Medicare
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant)
Traditional Medicare
The different parts of Medicare below help cover specific services. These are all run by the government.
| Plan | Coverage | Cost in 2023 |
|---|---|---|
| Part A (Hospital) |
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. | → No premiums, but do have deductibles → No cost for the majority of people |
| Part B (Medical) |
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. It covers surgeons, doctors and anesthesia in hospital. It also covers all bleeding disorder factor products. | → Recipient pays a $233 deductible, a premium of $164.90/mo plus 20% of services |
| Part D (Prescription) |
Covers medications. Includes Stimate, Amicar, Lysteda and others. | → Cost: $35-$50/mo on average |
Medigap Plans
Supplemental health insurance that covers costs (medical care or a hospital stay) not covered by traditional Medicare. These plans are offered by several private companies and the costs are based on the extent of coverage.
Medicare Advantage Plans
A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. This is very similar to plans offered by employers.
Medicare Advantage Plans include:
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Private Fee-for-Service Plans
- Special Needs Plans
- Medicare Medical Savings Account Plans
If you’re enrolled in a Medicare Advantage Plan:
- Most Medicare services are covered through the plan
- Medicare services aren’t paid for by Original Medicare
- Most Medicare Advantage Plans offer prescription drug coverage, and may offer vision and/or dental
Not Sure What Kind of Coverage You Have?
- Call Medicare at 1-800-MEDICARE (1-800-633-4227).
- OR call Social Workers, Colleen Joiner or Debbie Whelan at 734-996-3300.
Know your Medicare Drug Coverage Rights
Know your Medicare Drug Coverage Rights (In Spanish)
Bleeding Disorder Specifics
- Understand that you should not decline Medicare Part B. Factor is paid through your Part B plan.
- CSHCS or BCMH are always payers of last resort when you have Medicare. You cannot decline Medicare Part B and expect that CSHCS will cover your factor. It will not.
- Be sure to coordinate your benefits with other insurance plans to determine which plan is the primary payer. Medicare is often the primary, but not always. Call the Coordination of Benefits and Recovery Department at Medicare at 1-855-798-2627 or talk with your employer’s benefits counselor for more information.