What is Medicare?

Medicare Insurance

Medicare is a federal government insurance program that helps millions of seniors and people with disabilities pay for healthcare.

In-Network Medicare Plans for 2024

Hopscotch Primary Care is in network with most Medicare insurance plans, including Original Medicare and Medicare Advantage from the below insurance carriers, in addition to others. If you are unsure what plan you have or have any specific questions about your insurance, please contact us at one of our locations.

What you need to know

Medicare vs Medicare Advantage

Understanding your options is important when selecting Medicare coverage. Learn more about the difference between these health insurance plans.

Original Medicare

  • Original Medicare, also referred to as traditional Medicare, is a fee-for-service plan that consists of multiple parts
  • Part A covers hospital insurance, including inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care
  • Part B covers medical insurance, including doctor visits, outpatient care, preventive services, and some home health care
  • Original Medicare has no out-of-pocket maximum, so costs can be high if you need a lot of care
  • Typically has premiums, deductibles, and coinsurance costs

Medicare Advantage

  • Private insurance plan that offers an alternative to Original Medicare, sometimes known as Medicare Part C
  • Most plans include Part D, prescription drugs, for $0 premium​
  • Requires less cost sharing than original Medicare
  • Offers additional benefits such as vision, hearing, and dental services

Questions about Medicare?

Medicare FAQs

People 65 years old or older and younger people with disabilities. 

Annual Enrollment Period (AEP): Takes place from Oct 15 – Dec 7. During AEP, you can add, drop, or switch your Medicare coverage. This is also when you may consider switching from Original Medicare to Medicare Advantage 

General Enrollment Period (GEP): Takes place Jan 1 – Mar 31. If you didn’t sign up for Medicare during your IEP and you’re not eligible for a Special Enrollment Period (SEP), you can sign up during the GEP. 

Initial Enrollment Period (IEP): Takes place as you approach 65 years old.  Initial Enrollment Period begins 3 months before the month that you turn 65 and continues for 3 months after the month that you turn 65 (e.g. if your birthday is in June, your IEP will start March 1st and continue through September 30th).  

Special Enrollment Period (SEP):  This is a time outside of initial and open enrollment periods where you can enroll due to life circumstances, such as the following:  

  • You previously did not enroll in Medicare due to job coverage, but you are now retiring 
  • You have a change in income or health status and now qualify for a MA special needs plan 

  • Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. 
  • Medicare Part B covers doctor’s services, outpatient care, preventive services, and some home health care. 
  • Medicare Part D covers prescription drugs. 
  • Medicare Advantage plans cover all Medicare services and may offer extra benefits, such as vision, hearing, dental, and wellness programs.

Our Patient Relations Manager (PRM) can help you to answer other Medicare questions. Please contact one of our clinics and ask to be connected to the PRM for additional information.

New to Hopscotch? Meet Your Patient Relations Manager

Our Patient Relations Managers (PRM) help you navigate the healthcare system. They will work to understand your specific needs, and can help to provide information on insurance coverage and options.  

Areas where PRMs can support you include: 

  • Setting up insurance plan’s additional benefits like vision, dental and gym memberships 
  • Exploring ways to save on medical and medication costs 
  • Answering insurance plan questions 
  • Navigating medical bills 

Welcoming Medicare Patients

You deserve primary care that goes beyond. We bring exceptional primary care services to adult Medicare patients. Click below to request a visit and we will be in touch soon.

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