Medicare is a federal health insurance program with four parts, each covering specific health care expenses. These parts are identified by letters (A, B, C and D), with Parts A and B referred to as original Medicare when combined. Choosing the right Medicare coverage to meet your needs can seem overwhelming, but working with an experienced agency can help make the process easier.
Medicare Part A
Part A of Medicare, also known as hospital insurance, is designed to cover hospital costs. It can provide coverage for inpatient care in a hospital, skilled nursing facility—or religious nonmedical healthcare institution—hospice care, and home health care. While most people do not pay monthly premiums for Part A, they may be responsible for copayments, deductibles or coinsurance.
Medicare Part B
Part B of Medicare, or medical insurance, is meant to cover medically necessary and preventive services. Outpatient care, medical provider’s services, mental health services and durable medical equipment are some of the services Part B can help cover. With Original Medicare, you must pay all costs up to the Medicare-approved amount until you meet the yearly Part B deductible, after which you are responsible for 20% of the Medicare-approved amount for the services—Medicare generally pays 80% of covered medically necessary services. Medicare Part B typically covers 100% of preventive services if you see a medical provider who accepts the Medicare-approved amount as full payment for the covered service, also known as assignment. However, certain preventive services may require payment of a deductible or coinsurance.
Medicare Part C
Medicare Part C, also known as Medicare Advantage, is an optional alternative to Original Medicare coverage. Individuals must have both Medicare Part A and B to enroll in and maintain a Medicare Advantage Plan. You must continue to pay your Medicare Part B premium while enrolled in a Medicare Advantage Plan; many Medicare Advantage Plans include Medicare prescription drug coverage and other benefits that Original Medicare doesn’t cover. Medicare-approved insurers offer these plans, which may come with a monthly premium. Different options for Medicare Advantage plans include health maintenance organizations, medical savings accounts, preferred provider organizations, Private Fee-for-Service plans, and Special Needs Plans. Before signing up, it’s crucial to ensure that your preferred hospitals and healthcare providers are included in the plan’s network.
Medicare Part D
Part D of Medicare is optional and is designed to help cover the cost of prescription drugs. Private insurance companies offer Part D coverage; you must live in the plan’s service area to sign up. You can get prescription drug coverage by enrolling in a Medicare Health Plan with drug coverage or a Medicare Advantage Plan. You can also add Part D coverage to Original Medicare and some Medicare Advantage Plans.
How to Learn More About Medicare
If you are unsure about which Medicare coverage may be suitable for your situation, contact our team today for assistance in determining the right plan for you.
