Parts of Medicare
Understanding the Parts of Medicare
Medicare is the health insurance program offered by the federal government for people aged 65 and older, and those with disabilities and people who have end-stage renal disease (ESRD).
There are four parts: A, B, C, and D. Each part covers different elements of healthcare. You can enroll in one or more of these parts, but the most common parts that folks enroll in are A and B, known as Original Medicare, which cover most services. Typically, people have to pay a monthly premium, although this varies based on income.
Part A
Hospital Coverage
Part B
Medical Coverage
Part C
Medicare Advantage Plans
Part D
Prescription Drug Plans
Medicare Part A
Medicare Part A covers inpatient hospital expenses when you’re formally admitted to a hospital. It provides benefits for hospice care, blood transfusions, and some home healthcare services, as well as limited coverage for skilled nursing facility care.
Depending on your income, you might have to pay a premium for Part A. Those who have worked and paid FICA taxes for 10 years pay NO premium for Part A coverage. But you may have to pay copayments or a deductible for services under Part A — and you can apply for financial assistance.
Medicare Part B
Medicare Part B covers many outpatient services and tests, including screenings, flu vaccinations, diabetes supplies, medical equipment, and ambulance and emergency department services. People often have Part A and Part B together to receive the most coverage. Let’s suppose you stay in a hospital. In that case, Part A would cover the stay and Part B would cover the doctor’s services.
For Part B, some of your cost is the standard monthly premium of $148.50. However, your premium might be less or more — depending on how much you make.
Some services are covered under Part B at no extra cost if you visit a doctor that accepts Medicare. If you need a service that’s not covered by Medicare, you’ll have to pay for it yourself.
Get the right coverage at the right price.
Medicare Part C
Medicare Part C is better known as Medicare Advantage, an “all-in-one” alternative to Parts A and B. This is a batch of privately sold options that include the same benefits as Original Medicare, in addition to EXTRA benefits such as prescription drug coverage, dental, vision, hearing, and more. To join a Medicare Advantage plan, you must be enrolled in both Parts A and B.
You normally pay a premium for a Medicare Advantage plan, although in some cases it may be as low as $0. These plans require you to see doctors within a provider network.
Copays or other fees might apply. Your costs for Part C depend on the Advantage plan you choose, as there may be different PPOs, HMOs, MSAs, and MAPDs in your area.
Medicare Part D
Medicare Part D is the plan that covers your prescription drugs not covered under Part B. This part of Medicare is optional, but it would be wise to have it so your medications are indeed covered.
The cost varies depending on the medications you take, the plan you sign up for, and which pharmacy you choose. You’ll have a plan premium to pay, and depending on your income — you might have some additional costs. You may also have copayments or a deductible to pay.
For more information on the parts of Medicare and what they cover, please continue browsing our website. Oak Haven Insurance Agency is here to simplify Medicare.
Find Out if Medicare Covers Your Item, Test, or Service
Medicare consists of five main types of coverage: Part A, Part B, Part C, Part D, and Medicare Supplements (Medigap). These choices offer several options to meet your needs.
- Part A provides basic coverage if you’re hospitalized.
- Part B covers outpatient care, such as doctor’s visits and diagnostic tests.
- Part C (Medicare Advantage) is a private option combining Part A and Part B coverage, and offers extra benefits.
- Part D is the prescription drug benefit.
- Medicare Supplement (Medigap) is private health insurance that helps with copays, coinsurance, and deductibles not covered by Medicare.
It’s important to know what’s covered by Medicare and what isn’t. Since there are many different plans, it can be hard to know which one will provide the right coverage for you. Oak Haven Insurance Agency is here to make it easier.
