Medicare and Health Care

There have been significant changes to both Medicare and healthcare in general through the Affordable Care Act (ACA). Many consumers, working aged or nearing retirement, have concerns about how these programs will affect them or what kind of health insurance coverage will be available and fitting.


Medicare, enacted in 1965 under the Johnson administration, has been a resource available to individuals aged 65 or older and to others regardless of age, provided they meet very specific conditions. Medicare involves four distinct segments: Part A, Part B, Part C, and Part D.


Medicare Part A corresponds to inpatient care (hospital care), whereas Part B corresponds with outpatient care. Part D, refers to a prescription drug plan (PDP) available through the Medicare program, while Medicare Part C refers Medicare Advantage Plans a certain type of plan that offers both Part A and Part B, with some addition benefits. Additionally, there are also supplemental plans offered through private companies, called Medigaps, that help cover some of the items that traditional Medicare insurance does not.


While Part A is generally available to consumers premium free, Part B, Part D, and Part C are not. Neither are Medigaps. Additionally, each part of Medicare, while covering some items, will still involve health insurance out-of-pocket expenses such as deductibles, co-pays, coinsurance, and premiums. And the fact of the matter is that Medicare does not always cover necessary services, so a beneficiary in the Medicare program, may face paying for a life-sustaining service completely and wholly out-of-pocket. This can present a real issue to retirees living off their retirement income. While Medicare seems relatively simple, the reality is that navigating the coverage guidelines and claims process can be incredibly complex.


Also complex are the private health insurance programs offered through the Affordable Care Act and others affected by the ACA. With changes to mandated employer-offerings and private benefits, it can be difficult to navigate your options and your needs. Some of the same problems discussed with Medicare, we find with the health care exchanges—coverage guidelines, out-of-pocket costs, and numerous options.

At ViaQuest we have a significant amount of experience with both Medicare and Private Healthcare and we are capable of developing the right insurance solutions that meet your specific and unique needs.Give us a call at 281-335-7609 with your Medicare and Health Insurance questions.