Is Medicare An Insurance Company?

By: Edward Neeman
Published: Thursday, September 20 2018
Last Updated: 4 years ago

If you are thinking about Medicare coverage, turning 65 soon, or perhaps are already Medicare eligible, you may realize you are a little hazy about your Medicare benefits. For instance, is Medicare an insurance company? That appears to be a simple question, but the answer is more complicated. Medicare is health coverage funded by the Federal government for all Americans over the age of 65 and those with certain disabilities, but Medicare coverage doesn't all come from the same place. All Medicare plans offer a regulated list of benefits, but beyond that, there are a number of different plans available for you and your specific healthcare needs.

Is Medicare An Insurance Company?

While it is health insurance, Medicare is not an insurance company in the traditional sense. Rather, Medicare benefits are administered by a number of entities, including government agencies, private Medicare insurance companies, and private Medicare supplement insurance companies. It is a not single program, rather it is a series of programs and health coverage options, though the funding for Medicare benefits is collected through Medicare taxes on working Americans.

Who Administers Original Medicare?

Original Medicare, including Part A for hospital coverage and Part B for medical services, is administered by the Centers for Medicare & Medicaid Services (CMS). This is a department of the Federal Government that falls under the Department of Health and Human Services (HHS). HHS is overseen by the HHS Secretary who is appointed by the President. CMS administers original Medicare benefits, regulates the basic benefits package offered by all Medicare plans, and determines reimbursement rates for medical services included in your Medicare benefits. CMS also distributes funding to the Medicare insurance companies that administer Advantage plans while Medicare supplement insurance companies collect their funding directly from beneficiaries.

What About Medicare Advantage, Supplement, And Part D?

Private Medicare insurance companies provide Medicare Advantage and Medicare Part D prescription plans. There are also Medicare supplement insurance companies that offer Medigap plans to original Medicare enrollees. In both instances, these are usually the same private companies that offer commercial and employer health coverage. Medicare Advantage plans and Part D coverage for prescriptions are usually offered by the private insurers as a single plan to cover all your healthcare needs.

CMS distributes funding to the private insurance companies to manage these benefits. Some Advantage plans will cost no more than the normal Medicare Part B premium, but they can charge you an additional premium. Medicare Advantage insurance is required to cover all the same benefits as original Medicare Part A & B, but can elect to cover additional services like hearing, dental, vision, etc.

Medicare supplement insurance companies differ from the Advantage plans. They receive no funding from CMS, so they will charge you a monthly premium. In exchange, they help cover the gaps in your original Medicare coverage, including your deductible and copays. You cannot have both an Advantage plan and a supplement plan. Supplement plans are only used alongside original Medicare benefits.

Who To Call About Medicare Questions

This depends on which form of Medicare you have. If you have original Medicare, you can start with CMS and the people at Medicare itself. They can be reached at 1-800-Medicare. If you have another plan, be it an Advantage, supplemental, or Part D plan, you can contact the various Medicare insurance companies that manage your benefits. Generally, that contact information can be found on the back of your insurance card.

Compare Plans With FirstQuote Medicare

If you need help sorting through all the options available to you as a Medicare beneficiary, FirstQuote Medicare is a great resource. They offer free quotes in under 5 minutes that will connect you with all the Medicare options and Medicare supplement insurance companies offering coverage in your area. The FirstQuote Medicare brokers are licensed and informed about the Medicare insurance companies with the benefits you need.