4 Medicare Parts Explained
As the Baby Boomer generation goes on to reach the age of retirement with increasing numbers, so do their health needs get much larger. In response or reaction to this, the United States Federal Government created Medicare to meet the majority of these challenges.
For the uninformed, Medicare is a health care program run by the United States Federal Government for permanent US citizens. It’s separate from Social Security and Medicaid. Typically to become eligible you must be age 65 or older with some younger individuals that could qualify if suffering from specific disabilities or ALS or End-Stage Renal Disease.
There are four important parts of the Medicare system. Understanding how these parts work can help you with both time and money when applying. It’s an advantage to seek guidance and advice when selecting the right program that works well for your particular needs.
Let’s go over each of the parts that make up Medicare. Original Medicare Part A&B, Part C, and Part D.
Medicare Part A
Please remember that Part A covers hospital stays and most inpatient services. Coverage includes a Semiprivate room, hospital meals, skilled nursing services, care in special units such as intensive care, drugs, medical supplies and medical equipment used during an inpatient stay, lab tests and x-rays while an inpatient, operating room and recovery, some blood transfusions in the hospital or skilled nursing facility, hospice care for terminally ill to include all medications to manage symptoms and control pain.
Medicare Part B
Part B covers care at a clinic or at the hospital as an outpatient including; doctors visits, wellness visits, ambulatory surgery, ambulance and ER services, skilled nursing services, clinical lab, x-rays, MRI, CT scan, EKGs, smoking cessation programs, obesity counseling, and cardiac rehab, diabetes screening, mental health care, and medical equipment for use at home.
Medicare Part C
Part C is also known as Medicare Advantage Plan. By Federal Law, all Medicare Advantage Plans (Part C) must provide the same coverage as Part A & B but by a Private Insurance Company. In addition, many plans offer: Part D Prescription Drug Coverage, hearing exams or hearing aids, dental exams, cleanings or routine dental care, eye exams, eyeglasses or contact lens, wellness benefits such as gym memberships, could also include transportation and virtual visitations.
Medicare Advantage plan costs can vary by provider but are often premium-free. You must continue to pay your Part B Premium directly to Medicare.
Where you get care can affect your costs. Many Medicare Advantage plans are coordinated care plans and contract with a network of doctors, hospitals, and specialists. You might have to provide a PCP Primary Care Provider. Costs can vary if they are considered in-network or out of network.
Medicare Part D
Part D is also known as a Prescription Drug Plan. According to AARP, there are 6 key facts to consider when choosing a Medicare Drug Plan.
First, anyone who has Medicare Part A or Part B (or both) can get Part D coverage regardless of income or health.
Second, You are not obligated to enroll, but there may be consequences (such as permanent late penalties and delayed coverage) if you don’t sign up when you are first eligible to do so.
Third, to get Medicare drug coverage, you must select one approved private drug plan among many offering different choices. There is no single government plan.
Fourth, Is your income limited? If you qualify for a part of the program known as “Extra Help.” you’ll pay very little for your medications.
Fifth, Are your drug costs very high? You’ll pay no more than 5 percent of the cost of each prescription after you’ve spent a certain amount of money out-of-pocket in any one year.
And Finally, Do you have better drug coverage already? You probably won’t need Medicare’s Part D coverage. But it’s wise to check.
Contact A Medicare Specialist
It is important not to dismiss the assistance and resources provided without at least gathering some information. This can be done by either accessing the website Medicare.gov or calling 1-800-MEDICARE 1-800-633-4227, for more information.