North Carolina had 1,468,697 Mediacare beneficiaries in 2010.
Medicare is a health insurance program created mainly for senior citizens. As of 2011, Medicare comes in four parts. Until 1997, Medicare was comprised of only two, named A and B. Then Part C, usually called Medicare Advantage, was added. In 2003, Part D joined the others. All have their own benefits, and Parts B, C and D are optional. Medicare Advantage and Part D are sold by private insurance companies and change according to which state you live. In North Carolina, Medicare is overseen by the Department of Insurance.
Part A
Parts A and B are often referred to as Original Medicare. Original Medicare is bought from the federal government, although you can also buy the same benefits in a Medicare Advantage plan. Part A Medicare covers inpatient hospitalizations, home health services and hospice care. Inpatient care at a skilled nursing facility is also covered if it meets certain conditions. These are not long-term or custodial benefits, however. Medicare does not cover long-term or custodial care in a nursing facility.
Part B
Part B has benefits for preventive screenings, vaccinations, outpatient hospital care and ambulance services. A one-time "Welcome to Medicare" physical is included in Part B, as well as an annual wellness visit to create or update a personal preventive care plan. Screenings for cancer, HIV, glaucoma and diabetes are also Part B benefits. Many of the health screenings require no co-payment for the screening, although you may pay something for the doctor visit.
Medicare Advantage
Medicare Advantage (MA) plans are required to offer all the same benefits as Original Medicare, except for hospice care, which is always paid for by Original Medicare. Medicare beneficiaries buy MA policies from private companies, who are allowed to decide their own deductibles, co-pays and premiums. You may also get extra benefits through MA plans, such as vision, hearing, dental and Part D prescription drug benefits. MA plans are offered according to service area, so a plan in one county may not be good in another. As of 2011, only the HumanaChoice regional PPO, which includes drug coverage, is offered all over the state of North Carolina.
Part D Medicare
Part D covers prescription drug benefits only. Part D is optional, unless you are a North Carolina Medicare beneficiary who is also dual-eligible for Medicaid. You can get Part D bundled in Medicare Advantage or as a stand-alone plan used with Original Medicare. Some stand-alone Part D policies in North Carolina have no annual deductible, while others do. Plans with no deductibles have higher monthly premiums than those with deductibles. The rules regarding which medications your plan covers, co-pays and premiums depends on the company you buy it from. As of 2011, however, all Part D plans should allow you to buy both brand-name and generic medications at a discount once you have passed your initial coverage phase.
Tags: Medicare Advantage, North Carolina, Original Medicare, Carolina Medicare, co-pays premiums
