Medicare Part A
Hospital In-Patient Hospital Care, Skilled Nursing Care, and Hospice
Medicare Part A
Hospital In-Patient Hospital Care, Skilled Nursing Care, and Hospice
Medicare Part A does not have a premium if you or your spouse worked and paid taxes for 10 years or 40 quarters. You must be a US citizen or naturalized citizen that has lived in the U.S. for 5 consecutive years.
Part A (hospital insurance) covers hospital stays and inpatient care, including:
- Your hospital room and meals
- special units care; like intensive care
- Drugs and medical supplies used during an inpatient stay
- Lab tests, X-rays and medical equipment as an inpatient
- Operating room and recovery room services
- Skilled nursing services
- Some blood transfusions
- Hospice care, including medications to manage symptoms and pain
- Part-time, skilled care for the homebound after a qualified inpatient stay
- Rehabilitation services after a qualified inpatient stay
Medicare Part B
Medical Insurance
Medicare Part B is medical insurance and helps pay for services from doctors and other health care providers. This includes outpatient care, home health care, durable medical equipment, and some preventive services.
Medicare Part B coverage has a monthly premium for most people. Those drawing Social Security benefits can have this amount deducted from their monthly check.
Medicare Part B coverage includes:
- X-rays, MRIs, CT scans, EKGs and some other diagnostic tests
- Ambulatory surgery center services
- Some health programs, like smoking cessation and obesity counseling
- Ambulance and emergency room services
- Physical therapy, occupational therapy and speech-language pathology services
Medicare Part C
Medicare Advantage & other health plans
Medicare Part C
Medicare Advantage & other health plans
Medicare health plans provide Part A (Hospital Insurance) and Part B (Medical Insurance) benefits to people with Medicare. These plans are generally offered by private companies that contract with Medicare. They include:
Medicare Advantage Plans (Part C)
Medicare Advantage Plan (Part C) A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D).
Medicare Cost Plans
A type of Medicare health plan available in some areas. In a Medicare Cost Plan, if you get services outside of the plan’s network without a referral, your Medicare-covered services will be paid for under Original Medicare (your Cost Plan pays for emergency services or urgently needed services).
Program of All-inclusive Care for the Elderly (PACE)
A special type of health plan that provides all the care and services covered by Medicare and Medicaid as well as additional medically necessary care and services based on your needs as determined by an interdisciplinary team. PACE serves frail older adults who need nursing home services but are capable of living in the community. PACE combines medical, social, and long-term care services and prescription drug coverage.
Medicare Part D
Prescription Drug Insurance
Part D of Medicare is insurance for your prescription drug needs. These plans are offered through private insurance companies and can be purchased as a stand-alone option with Original Medicare or in conjunction with a Medicare Supplement Plan. Many Medicare Advantage plans include prescription drugs. Keep in mind that there can be a Part D premium penalty for late enrollment.
Things to consider when choosing a Part D plan include:
- Costs; what’s the monthly premium?
- Are my drugs covered?
- How much will my medications cost?
- Are there deductibles that will apply?
- Which pharmacy can I use?
- Formulary structure: in general, the lower the tier, the lower your cost for the drug will be.
Medigap
Supplemental Insurance
Medigap
Supplement Insurance
Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:
- Copayments
- Coinsurance
- Deductibles