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Medicare provides health coverage and peace of mind for many Americans. But managing Medicare, and the supplemental insurance plans available, can be daunting. The Wladis Companies, Inc. can help you navigate the Medicare system and make sure your health is protected in your golden years.

Who Qualifies for Medicare?

  • People age 65 or older who paid Medicare taxes while working
  • People under 65 with certain disabilities
  • People of any age with end-stage renal disease (permanent kidney failure) or amyotrophic lateral sclerosis (ALS)

How Does Medicare Work?

Medicare is administered by the U.S. government. It covers some, but not all, of its enrollees’ medical expenses. Enrollees typically purchase a supplemental insurance plan and make co-payments to meet the full cost of care.

Medicare Part A

Generally there is no monthly premium if you qualify and paid Medicare taxes while working. Helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facilities
  • Hospice and home health care

Medicare Part B

Requires copayments and a deductible. Helps cover:

  • Doctors’ services
  • Outpatient care
  • Diagnostic testing
  • Durable medical equipment
  • Medically necessary services not covered by Part A

Medicare Part C

Also known as Medicare Advantage Plans, these are managed by private companies approved by Medicare. They may include Parts A, B and D coverage. These plans assign their own copayments, deductibles and coinsurance.

Medicare Part D

Provides prescription drug coverage. Requires a monthly premium. These plans are administered by private Medicare-approved companies.

Medicare and Other Health Coverage

People who are covered by a group health plan are still eligible for Medicare. Determining which plan pays first can be complicated. This table illustrates some of the most common scenarios.

If you And are covered by a Pays first Pays second
Have Medicare coverage and are retired Group health plan through your former employer Medicare Group health plan
Qualify for Medicare due to age but still work Group plan through an employer with 20 or more employees Group health plan Medicare
Qualify for Medicare due to age but still work Group plan through an employer with fewer than 20 employees Medicare Group health plan
Qualify for Medicare due to disability Group plan through an employer with 100 or more employees Group health plan Medicare
Qualify for Medicare due to disability Group plan through an employer with fewer than 100 employees Medicare Group health plan

Make sure you and your loved ones have adequate health coverage. Let The Wladis Companies, Inc. help you manage the complexities of Medicare.

Just call us. We’re here to help.