Medicare is a federal health insurance program that pays for various health care expenses. It’s a plan that’s typically available for people who are at least age 65, adults with certain approved medical conditions, and those with qualifying permanent disabilities. Medicare is similar to Social Security, in that it is an entitlement program that most U.S. Citizens earn the right to by working and paying their taxes for a minimum required time period.
Understanding the difference between Medicare Part A, Part B, Part C and Part D
Medicare, unfortunately, can be overwhelming and confusing. The Medicare program consists of four different parts: Parts A and B (referred to original Medicare), Medicare Part C (Medicare Advantage) and Medicare D, which is prescription drug coverage. To help you understand more about Medicare, here is a basic overview of the four parts.
Medicare Part A
Part A is hospital insurance, which covers inpatient stays in the hospital, hospice care, some services provided by a home health care agency, and a specified amount of time in a nursing care facility. The majority of Medicare Part A beneficiaries are not required to pay a monthly premium in order to receive coverage (known as premium-free Part A). Typically, if you have worked a minimum of ten years (equal to 40 quarters) and you paid your Medicare taxes while employed, you are eligible for Medicare Part A. If you do not meet the qualifications, you pay a monthly premium. Part A usually does not cover the full cost of your hospital bill, so you may be responsible for some of the cost.
Medicare Part B
Medicare Part B is medical insurance that covers certain non-hospital medical expenses such as blood tests, supplies, diabetic screenings, doctor’s office visits, and outpatient hospital care. You will be required to pay a monthly premium for Medicare Part B, and the fee can sometimes be higher for those with high incomes. Another government program, known as Medicaid may help cover the Medicare Part B premiums for those with lower incomes. Beneficiaries of Part B Medicare are typically responsible for a portion of their health care costs, and you will have to pay a deductible each year before Part B benefits kick in to help.
Medicare Part C
Medicare Part C is a supplemental policy designed to cover some, or even all of the costs Part A and Part B do not cover. After coverage from Parts A and B are exhausted, there’s typically about 20% left over. Part C covers those remaining costs.
Part C goes by many names, including Supplemental, Medigap, Medicare Advantage, and others. Essentially, Part C includes every type of Medicare coverage in one plan. This type of coverage is offered through private insurance companies that are contracted through the Center of Medicare and Medicaid Services to provide a Medicare benefits package as an alternative to an original Medicare plan. It is optional to enroll in a Part C Medicare plan and in order to obtain this plan, you must have original Medicare Part A and Part B. You may also be required to continue paying a premium for Part B if you have Part C. Some of the Part C plans may have a smaller deductible and allow you to pay a smaller share of the remaining costs.
Medicare Part D
Part D is the optional prescription drug coverage, and it is available as a stand-alone prescription drug plan through a private insurance company. The monthly fee varies among insurers. You are responsible for sharing the costs of your prescription drugs, which vary according to the plan in which you are enrolled. Shared costs may include a deductible, a percentage of the full cost of the drug, and a flat co-payment amount.
Some people who have a limited incomes which prevents them from being able to afford their medications may qualify for a program known as the Extra Help Program. This program will help with your premium, copayment deductible, or the coinsurance, even if you have Medicare Part D.
If you have more questions regarding Medicare coverage, contact Norgard Insurance Group online or call us at (813) 454-5072 and we will be happy to help you choose the best Medicare option for your needs.