Updated: Jun 1
Medicare is a well-known healthcare network. Medicare-enrolled almost 60,000 people in the United States in 2018. This figure is expected to rise year after year. Despite its widespread use, Medicare can be perplexing to many people because each Medicare part has its own set of programs and costs.
Understanding what each aspect of Medicare covers and its costs will help you make the most of your coverage. If you're approaching 65 or decades out, you should be familiar with Medicare components, including what they cover and where they come from.
Continue reading to learn more about Medicare's various components.
Parts A & B: Original Medicare.
Hospital insurance is covered under Part A. It covers inpatient stays in hospitals and other care facilities. It may also help pay for hospice care, home health care, and nursing home care, but only for a limited time and under certain conditions. Beneficiaries are frequently advised that Medicare will only cover a maximum of 100 days of nursing home care.
Part B is medical care. It will help cover physical therapy costs, physician services, reliable medical equipment such as hospital beds, wheelchairs, and other services, including lab testing and health screenings. On the other hand, Part B isn't free. To obtain it, you must pay monthly premiums and an annual deductible.
The premiums are determined by the income level of the Medicare recipient. Plus! There are some cases where seniors are immediately covered by Part B, while others must enrol.
Part C: Medicare Advantage plans.
These Medicare-approved policies are available from insurance geeks providers. To maintain your Part C policy, you must pay both your Part B and Part C premiums on time. It's an understatement to say that no two Part C plans are alike.
Provider networks, premiums, copays, coinsurance, and out-of-pocket spending caps can all differ significantly. That is why it's a good idea to shop around. Seniors may move from Original Medicare to a Medicare Advantage plan or vice versa during Medicare's annual Open Enrollment Period. Any such change is much more prudent if a Medigap strategy is already in effect.
Medigap plan vs. Part C plan
Medigap plans or known as Medicare Supplement plans were created to fill in the holes in Part A and B plan coverage. If you already have Part A and Part B, a Medigap program will cover some of your copayments, coinsurance, and deductibles. Hence, to keep a Medigap policy active, you must pay both Part B and Medigap plan premiums. Also, Prescription drug coverage or Part D is no longer available under these contracts.
Part D: Prescription drug plans
Although most Part C policies provide prescription drug coverage, insurers also offer Part D plans as a standalone option to Original Medicare beneficiaries. To keep Part D coverage, you must continue to pay Part B premiums in addition to drug plan premiums, as required by Medigap and Part C coverage.
Any Part D plan has a formulary, which is a list of medicines that the plan covers. Most Part D plans divide licensed drugs into tiers based on their price. The good news is that Medicare Geek can help you find the best Part D plan for you.