Parts of Medicare
There are 5 distinct parts of Medicare, each with its own function, coverage, cost, and eligibility.
Medicare Part A
Medicare Part A is one half of Original Medicare alongside Pat B. Anyone 65-years old or older, or who has received Social Security disability benefits for at least 24 months, is eligible to enroll. With Part A, you will receive emergency medical care coverage, including:
- Emergency hospital stays and healthcare
- Skilled nursing facility stays and healthcare
Each year, you will receive an allotted 60 days to spend in these facilities. After that, you will be required to pay more out-of-pocket. This number resets every benefit period (year). If you worked at least 10 years paying Medicare taxes, you are eligible for premium-free Part A. You are required to pay a deductible for each benefit period, which is set at $1,484 in 2021.
You may also receive limited benefits for:
- General clinical/nursing care
- Short-term nursing home care
- Home healthcare
Medicare Part B
Medicare Part B provides essential medical benefits for a large variety of needs, specifically anything considered “medically necessary,” including but not limited to:
- Ambulance services
- Durable medical equipment
- Mental health services
- X-rays and lab tests
- Certain outpatient prescriptions
- Provider services
- Screenings and vaccines
The standard Part B monthly premium in 2021 is $148.50, and the annual deductible is currently $203. You will also pay a 20% copayment for most benefits.
Medicare Part C
Medicare Advantage, or Part C, provides you with a network of healthcare professionals at a reduced cost than it would be with Original Medicare alone. The Advantage plan’s network will vary based on the area it is located and the type of plan you purchase. With an Advantage plan, you are covered for your regular healthcare needs, as well as all of the benefits of Original Medicare.
You will be responsible for the plan’s premiums, deductibles, and copayments/coinsurance. These are typically low, however, and are still intended to cost overall less than with Original Medicare.
Many Advantage plans charge little to no premiums and low deductibles. Your out-of-pocket copayments/coinsurance will depend on the service and whether or not its in-network. There are 5 types of Advantage plans to choose from:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Medical Savings Account (MSA)
- Private Fee-For-Service (PFFS)
- Special Needs Plans (SNPs, includes D-SNP, C-SNP, and I-SNP)
Medicare Part D
Medicare Part D provides prescription drug coverage. To be eligible for Part D coverage, you must enroll/be enrolled in Original Medicare. Once you have both Part A and Part B, you may choose if you want Part D as well. It will more than likely also be included in an Advantage plan, if you have one.
Part D covers a huge variety of prescriptions, including:
- Cancer treatment drugs
- Mental health prescriptions, such as antipsychotics and antidepressants
There are 10 different Medicare supplements—plans A, B, C, D, F, G, K, L, M, and N. Depending on your budget and the amount of coverage you’re looking for, you are sure to find a supplement that suits your needs. These plans will vary in coverage, but can cover deductibles, coinsurance, copayments, and more.
Understand Your Medicare with The Coleman Agency—Call Today
This information only gets you started—you need to make sure that you have the Medicare coverage you need to feel safe and secure. If you are interested in learning more about your Medicare coverage, call The Coleman Agency.