WHAT DOES MEDICARE COVER?
THE 4 PARTS OF MEDICARE
Medicare coverage is divided into 4 parts and often times the parts of Medicare are confused with available plan options.
In just a few minutes you can easily understand the 4 different parts of Medicare and what is covered.
MEDICARE PART A
HOSPITAL COVERAGE
Medicare Part A provides your inpatient hospital coverage and is generally free so long as you have worked in the U.S. for 10 years or are married to someone who is at least 62 and has worked for 10 years.
While in a hospital, Part A provides coverage for:
Semi-private rooms
Meals
General Nursing
Drugs required during your inpatient treatment
Skilled Nursing Facility Care
Long Term Care Hospital Services
MEDICARE PART B
MEDICAL COVERAGE
Medicare Part B provides your outpatient Medicare coverage and is not free as many retirees come to learn. Each year Medicare evaluates the cost of Part B and makes changes if needed.
Part B generally covers medical services that happen outside a hospital. However, when a physician provides services inside a hospital, those services may also fall under Part B.
Part B covers things like:
Doctor’s office visits
Ambulance
Preventive services
Lab testing
Durable medical equipment
Some outpatient prescription drugs
MEDICARE PART C
MEDICARE ADVANTAGE
Medicare Part C is a bit confusing at first. Unlike Part A and Part B which cover medical benefits, Part C is actually a different type of Medicare coverage.
Medicare Part C is another way of saying private insurance. In 1997, the Balanced Budget Act of 1997, created Medicare Part C, which allowed private health insurance companies to create health insurance plans called Medicare Advantage Plans.
Medicare Advantage Plans replace Part A and Part B with coverage that is supposed to be at least as good as those parts. Part C plans often have lower premiums and provide additional coverages that Medicare Part A and Part B do not.
Before enrolling in Medicare Part C, you need to learn about Medicare Advantage Plans vs Medicare Supplement Plans. Click here to learn more about your Medicare Options.
MEDICARE PART D
PRESCRIPTION COVERAGE
Medicare Part D is optional Prescription drug coverage where enrollees choose a prescription drug plan from a private insurance company to lower the cost of their prescriptions.
Even if you do not take prescriptions, you will want to choose a Part D prescription drug plan because if you don’t when first eligible you will have enrollment penalties later.
However, if you will have other creditable prescription drug coverage (like through the VA), you may not need to choose a Part D prescription drug plan.
WHAT PARTS OF MEDICARE DO YOU NEED?
At a minimum you will need to have Medicare Part A and Medicare Part B. If you later decide to enroll in a Medicare Advantage Plan or Medicare Supplement Plan, you will need to have these coverages anyway.
If you don’t enroll in Medicare Part A and Part B when first eligible, you may have a lifetime late enrollment penalty (LEP) that will increase your costs.
Even if you don’t take prescription drugs, you will want to choose a Medicare Part D Prescription Drug Plan or have other creditable drug coverage to avoid late enrollment penalties later.