Learn about the basics of Medicare Parts A, B, C & D. What do the parts of Medicare cover? When do you need to enroll?
Medicare Part A
Part A is hospital coverage. It covers care you receive while an inpatient in a hospital, skilled nursing facility, home healthcare, hospice or need blood.
Medicare Part B
Part B is Medical coverage. It covers doctor visits, clinic services, preventative, ER and Urgent care and care you receive as an outpatient including durable medical equipment.
Medicare Part C
Part C is Medicare Advantage. These plans combine the coverage of Parts A and B into one plan. They often include prescription drug coverage and extras like Dental, Vision, Hearing, Gym Memberships and more.
Medicare Part D
Part D is prescription drug coverage. Plans cover many medications that are prescribed by your doctor or other qualified health professionals.
In addition to Medicare Part A and B you may choose:
Option 1: Medicare Supplement (Medi-gap) + Part D
Medicare supplement plans are designed to “Supplement” or cover the gaps in the original Medicare program. You may choose a plan to cover the cost of certain deductibles, co-pays and co-insurance cost.
WI, MN and MA are called Standardized States offering a Basic plan plus your choice of additional Riders (additional coverage options) to customize your plan.
The rest of the USA has pre-built plans to choose from labeled with a letter.
**All Plans work the same and follow all federal and state Medicare coverage guidlines**
Option 2: Medicare Advantage
Medicare Advantage plans combine the benefits of Medicare A and B and typically include Part D built in to the plan. These plans have low premiums with a Pay-As-You-Go structure where you pay co-pays for services you need throughout the year.
Medicare Advantage plans are required to provide you coverage at least as good or better then Medicare Part A and B and will cover all services normally covered by A and B. You may also find plans that have additional coverage and services provided that are not normally covered by original Medicare A and B. Such as included Part D, Dental, Vision, Hearing, Free Gym Memberships and much more.
Many people ask how a Medicare Advantage plan can offer all of these benefits at such a low or in some cases no monthly cost. This answer is simple, the federal government/Medicare pays the insurance company of your Medicare Advantage choice a monthly administrative fee to the fund the coverage of benefits and services at least as good as Medicare. This administrative fee can be $700/month or more.
Other Potential Options:
Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage. If you wait to enroll, you may have to pay a penalty, and you may have a gap in coverage.
Use these steps from medicare.gov to gather information so you can make informed decisions about your Medicare.
Annual Enrollment Period (AEP): October 15th-December 7th of each year
During the AEP you have the right to review you Medicare plan options and make changes to your plan.
Here’s a quick rundown of what you can do during the Annual Enrollment Period:
Changes you make during the AEP go into effect January 1 of the next year.
From January 1-March 31 of each year is called the Medicare Advantage Open Enrollment Period (OEP). During this time you have the right to make a one time change to your Medicare Advantage and/or Part D prescription drug plan.
Your new plan will start the first of the follow month that you complete an enrollment application.
You’ve just been diagnosed with a disability and may qualify for Medicare. Now what? The type of disability has everything to do with when your coverage begins, and whether you are automatically enrolled or if you need to take steps to start the enrollment process.
The Affordable Care Act (ACA or “Obamacare”) was signed into law by President Barack Obama in 2010. A major overhaul of the U.S. health-care system, Obamacare aims to reduce the amount of uncompensated care the average U.S. family pays for by requiring everyone to have health insurance or pay a tax penalty.