Medicare
How Does Medicare Work?
Once you know the basics, Medicare becomes easier to understand. Learn about the fundamentals to get a better understanding of what you can expect from your Medicare coverage with Blue Cross and Blue Shield of Montana.
Medicare Basics
Most Americans join Medicare when they turn 65, but it’s also available to younger people with end-stage renal disease (ESRD), or permanent kidney failure requiring dialysis or a kidney transplant.
What is Medicare?
Medicare is a national health insurance program administered by the federal government. It is not part of the health insurance marketplace. Medicare is made up of four parts (identified by a letter), which cover specific types of services and costs.
Parts vs. Plans
When you’re learning about Medicare, you may read a lot about "Parts" and "Plans." For instance, you may read about Part A or Plan A. The two are different, and they are easy to distinguish from one another. Here’s what you need to remember:
Parts
Medicare is made up of Parts.
Medicare Parts cover specific benefits, like hospital or doctor visits, medications, and more. Most people have Original Medicare Part A (hospital insurance) and Part B (medical insurance). Some people may have Part C, a Medicare Advantage plan that combines Part A and Part B, with additional benefits. Other people may have Part D, a prescription drug plan.
Plans
Medicare Supplement Insurance is made up of Plans.
Medicare Supplement Insurance Plans cover certain costs that the Medicare Parts do not. Different Medicare Supplement Insurance Plans cover different types of costs.
Medicare Parts
When you sign up for Medicare, there are several options to choose from when selecting your coverage. It's important to understand what type of coverage each plan offers: Original Medicare (Part A and B), Medicare Advantage (Part C), and Prescription Drug Coverage (Part D).
Original Medicare
Original Medicare is offered by the Federal Government. It consists of Parts A and B.
Part A: Hospital Insurance
- Inpatient hospital care
- Skilled nursing facility care after a hospital stay
- Some home health care and hospice services
Part B: Medical Insurance
- Doctor's office visits and services
- Most outpatient care
- Home health care
- Durable medical equipment
- Many preventive services
Medicare Parts: Additional Coverage Options
You can select to purchase more Medicare coverage offered by Blue Cross and Blue Shield of Montana. Medicare Parts C and D can offer coverage beyond Original Medicare such as prescription drug coverage and even dental benefits.
Medicare Advantage - Part C
Medicare Part C, or Medicare Advantage, combines Part A and B of Original Medicare with added benefits. Medicare Advantage plans are offered through private insurance companies.
Part C: Bundles Part A, Part B, plus additional benefits (often including Part D)
Part C always covers you for all benefits included in Parts A and B.
Coverage may include:
- Dental, hearing and/or vision services
- Health, wellness and fitness programs
Additional plan benefits may also include:
- Options that may or may not include prescription drug coverage
- Provider networks to help manage costs
- A Part B Premium Buy-down benefit that reduces the Medicare Part B premium that you pay to the Social Security Administration
- A preloaded flexible spending card to help reduce your out-of-pocket expenses for covered dental, vision, and hearing services
Medicare Prescription Drug - Part D
You may enroll in a Part D plan to get prescription drug coverage through Medicare.
You may choose a standalone Part D plan with Original Medicare or bundle Part A, B , and D coverage in a Medicare Advantage Prescription Drug Plan.
Part D: Prescription Drug Coverage
Part D helps pay for prescription drugs with copays or coinsurance.
Learn more about Medicare Part DMedicare Plans: Additional Coverage Options
Medicare Supplement Insurance Plans can help cover certain costs with Original Medicare. The plans are lettered with each plan offering different benefits. Medicare Supplement Insurance Plans are available through private insurance companies.
You can choose to enroll in a Medicare Supplement Insurance Plan on its own or paired with a Part D plan. If you are enrolled in a Medicare Advantage plan, you cannot also enroll in a Medicare Supplement Insurance Plan.
Medicare Supplement Insurance Plans
Medicare Supplement Insurance Plans help pay for:
- Coinsurance
- Copays
- Deductibles
Helpful Tools and Resources
Help Me Choose a Plan
Not sure whether a Medicare Supplement Insurance Plan or a Medicare Advantage Insurance Plan is right for you? Just answer a few questions to help you decide.
Download the Decision Guide
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If you currently have employer coverage through BCBSMT, explore how you can stay with the insurer you know and trust.
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Get Help from an Agent
Fill out a simple form and a BCBSMT authorized agent will contact you within two business days. You’ll get the personalized help you need to find the right insurance plan for you.
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Get Your Free Medicare Booklet
Unsure about Medicare options? Our guide can help. Learn about different plans, get clear answers and make an informed decision.
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