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Medicare is a federal health insurance program for people ages 65 or older. Others younger than 65 may also be eligible if they have certain disabilities or diseases, such as End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), otherwise known as Lou Gehrig's disease. Learn more about ESRD eligibility. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage HMO website).
For a summary of Medicare benefits, rights, and protections; lists of available health and drug plans, as well as answers to frequently asked questions about Medicare, download a PDF copy of the current "Medicare & You" Handbook.
Part A (Hospital Insurance) primarily covers inpatient costs. These costs can include hospital stays for a set number of days, brief stays in a skilled nursing facility (for rehabilitation) and hospice benefits (including hospice care, prescription medications and grief counseling). Additionally, if certain conditions are met, Part A may also include some home health care benefits.
Part B (Medical Insurance) primarily covers outpatient costs, including doctor visits. Part B covers certain services, such as X-rays, lab tests, chemotherapy and vaccinations, among other treatments administered in a doctor’s office or on an outpatient basis. Outpatient care, home health, ambulance services and preventive services may also be covered. Part B can also help with the cost of medical supplies, including durable medical equipment such as canes and scooters for the mobility-impaired, prosthetic devices, oxygen, and eyeglasses.
Generally, you pay 20 percent of the Medicare-approved amount after you pay your Medicare Part B deductible for the year. Medicare pays the other 80 percent.
Part C, also known as Medicare Advantage, is a type of Medicare health plan offered by private health insurance companies, contracted with Medicare, that sell products to provide you with all of your Part A and Part B benefits. Memorial Hermann Advantage HMO is a Medicare Advantage plan that contracts with Medicare to provide your Part A and Part B benefits.
While you must continue to pay your Medicare Part B premium, Part C coverage can help pay for services that Original Medicare does not.
In many cases, Medicare Advantage plans offer enhanced benefits that Original Medicare does not cover, like vision, dental and prescription drug coverage. Therefore, benefits and costs may vary from plan to plan.
Medicare Advantage plans can be offered by Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNPs) and Medical Savings Account Plans (MSAs). Memorial Hermann Health Plan is proud to offer Memorial Hermann Advantage HMO plans.
Learn why you or your loved ones may need the additional benefits of Medicare Advantage coverage from our Memorial Hermann Advantage HMO plans.
Medicare Part D (also known as Prescription Drug Coverage) is the part of the Medicare program designed to help cover cost of prescription drugs, lower costs of both brand-name and generic drugs, as well as help protect against higher costs. Individuals on Medicare are eligible for prescription drug coverage under a Part D plan, if they are signed up for benefits under Medicare Part A and/or Part B.
However, unlike Original Medicare (Medicare Parts A and B), Medicare Part D prescription drug coverage is administered by insurance and other private companies approved by Medicare. You have to sign up for coverage with a Medicare-approved Part D plan in order to receive benefits.
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