Parts of Medicare Simplified:
Medicare can seem very complicated and daunting at a first glance but if we break Medicare down into its “Parts”, there are 4 parts, it quickly becomes clear what coverage is provided and what your options are. The 4 parts of Medicare
- Part A Hospital
- Part B Medical
- Part C Medicare Advantage
- Part D Prescription
Part A: Hospital
Now Part A, is hospital Insurance. This will be automatic and there is no premium as long as you worked a minimum of 10 years or 40 quarters and paid your Medicare taxes. Part A will help cover in-patient care in hospitals, skilled nursing facilities, hospice, and home health care (inpatient care in a skilled nursing facility that’s not custodial or long-term care).
Part B: Medical
Part B is medical insurance and this part requires a premium. The current premium for most people is $144.60 per month but please be aware that it’s subject to your annual income 2 years prior. If you are a high income earner you may be subject to a higher premium per month. Medicare Part B will cover 80% of Medicare approved medical services once you have met the yearly $198 deductible. Medical services include things such as doctor visits, hospital outpatient care, home health care, and preventative services like your annual physical exam, flu shots, things of that nature.
Part C: Medicare Advantage or Medicare Advantage Prescription Drug Plans
Medicare Part C or Medicare Advantage plans are managed healthcare plans that are Medicare approved and offered by private insurance companies. In order to qualify, you must have your part A and B set up, live in the service area, and not have end stage renal disease (which is also known as kidney failure). These types of plans combine benefits and services covered under Medicare part A and part B, and often part D. In other words, they are an all in one package that covers hospital, medical, and sometimes prescription drugs. Additionally, some will even go above and beyond what Medicare covers by including additional benefits such as vision, dental, gym benefit, over-the-counter benefits, and many more.
Part D: Prescription drugs
Medicare Part D is a federally created program to help lower the cost of prescription drugs. This type of coverage is offered by private insurance companies and can be included in your Medicare advantage plan or it can be stand-alone but either way, no matter what, how we’re accessing our Medicare prescription drug coverage is always through Medicare part D. One thing you’ll always want to keep in mind when shopping for a part D plan is their prescription drug formulary. All companies use their own covered drug lists, so always make sure that the plan you’ve chosen covers all of your prescription drugs. Lastly, Medicare part D plans are optional but please be aware that if you do not enroll in one when you first become eligible you may be subject to a late enrollment penalty if you decide to enroll in one at a later date.
Still needs assistance?
Please visit our other Medicare part A, B, C, and D sections on our website for a more in depth look at cost, eligibility, and coverage, and more.
Still have questions or need assistance applying for your Medicare benefits? You are not alone, AHIC is here to help. If you would like someone to walk you through the process of applying for Medicare, shopping for a plan, then please click on the link below. Our services are at NO COST to you and we will be here to help you for the lifetime of your policy.