Allina Health | Aetna is an affiliate of Allina Health and Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Allina Health | Aetna.
As you approach retirement age, you may be starting to think ahead to the future. What are your health coverage options? For those new to Medicare, it helps to first get up to speed on some of the basic terms. That way, when it’s time to make those important health care decisions, you’ll be better prepared to choose a plan that fits your needs.
Read on to decode some of the more commonly misunderstood Medicare terms. (You might even be surprised to realize how much you already know!)
Medicare is the federal health insurance program for people age 65 and older and younger people with certain disabilities. Read more on getting Medicare when you have a disability. Medicaid is a joint federal and state program that provides health coverage for people with limited income.
They mean the same thing. Original Medicare, the federal health insurance program, includes two parts: Part A (hospital coverage) and Part B (medical care). Part A typically covers inpatient care in a hospital or skilled nursing facility, and home health care. Part B usually covers doctor visits and preventive services. Visit “The Parts of Medicare” to learn more.
Both terms refer to the same thing. Instead of Original Medicare from the federal government, you can choose a Medicare Advantage plan (Part C) offered by a private insurance company. These plans include all of the benefits and services of Parts A and B. They may also include prescription drug coverage as part of the plan. In addition, Medicare Advantage plans may offer added benefits and services, such as vision, dental and hearing coverage, and fitness memberships. Explore our Medicare Advantage plans to find the right one for you.
Don’t be confused by these terms — they mean the same thing. For those on Original Medicare, you can buy additional coverage through private insurance companies to help pay for costs that aren't covered, such as copays, coinsurance and deductibles.
Medicare Advantage HMO plans usually require you to stay within a provider network. It’s an affordable option for people who are working with a variety of doctors and would benefit from coordinated care across a network of local providers. The choice of specialists is narrowed to keep costs lower.
Medicare Advantage PPO plans offer more flexibility and choice in a wide network of providers. You may visit doctors, specialists or hospitals out of network, but it may cost more. Some PPO plans may have a higher monthly premium than HMO plans.
This is a list of prescription drugs that’s covered by the plan. To lower costs, many plans place drugs into different tiers — or pricing categories — on their formularies. Drugs in each tier cost a different amount, and plans can structure their tiers in different ways. Generally, the lower the tier, the less you pay.
We’ve also included some basic health insurance terms that are helpful for understanding your Medicare coverage.
Now that we’ve covered the basics, you should be better prepared to make the right decisions to reach your health goals.
For a more complete list of terms, visit our Allina Health | Aetna Medicare glossary.
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Allina Health | Aetna is an affiliate of Allina Health and Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Allina Health | Aetna.
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