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The ABCDs of Medicare: What covers what?

Written by by Peter DiGuglielmo. Posted in November

Trying to figure out the different parts of Medicare can be a confusing process. That’s because each part (A, B, C and D) provides a different set of benefits. When you’re ready to enroll, it’s important to understand those differences so you can make the best decisions. Here’s a brief explanation to get you started:

 

Medicare Part A

Provided by the federal government at no cost to most people, Medicare Part A covers care you receive in a hospital or other inpatient or long-term care facility. This includes nursing services, a semi-private room, meals, medications, and other hospital services and supplies. Medicare Part A also covers a stay in a skilled-nursing or rehabilitation facility after a qualifying hospital stay of at least three days. Medically necessary home healthcare and hospice care are also covered. You are eligible to begin receiving benefits when you turn 65.

Medicare Part B

An optional plan also provided by the federal government, Medicare Part B does require a premium. It covers several medically necessary services that are not covered by Part A. These include outpatient care, ambulance services, and durable medical equipment. It also covers preventive care, like flu shots and health screenings, as well as part-time intermittent home health/rehabilitative care if it’s deemed medically necessary by a physician. You can enroll in Part B at the same time you enroll in Part A.

Medicare Part C/Medicare Advantage

If you are eligible for Medicare Part A and Medicare Part B, you can get a combined plan managed by a private insurance company, like Medical Mutual. This is known as Medicare Part C or Medicare Advantage. Offered in contract with the federal government, these plans offer the same benefits you get in Part A and Part B, plus additional benefits, like prescription drug coverage. Medicare Advantage plans may require a monthly premium in addition to the Original Medicare Part B premium. You must also live within the plan’s service area.

Medicare Part D

Medicare Part D is an optional prescription drug plan available to anyone enrolled in Medicare Part A. Some private insurers, like Medical Mutual, offer prescription drug coverage in their Medicare Advantage plans. Premiums and out-of-pocket expenses can vary depending on the plan you choose. Additional costs may include a deductible and copays or coinsurance after you meet your deductible. You must live within the plan’s service area to be eligible for Medicare Part D.

As you can see, there are several options available to you. If you’re interested in a Medicare Advantage plan, there are many insurance companies that can help. With a little more research, you can learn more and be able to choose a plan that best fits your needs.❦