of which plan to pick depends on lifestyle, health, budget and your tolerance for exposure.
The more you know and understand about your Medicare benefits and options, the better your position going forward. As Ben Franklin said,” An investment in knowledge always pays the best interest.”
Stephanie Octaves is an Insurance Professional specializing in Senior Insurance Solutions and Medicare Insurance. “I saw the effects of the confusion and misinformation in the senior market. I really feel that with the proper, correct information, presented in an understandable way that our Seniors can position themselves for the future and achieve the peace of mind and security that they deserve at this exciting stage of life. We strive one client at a time to make sure that we address the individual and that they are better for having met us, regardless of whether they choose us as their broker.