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ARTICLE Understand Medicare

Understanding Medicare

Medicare Employer Guides
This "Medicare Made Clear" guide is specially designed for employer benefits administrators. It helps equip employers and plan sponsors with the knowledge needed to answer questions that employees may have as they reach retirement.
- Medicare Made Clear (PDF)

Medicare Consumer Guides
This "Show Me Guide" guide from UnitedHealthcare covers Medicare eligibility, enrollment, Medicare Advantage, Part D, and other topics.
- Show Me Guide (PDF)

Medicare can be confusing. Take a moment to learn how it works, what the different coverage options are and what they offer.

What is Medicare?
Medicare is a Federal government program, run by the Centers for Medicare & Medicaid Services (CMS), which provides health insurance coverage to eligible beneficiaries. To be eligible for Medicare, a person must meet at least one of these requirements:

  • Age 65 or older
  • Under age 65, but disabled for more than two years and eligible for Social Security Disability Income (SSDI) benefits
  • Any age, but have end-stage renal disease (permanent kidney failure requiring dialysis or kidney transplant)

Medicare coverage options
Medicare is divided into four parts, which offer different types of coverage.

  • Medicare Part A provides help with hospital costs 
  • Medicare Part B provides help with doctor and other outpatient costs
  • Medicare Part C allows you to receive your Medicare Part A & Part B benefits from a private insurance company (also called Medicare Advantage plans)
  • Medicare Part D provides help with prescription drug costs 

Original Medicare: Medicare Part A & Medicare Part B
This is Medicare's standard health plan, referred to as Original Medicare. It covers hospital and medical services. Under Original Medicare, beneficiaries receive their benefits directly from the government. When a beneficiary receives covered services, the government pays the doctor or hospital directly for the care.

  • Medicare Part A helps cover inpatient care in hospitals, including critical access hospitals and inpatient rehabilitation facilities. It also helps cover hospice care, some home health care (for those who meet certain eligibility requirements) and skilled nursing facilities (not custodial or long-term care).
  • Medicare Part B helps cover doctors' visits, outpatient care and some services not covered by Part A, such as physical or occupational therapy. It may also cover some preventive services, and in some cases, medically-necessary home health care services.

Medicare Part C: Medicare Advantage Plans
Under Medicare Part C, beneficiaries have another way to get their Medicare Part A and Part B benefits. Instead of receiving their benefits from the government, beneficiaries can elect to receive them through a private insurance company, like UnitedHealthcare, that contracts with Medicare. 

Usually referred to as Medicare Advantage (MA) plans, these plans provide all the Part A and Part B covered services and may offer extra coverage for other medical services. Many plans also include Medicare Prescription Drug coverage (Part D).

There are different types of Medicare Advantage plans. Learn about the Medicare Advantage plans UnitedHealthcare offers:

Medicare Part D: Prescription drug coverage
This is insurance coverage that helps pay for the costs of prescription drugs. These plans are offered through private insurance companies, like UnitedHealthcare, that are approved by Medicare. 

Part D plans can be purchased as part of a Medicare Advantage plan or as a separate Prescription Drug plan (PDP). Insurance companies must meet the guidelines and standards set by the Federal government for Part D plans. However, all plans are not the same—costs and drugs covered can vary.

Learn about UnitedHealthcare's Medicare Part D Prescription Drug plans.

Medicare Supplement Insurance Plans
These insurance policies, also called Medigap policies, help pay for some or all of the health care costs, or "gaps," that Original Medicare doesn't cover, like copayments, coinsurance and deductibles.

Medicare supplement insurance plans are sold by private insurance companies, like UnitedHealthcare. While these plans help offset some of the cost-sharing associated with Original Medicare, they are not part of the Medicare program. 

Medicare Supplement plans are regulated by Federal and state laws to protect you. There are up to ten standard plans available, designated by letters A through N. Note: In Massachusetts, Minnesota, and Wisconsin, Medicare supplement plans are standardized in a different way.

Learn about UnitedHealthcare's Medicare supplement insurance plans. We also offer Senior Supplement plans, which are similar to Medicare supplement plans, but offered only to groups.

Want more detailed Medicare information?
Learn more about how Medicare works and help your retirees get a better understanding of Medicare coverage options, eligibility, costs and benefits.

UnitedHealthcare Medicare Advisor (PDF)

Download the Medicare Made Clear Overview of Medicare for Benefits Administrators (PDF)

Download the Medicare Made Clear Show Me Guide. (PDF)

 

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