Medicare Basics: Understanding the Parts of Medicare

October 22nd, 2019

If you’ve spent any time reading about Medicare, you know there are different parts. You’ve probably heard about Parts A and B. Maybe you’ve also heard about Part D. But what about Part C? And why is there Original Medicare? What’s Medicare Advantage? What’s Supplemental Insurance?

All of these different parts can make shopping for the right Medicare plan overwhelming and confusing. That’s why we’ve created this handy guide. Take a deep breath and let us explain the different parts of Medicare. Then you can make an informed decision about your plan!

Part A

Most people become eligible for Medicare Part A without premiums when they turn 65. Part A includes things like hospital stays and typically covers services like: 

  • Inpatient care at a hospital
  • Care from a skilled nursing facility (including inpatient care)
  • Hospice care
  • Home health care

If you don’t automatically get premium-free Part A, you’ll have to purchase it yourself. For example, if you haven’t paid Medicare taxes for at least 10 years, you will likely have to buy Medicare. If you have paid Medicare taxes for fewer than30 quarters (7.5 years), you’ll likely have to pay around $437 per month. If you paid Medicare taxes for between 30 and 39 quarters, you’ll probably have to pay about $240 per month. 

Part B

Where Part A generally covers hospital care, Part B covers preventative services. This means that if you receive care for things like preventing an illness or diagnosing a condition, it would fall under Medicare Part B. Here’s what this could include:

  • Ambulance services
  • Clinical research
  • Durable medical equipment
  • Limited outpatient prescription drugs
  • Mental health services, including inpatient care, outpatient care, and partial hospitalization
  • Second opinion before surgery

Unlike Part A, most people do have to pay Medicare Part B premiums. What you pay is based on your yearly income, ranging from $135.50 to $460.50 for the highest earners. In 2019, the Part B deductible was $185. Once patients meet this, they usually pay about 20% of the Medicare-approved amount for equipment and services.

Part C

You may have heard Medicare Part C plans referred to by another name: Medicare Advantage Plans. However, unlike Parts A and B, Part C is only offered through private companies. However, these plans are still approved by Medicare.

If you choose a Medicare Advantage Plan, you can expect it to cover everything offered by Parts A and B. Depending on which Medicare Advantage Plan you select, you may also get extra coverage. For example, you may receive access to vision, dental, hearing, and wellness resources. You may also receive prescription drug coverage.

Just be sure to thoroughly understand your Medicare Advantage Plan before you join it. These plans may have different costs and requirements for receiving services and treatments.

Part D

Medicare Part D provides prescription drug coverage. This plan is optional, so you don’t have to sign up for it right away if you don’t have creditable drug coverage from another source, such as an employer plan. However, if you don’t have creditable drug coverage from another source and don’t sign up within a 63-day late enrollment period, Medicare will add a penalty to your Part D premium.

If you already get coverage through a different plan, it’s in your best interest to find out if you’re already receiving creditable drug coverage. This way you can avoid doubling up on prescription drug coverage and paying a penalty.

Medicare Supplement or “Medigap” Insurance

Though Medicare Parts A, B, and D cover many healthcare expenses, you may still incur costs that Medicare doesn’t cover. This can include things like deductibles, co-pays, and expenses related to a serious illness.

Medicare Supplemental Insurance, or Medigap coverage, helps with these extra expenses. You will pay a premium if you join a Medigap plan, though the cost varies. Right now, you can choose from Plans A, B, C, D, F, G, K, L, M, and N. However, Plan F will no longer be available to new Medicare users after 2019. 

If you’re feeling prepared to pick your Medicare plan, head on over to our Medicare center. There, you can compare plans and choose with confidence!

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