Medicare Part A covers your hospital expenses. This includes hospital stays, skilled nursing care, hospice, and home health-care services. You may have to pay various deductibles, coinsurance, and copayments. You earn Part A by paying taxes toward Medicare while working for 10 years (or 40 quarters). If you did not earn Part A, you will pay a premium.
Medicare Part B covers services that treat illnesses or conditions such as doctor’s office visits, lab work, x-rays, and outpatient surgeries. It also covers preventive services like cancer screenings and flu shots. Part B also covers medically necessary durable medical equipment such as wheelchairs and walkers to treat a disease or condition. Most people pay a premium for Part B. Even if you are enrolled in a Medicare Advantage plan that provides your Part A and Part B benefits, you will still pay your Part B premium.
Original Medicare doesn’t cover prescription drugs. Although Medicare Part D coverage is optional, it can be valuable if you take medications. You will pay a late-enrollment penalty if you don’t sign up for Medicare Part D Coverage when you are first eligible. You can get Medicare Part D prescription drug coverage either through an independent Prescription Drug Plan (PDP), or through a Medicare Advantage Plan that includes prescription drug coverage.
You can protect yourself against Medicare Part A and Part B coverage gaps and expenses by purchasing a Medicare Supplement Insurance Plan (often referred to as Medigap insurance) or a Medicare Advantage Plan (Medicare Part C), which often provides extra services, like vision and fitness coverage, not covered by Original Medicare.
Also called Medicare Part C plans, Medicare Advantage plans are offered by private insurance companies. When you enroll in a Medicare Advantage plan, you must continue paying your Part B premium.
Depending on your area, Medicare Advantage Plans can offer additional benefits not covered by Original Medicare like dental, vision, hearing, and prescription drugs to name just a few.
Your costs will vary by the services you use and the type of plan you purchase. Each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how you get services, like needing a referral to see a specialist or using in network doctors and hospitals.
Remember, plan benefits can change from year to year. Talk to a licensed agent at Tepe Group to review your needs.
Original Medicare, (Part A and B) pays for many health-care services and supplies, but it doesn’t cover everything. Medicare Supplement (or Medigap) plans are sold by private insurance companies, and are designed to help fill the gaps in Original Medicare Part A and Part B coverage.
These Medigap plans help pay some of the hospital and medical costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and yearly deductibles.
Coverage levels and premiums vary, but the benefits of each plan within a lettered category have to remain the same despite the insurance company or location.