Medicare
Original Medicare
The Original Medicare program is currently made up of 4 Parts. At any given time, you will be using either Part A, Part B, and Part D OR you will be using Part C. Learn more below:
Medicare Part A
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part A usually doesn't cost you anything in terms of a monthly premium as long as you have paid 40 quarters in the Medicare system through you taxes while you were working.
If you do end up needing to use your benefits, there is a large deductible that needs to be met before Part A starts paying benefits. After that deductible is met you will be covered for the first 60 days after before you start to realize copays and coinsurance.
Medicare Part B
Medicare Part B is outpatient medical coverage. Part B helps pay for medically necessary services performed on an outpatient basis that are needed to diagnose and treat a medical condition.
Visits to your Primary Care Physician, specialists, surgeries, lab work, and preventative services are all covered under Part B. There is a monthly premium that you would be responsible for that will be withdrawn directly from your Social Security check if you are drawing Social Security. Otherwise, you would need to pay the premium 3 months at a time from your checking account.
There is a once a year deductible that you would have to meet before Part B pays anything. After the deductible is met there is a 80/20 split where you would be responsible for 20% of the costs of service.
Medicare Part C
Medicare Part C is also called Medicare Advantage (MA or MAPD). It’s an alternative to Original Medicare. Medicare Advantage may include prescription drug coverage, along with other extra benefits. Medicare Part C is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website. These are usually network plans such as HMO's and PPO's with copayments and coinsurance found all throughout the plan based on services rendered. If you have an MA plan, this becomes your Primary Insurance and Original Medicare gets set aside but you will still need to continue paying your Part B premiums.
Medicare Part D
Medicare Part D is your prescription drug coverage. Part D coverage is available as a Stand Alone Option (PDP) or as part of a Medicare Advantage plan (Part C). Part D plans are offered by private insurance companies contracted and approved by Medicare and it is mandatory that you have credible drug coverage when you join Original Medicare or if you choose a Medicare Advantage plan.
To learn more about the options of having Original Medicare with a Supplement and Drug Plan OR choosing a Medicare Advantage plan, please click one of the buttons below.
You can also complete the form on this page to schedule a free consultation!
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