Medicare

Medicare is one of the most widely discussed health insurance plans in the nation, and for good reason – anyone who gets it can save thousands on healthcare expenses. It is also divided into four parts: Part A, Part B, Part C, and Part D.

Medicare Part A

Part A is one part of Original Medicare that provides coverage for inpatient hospital care. When you first become eligible to enroll in Medicare, Part A will be the first part you will enroll in, although some people will be automatically enrolled. To enroll in Part A, you’ll do so during your Initial Enrollment Period, which starts three months before your 65th birthday month, and then ends three months after. 

Other coverage that’s included with Part A is:

  • Skilled nursing facility care
  • Hospice care
  • Home health care
  • Nursing home care

Medicare Part B

Medicare Part B covers medically necessary outpatient procedures and services. This includes such services as:

  • X-rays
  • Screenings
  • Flu shots
  • Durable medical equipment (e.g. oxygen equipment and blood glucose monitors).

Medicare Part B is the second part of Original Medicare. You may also be automatically enrolled in Part B, but if not, you can still enroll during your Initial Enrollment Period.

Once you’re enrolled in both Parts A and B, you can also add on a Medicare Supplement plan. A Medicare Supplement plan, also known as Medigap, is there to pick up where your Original Medicare coverage left off. When you get your treatments, you still have out-of-pocket costs such as deductibles, copayments, and coinsurance that you will need to cover. Medicare Supplements can take care of that and you have 10 plans to choose from – A, B, C, D, F, G, K, L, M, and N.

Part C (Medicare Advantage)

Medicare Part C is also commonly known as Medicare Advantage. These plans are offered through private insurance companies. Types of Medicare Advantage plans include:

  • Health Maintenance Organization
  • Preferred Provider Organization
  • Medicare Savings Account
  • Special Needs Plans
  • Private Fee-For-Service

Its benefits are:

  • Getting the same coverage as Original Medicare, with additional benefits
  • Additional benefits may include dental, vision, and hearing care, as well as prescription drug coverage
  • Having multiple coverage options

Part D

Medicare Part D provides prescription drug coverage. Coverage is:

  • Based on a formulary (list of medications the plan covers)
  • All Part D plans must cover two drugs from each category or class
  • They also must cover drugs that fall into these specific categories: anticancer, antidepressants, antipsychotics, anticonvulsants, immunosuppressants, and HIV/AIDS drugs.

You can get Part D coverage as a standalone plan when you’re enrolled in Original Medicare, or you can have it as an added benefit with a Medicare Advantage plan.

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