Managed Care 101

Your Health Plan and You

Your choices in managed care include:

No matter how you access your Medicare Health Care, you are still in the Medicare program.

The Original Medicare Plan is also known as "fee-for-service"

You are usually charged a fee for each health care service or supply you get. If you are happy getting your health care this way, you do not have to change. You will stay in the Original Medicare Plan unless you join a Medicare Advamtage Plan. Under the Original Medicare Plan, you can use your red, white and blue Medicare card when you get health care. You may go to any doctor, specialist, or hospital that accepts Medicare. Generally, a fee is charged each time you get a service. Under the Original Medicare Plan, you pay the monthly Part B premium. It is usually taken out of your monthly Social Security, Railroad Retirement, or Civil Service Retirement payment. Each year you also pay a deductible before Medicare pays its part. Thereafter, Medicare pays its share and you pay your share.

After you get a health care service, you get an Explanation of Medicare Benefits or a Medicare Summary Notice in the mail. These are sent by a company that handles bills for Medicare. The notice lists what was charged, what Medicare paid, and how much you must pay.

Under Original Medicare - How Do My Out-of-Pocket Costs Vary?

Your costs depend on:

Original Medicare Plan with a Supplemental Insurance Policy

There are many companies who offer private health coverage that pays for some or all of the health care costs not covered by Medicare. This coverage is sometimes called "supplemental coverage."

These types include:

* If you drop your employer or union based group health insurance coverage, you probably won't be able to get it back.

What is Medigap?

Ror more information about medigap policies, call 1(800) medicare (1-800-633-4227)

You can join a Medicare Managed Care Plan if:

If you join a Medicare Managed Care Plan:

How does Managed Care work?