Understanding The Basics of Medicare
Parts A and B offered by the federal government
Part A covers inpatient hospital care. While you are in the hospital, it covers everything that is crucial for your treatment. Like your medications, X-rays, lab tests, operations, and meals. It can also pay for necessary follow-ups to inpatient care like physical therapy or skilled home nurse care. And, it covers hospice services for the terminally ill.
The federal government provides Part A, and most people don’t pay a monthly premium. If you’re admitted to a hospital, there’s a deductible and some further cost sharing that you pay.
Part B covers doctor’s care when you’re sick or have a medical condition. It pays for outpatient hospital and clinic care, lab tests, and some nursing care at home if you’re homebound. Part B generally makes it easier to get preventative care, including things like your annual wellness exam, preventative screenings, and yearly flu shots. It can cover the medical equipment you need for your home. And it can cover you if you have to go to the Emergency Room. It also covers most doctor services while you’re in the hospital.
The federal government provides Part B, and you’ll have to pay a monthly premium. For visits to the doctor, part B has a deductible and some cost sharing that you pay.
These are your options offered by Private Insurance Companies
An All-in-One option you can purchase to replace Part A and B
This is called Part C.
Medicare Advantage combines the coverage of Part A and B – Original Medicare, plus extra benefits. Many plans include prescription drug coverage as well as dental and vision care. Some plans have no copays for most labs or tests. And some even have extra benefits like gym memberships and transportation.
Most plans offer $0 premiums, but you do have to pay your Part B premium. Most plans have copays for treatment. And you’ll continue to pay your Part B premium. Medicare Advantage plans have a yearly limit for out-of-pocket costs you have to pay. Once you reach that amount, you won’t pay more for any of your Medicare costs, your plan will cover it. Different plans have different maximums.
Medicare Advantage plans work all by themselves. They replace Medicare Parts A and B and because of this all-in-one approach, you don’t pair them with Medicare Supplement policies.
These Policies are often purchased separately to supplement Part A and B
This is called Part C.
Part D covers your prescription drugs and is a great addition to pair with Medicare supplement insurance. You probably won’t need it if you get Medicare Advantage since most Medicare Advantage plans include it. Remember what prescriptions are covered depends on which plan you get. But you most likely won’t need it if you choose Medicare Advantage instead. You can also pair it with Medicare supplement insurance for even more coverage. Just remember: which prescriptions are covered depends on which plan you get.
You have to get your Prescription Drug Plan through a private insurer. You’ll pay a monthly premium and a yearly deductible. You’ll also pay a coinsurance (a percentage of the cost for your prescriptions) or a copay (a flat fee for some of your prescriptions’ cost).
This is also called Medigap.
Medicare Supplement (also known as Medigap) covers things that Original Medicare doesn’t, like copays, deductibles, and coinsurance. It does all this with a steady, predictable, monthly bill you can budget for. And it can’t be cancelled. It will be renewed for as long as you pay your premium on time.
You can add a Prescription Drug Plan and a Dental plan to Medicare supplement insurance to get even more coverage.
You have to get Medicare supplement insurance through a private insurer, like Mutual of Omaha. You’ll have to pay a monthly premium and depending on the plan you may also have copays.
